An online survey of hospital chief information officers reveals that despite progress in electronic health records adoption providers continue to experience problems with EHR usability and reliable information retrieval at the point-of-care.

In the survey, conducted by research firm Frost & Sullivan in conjunction with the College of Health Information Management Executives, CIOs identified key “pain points” in the use of EHRs including time-consuming data entry tasks and significant difficulties in finding and reviewing data. Both pain points can result in significant productivity losses for clinicians as well as potential risks to patient safety. In addition, healthcare IT executives also cited the inability to create targeted queries or easily access unstructured data such as clinician notes as a major pitfall.

The survey looked at several issues pertaining to how EHR technology impacts clinician end-users, particularly information retrieval. What Frost & Sullivan discovered is that EHRs are too slow and lack precision in information retrieval; users can’t do targeted queries or easily get at unstructured data. According to the firm, the rudimentary search functionality and poor usability of many EHRs are more important causes of search problems than lack of end-user training or clinician dislike of technology.

“U.S. regulatory authorities will take notice of the growing chorus of complaints about EHR usability, resulting in a push to devote more resources to solving this issue,” predicts Frost & Sullivan’s Connected Health Principal Analyst Nancy Fabozzi. “Further, the high levels of end-user frustration with usability present strong business opportunities for pioneering technology vendors.”

Fabozzi told Health Data Management that 60 CIOs were surveyed from hospitals across the United States, with about half from stand-alone hospitals and the other half from multi-hospital systems. “This sample size represents hundreds of clinician end-users," she asserts.

Natural language processing (NLP) and visualization dashboards are helpful technologies for enhancing EHR usability, Fabozzi argues. In particular, she says NLP can produce readable summaries of unstructured text, helping clinicians retrieve information needed for point-of-care decision making.

“Data visualization dashboards will enable end-users to quickly understand data trends, significantly enhancing ease-of-use by streamlining and organizing vast amounts of data,” adds Fabozzi. “The ability to triangulate EHR data with data from other sources is also crucial to ensure access to the right medical information for healthcare providers.”

Last month, the American Medical Association announced a new framework for improving EHR usability designed to benefit both caregivers and patients. AMA’s framework outlines eight EHR usability priorities: enhance physicians' ability to provide high-quality patient care; support team-based care; promote care coordination; offer product modularity and configurability; reduce cognitive workload; promote data liquidity; facilitate digital and mobile patient engagement; and expedite user input into product design and post-implementation feedback.

AMA argues that despite numerous usability issues physicians are mandated to use certified EHR technology to participate in the Medicare and Medicaid incentive programs. “Unfortunately, the very incentives intended to drive widespread EHR adoption have exacerbated and, in some instances, directly caused usability issues,” according to the association.

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