Electronic Health Records

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Top 10 EHR Adoption Challenges

While meaningful use presents its own series of challenges, many more obstacles stand between providers and the adoption of EHR systems.

By Kyle Murphy, PhD

- Last month, in advance of its meeting this month, the Office of the National Coordinator’s Health Information Technology Policy Committee (HITPC) provided insight into what ails the adoption of electronic health records (EHRs) across the country. The group identified six factors impacting provider participation in federal and state initiatives regarding meaningful use:

• Knowledge of meaningful use
• Technical resources
• Vendor support
• Information for specialists
• Return-on-investment (ROI)
• Availability of state programs

Because its chief focus is the involvement of eligible professionals (EPs) and hospitals in the Centers for Medicare & Medicaid Services (CMS) EHR Incentive Programs, the HITPC only accounts for a limited range of factors. With less than two months remaining before EPs must begin their reporting period to receive maximum incentives under the Medicare portion of the EHR program, little time remains to mitigate the effect of these factors.

Read Also: EHR Adoption Gaps Remain Key Barriers in Annual ONC Report

While meaningful use presents its own series of challenges, many more obstacles stand between providers and the adoption of EHR systems. Reviewing our interviews with physicians and CIOs, we’ve compiled a list of the top EHR adoption hurdles:

1. Cost: Few providers have enough cash on hand to make an upfront capital investment in an EHR system. Coupled with that is the inability to calculate the total cost of the solution when infrastructure, training, and support are taken into account. For an EHR system to stick, it needs the right amount of resources behind it. Without them, a return on investment (ROI) won’t be reached.

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2. Time: Many providers, especially those working in small practices, report that they fear losing business as a result of putting the right amount of time into deploying an EHR system. And for many of them these fears aren’t unfounded. Considering the revenue these providers generate from their patient encounters, a dip in patient visits to prove detrimental to their bottom line.

3. Preparation: In order for a hospital or small practice to make a well-informed decision, all stakeholders must collaborate and reach a consensus. Without a shared vision and widespread support, the successful implementation and sustainability of the right system could be doomed from the outset. A great amount of planning on the front end will ensure that fewer surprises appear on the back end.

Read Also: EHR adoption v. implementation: Consultant Q&A

4. Rollout strategy: Two approaches dominate the conversation about how an EHR system should go live. On the one hand, there’s the big bang theory wherein everything launches at once; on the other hand, there’s the incremental approach in which portions of the system become available one at a time. The former requires significant resources and a dedicated support staff that can respond to the needs of providers in real-time; the latter affords providers a gentle learning curve to grow with the capabilities of the system. Choosing the wrong strategy could lead to waning support of the EHR experience.

5. Availability of vendors: The great rush to adopt an EHR system before incentives expire has stretched the resources of vendors. With green and overworked personnel struggling to keep pace with market demands, providers aren’t getting the support they expect from the sizeable investments they must make. While many CIOs and small practices have turned to EHR consultants and regional extension centers (RECs), respectively, to fill these gaps, plenty more have not. Putting too much onus on the vendor could easily jeopardize the best of intentions.

6. Training: One area that’s most likely to get the short end of the stick investment-wise is training. Enough firsthand experience and research have shown that personnel who receive adequate training on an EHR system show better progress and higher user satisfaction than those who don’t. While sufficient training is understated, its effect on the sustainability of an EHR can’t be emphasized enough.

7. Communication: Adopting an EHR system is much more than an IT task. To deploy a fully-functional system, providers and IT personnel need to communicate openly and efficiently. It’s a two-way street of knowledge sharing. IT staff want their providers to have the tools necessary to do treat their patients. Providers need their feedback to be incorporated into fixes and enhancements in the EHR system.

8. Interoperability: If the EHR is a complement to other health IT systems in a practice or hospital, the ability of a new system to communicate with existing systems is a crapshoot. Developments in EHR standards are being bandied about by decision-makers and health IT innovators; however, many providers still report difficulties in getting different aspects of the practice (e.g., administration, finance) to speak the same digital language.

9. Culture: Some providers have worked so long in a paper world that the transition to a digital format proves daunting. Workflows must change. Technology skills must improve. Using an EHR software means that doctors, nurses, and others adapt their tasks to electronic recordkeeping. Simply reproducing paper-based system doesn’t take advantage of what a digital system can do.

10. Data migration: Moving to an EHR from either a paper-based or other digital system could lead to data loss. While data entry and document scanning are time-consuming tasks, they can costs less time if only necessary data is moved. The purpose of transitioning to an electronic system is not to archive all paper documentation; it’s to move information that’s critical to the patient’s treatment going forward. Exporting digital information is its own beast if the former system obeys no common standards. This could prove a logistical nightmare.

Top 10 meaningful use challenges
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