Worries over the usability of electronic health records have escalated recently -- in tandem, it seems, with their broad adoption. Now comes research from Frost & Sullivan that confirms this, and suggests that EHR usability challenges are likely to get worse before they get better.

Top problem: Information retrieval. It's nearly impossible for physicians to get the right information at the right time from their EHRs. They need it at the point of care. When it's not there, it's not merely frustrating. It puts patients at risk.

In Frost & Sullivan's analysis, "EHR Usability – CIOs Weigh in On What’s Needed to Improve Information Retrieval," Principal Analyst Nancy Fabozzi posits that as EHR data expand, the retrieval problem will get worse.

The CIOs she queried highlighted these pain points:

• Slow and inaccurate information retrieval from EHRs as well as difficulty in finding and reviewing data, both of which result in productivity losses for clinician end-users as well as potential risks to patient safety.
• Inability to create targeted queries or easily access unstructured data such as clinician notes.
• Time-consuming data entry tasks.

[See also: EMR usability seen lacking.]

Fabozzi conducted her research in conjunction with CHIME. Sixty CIOs and CTOs responded to an online survey. Most respondents were associated with a stand-alone mid-sized community hospital.

"I would say this is sort of representative of kind of the average hospital in America," Fabozzi told Healthcare IT News.

Why query CIOs rather than the end users?

"We wanted to get the CIO vantage point because when we have focus group and go to meetings and talk to CIOs, we're consistently hearing that they are concerned about search functionality," she said. "When we talk to physician end users, they'll certainly complain about that. We wanted to understand what the locus of the problem is.

"Was it the physician or the nurses or the technology itself? We believe really the problem is that these tools are not maximized for the type of information retrieval you need to plan care. It's a lack of technology. It's not the training, not the physicians."

[See also: Object of beauty, or ungainly nuisance? and Object of beauty, or ungainly nuisance?]

Help is on the way

The response to EHR usability issues may have been lacking to date, but it is coming, Fabozzi asserted.

"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," she said.

Will the functionality issues be fixed on existing platforms, or will there be a turnover of EHR technology? In Fabozzi's view, it will be both.

As she sees it, the high levels of end-user frustration with usability present strong business opportunities for technology vendors.

"New vendors are emerging to address these challenges," she said. "Innovation will most likely come from companies with deep expertise in advanced enterprise search technology."

Natural language processing and visualization dashboards are the technologies most suitable to improve EHR usability, in her view. Natural language processing 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," added 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."