Electronic Health Records

Adoption & Implementation News

Is Meaningful Use Responsible for Limited EHR Usability?

By Kyle Murphy, PhD

- As its name clearly indicates, meaningful use places emphasis on the adoption of certified EHR technology and more specifically describes the quality EHR use must take, but meaningful use has missed the mark in defining EHR usability from the end-user’s perspective according to Nancy Fabozzi of Frost & Sullivan.

“The industry has been focused on problems with interoperability and data entry, which are both significant problems for clinicians,” she maintains. “If we are going to get the right information to the right provider at the right time, you’ve got to be able to find the data and quickly because clinician end-users are just not going to sit there for a long period of time hunting and checking for information. At some point in time, they are going to give up.”

The Frost & Sullivan Principal Analyst of Connected Health bases her claims on findings from a report she recently authored which found that imprecise data and limited searchability were major pain points for healthcare CIOs.

It is a particularly sad state of affairs considering that the oft-trumpeted potential of EHRs to improve on the constraints of paper records, which were actually quite easy to use. “A well-organized, up-to-date paper chart is actually a very user-friendly vehicle,” adds Fabozzi.

As a result of the EHR Incentive Programs and the temptation of EHR incentive payments for EHR adoption, many healthcare organizations and providers rushed to implement technology that can prove an obstacle for efficient clinical workflows.

“We have first-generation EHRs that aren’t very useable, but everyone had to buy them because of meaningful use,” Fabozzi explains. “Now they are stuck with these things that don’t work, so in the next five years they are going to layer in all this other stuff. They are going to get sick of those, their contracts are going to expire, and then there will be a whole new generation of tools that will be a lot better.”

According to the health IT expert, inadequate EHR usability will likely result in the creation of bolt-on environment wherein healthcare CIOs will have one of two options to choose from in order to improve the EHR end-user experience:

EHRs are a mature market and it’s very hard to rip and replace. We’re going to be in a bolt-on environment and that’s the only way this is going to be addressed. CIOs will have to go in either through an open API and finagle with the ways these things or they will have to buy a solution that will address some of these problems. That’s where the market is going.

A consequence of these developments is delayed progress toward achieving effective population health management and the aims of accountable, as Fabozzi revealed in a previous story. Further delaying this progress is the need to gather, parse, and then push actionable patient health data to the point of care.

“Data aggregators and warehouses are a becoming an important element,” Fabozzi continues. “But what you have to look at next once you have aggregated and integrated the data is how it is brought forth. We have to be bold when thinking about what these tools are and how clinicians interact with them.”

A key development to keep an eye on, says Fabozzi, is the visualization of data for the clinical end-user.

“That to me is where somebody is going to blow it out of the water,” she insists. “A light bulb is going to go off and someone will say, ‘This is what an electronic health record has to look like for a clinician to be able to use it,’ and it’s not going to look anything like what we see today.”

Without improvements to EHR usability, the long-term goals of scalable value-based care via EHR use will elude healthcare. With Stage 3 Meaningful Use requirements still undetermined, there is opportunity for the EHR Incentive Programs to help drive EHR usability forward but the onus is likely on healthcare CIOs and EHR end-users to demand more from their EHR vendors to achieve the levels of EHR usability they desire.

Want more about EHR usability? Read why comprehensive EHR adoption is the key to population health management and accountable care here.

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