Many electronic health record (EHR) challenges for public health professionals begin early—during implementation and training—and can continue throughout the system’s life. A strong EHR is essential for local public health agencies. It serves as the central hub for patient management, data analysis, and reporting, offering clear benefits when it works well. However, the transition from paper to digital systems hasn’t been smooth. A study published in the National Library of Medicine found that healthcare workers often face increased administrative burdens and workflow disruptions. These issues lead to clinician frustration, patient care errors, reduced patient interaction, and a rise in “technostress”—stress caused by using complex digital tools (Provenzano et al., 2024). Based on feedback from public health agencies, the most common EHR pain points fall into six key challenges. In response, we offer practical solutions to help agencies overcome these obstacles and use EHRs more effectively to serve their communities. Challenge #1: EHR Onboarding Process is Too Long and Too Hard The Problem: The setup process for a new EHR can feel like an endless and daunting project. Timelines stretch far beyond what was promised, and the complexity of the system can make it feel overwhelming before it’s even operational. The burden of setup often falls squarely on the agency, requiring a significant investment of time and resources that are already stretched thin. The Solution: Look for a vendor that takes on the heavy lifting of the setup process. An effective onboarding plan should be streamlined, not “one-size-fits-all.” The vendor’s team should work closely with you to understand your agency’s business model and priorities from day one. Specifically, they should take the lead in customizing and setting up the system for your initial priority programs, ensuring a smooth and rapid launch. Customer feedback can be a good indicator of a vendor’s commitment to this approach. Wells County, North Dakota moved from another vendor to Nightingale Notes by Champ Software and found the EHR onboarding process to be effective and efficient. Challenge #2: Poorly Executive EHR System Training The Problem: Many agencies receive generic, lecture-style training that ignores their specific workflows and programs. As noted in Bridging Theory and Practice: Software Training Best Practices Grounded in Adult Learning Theory: “Experiential learning is a cornerstone of effective adult education… Simulations allow for the application of theoretical knowledge in a practical setting, reinforcing understanding and increasing retention.” Without a trainer who understands your daily