Performing Comprehensive Root Cause Analysis for EHR Speed & Reliability

Operationalizing KLAS EHR Speed and Reliability Recommendations

By Ryan Oliver, SVP of Healthcare Solutions at Goliath Technologies

This is the second installment in our three-part series on Operationalizing KLAS EHR Speed & Reliability Recommendations. In the article, we explored Phase 1: Proactive Monitoring – detailing how health systems are using Goliath Technologies to move beyond anecdotal reports and gain objective, real-time data about clinician EHR experience. We highlighted how Goliath helps IT teams detect hidden issues such as logon delays and system slowness, even before clinicians submit support tickets.

Now, in Phase 2, we focus on the next critical step recommended by KLAS: performing a comprehensive root cause analysis (RCA). While proactive monitoring tells you that something is wrong, RCA helps you understand why, so you can fix the issue at its source and prevent it from recurring.

Traditional RCA efforts can be manual, slow, and incomplete. Goliath changes that by automating the process with embedded intelligence, delivering precise insights into performance disruptions across the entire IT stack. In this article, we’ll walk through three best practices to fully operationalize RCA using Goliath.

Some of the most frustrating EHR problems are intermittent, easy to fix – but hard to detect. Goliath’s pattern recognition dashboards surface trends in ticket volumes, time of day, user groups, and system interactions. These insights enable IT to stop chasing symptoms and instead eliminate systemic disruptions at their source. 

Aging or underperforming hardware can silently degrade clinician experience over time. Goliath correlates device-level performance with user experience to identify hardware issues before they disrupt care. This empowers IT teams to remain compliant with EHR vendor requirements and proactively replace equipment – preventing costly downtime and clinician frustration. 

Automating RCA to Drive Faster, Lasting Improvements

Comprehensive root cause analysis is a necessity for healthcare organizations striving to deliver fast, reliable EHR performance.  Goliath automates this process by providing a common set of facts that shows the number of clinicians being impacted, the duration of issues, and the root cause.

An example of this was published in a recent article, by Thomas Charlton, where a top 5 largest non-profit health system was facing widespread Epic Hyperdrive speed and reliability issues, with clinicians experiencing slow Citrix logon times that impacted over 37,000 users across 60 locations. The IT team struggled to pinpoint the root cause due to the use of generic unassigned accounts and intermittent issues spanning multiple health systems. Traditional support tickets did not reveal the full extent or source of the problem, delaying effective remediation.

By leveraging Goliath’s AI-enhanced contextual data and automated root cause analysis, the team identified that long Citrix “profile load” times caused the slow logons. The root cause was traced to a legacy, incorrect home folder path in Active Directory, forcing timeouts during login. After removing this obsolete path, logon times dropped by more than 50%. Furthermore, Goliath’s continuous monitoring enabled proactive alerts for future performance issues, helping the health system maintain fast, reliable Epic Hyperdrive access for all users.

By operationalizing RCA with Goliath, health systems can move from reactive firefighting to proactive performance assurance – ultimately improving clinician satisfaction, reducing support burden, and protecting patient care.

If you are having end user experience issues with your clinical or business applications reach out and let’s discuss. We find and fix very specific issues and in a discovery conversation we will let you know if we can assist. If the issues you are experiencing are outside our purview, we will share that as well.

If you want to learn more, check out our EHR Speed & Reliability Improvement Program.