With the advancement in Information Technology, many software have been developed to save and manage useful information. EHR (Electronic Health Record) is the digital system to manage and save the information of a patient's paper chart. It holds the patient's medical history, diagnosis, medication and some other information related to health. It helps patients to get the advice of doctors anywhere from the world for better treatment. But some barriers are limiting the use of EHR between health care centers.
Office of the National Coordinator for Health Information Technology published a report in 2018 which calls the six challenges for instigating EHR.
One of the biggest barriers to EHR interoperability is technical issues. Due to technical issues hospitals are unable to receive or send the data. Sometimes it becomes difficult to send or receive the data if the exchange partner doesn't have EHR. Data quality and data matching is another major technical issue.
It can cost a lot for health system provider to develop an EHR system. The developing, optimizing and maintaining the patient record electronically can be expensive for the organizations who see fewer business incentives in it.
Each patient's data and health record has been taken as an asset for health centers. Most centers take it as leakage of privacy as they consider each individual's data as an advantage due to the competitive environment. Lack of trust between hospitals limiting the use of EHR and exterminates the real purpose of an electronic system.
AS EHR saves every record of the patient including administrative information like billing information and federal requirements. It burdens the EHR system and makes it difficult to move from one place to another electronically.
There are many set standards associated with electronic health record which are not useful in sharing. These requirements only create problems the data transfer. Quality measures report which is not relevant but necessary to add for federal report requirement.
EHR can be difficult for end-users due to its interface which varies organization to organization or system to system. Lack of developer engagement with end-users also create problems and make it difficult to implement. Less IT skills is another barrier to using EHR.
There are also other challenges to EHR implementation. Staff resistance is one of them. Staff finds difficult to accept the changes8 in the working environment. When an organization implements EHR and change its patient data keeping way staff shows a lack of interest and low work efficiency has been noticed in most of the cases. Data migration seems very tiring but it needs to get migrated very accurately because the patient's data is a very sensitive document.
In 2018 Medical Economics asked over 3,000 physicians about their greatest challenges when it comes to operating their EHR systems
These were their answers.
What have been the disadvantages of your EHR system (if any) to your practice's daily operations?
Spending too much time entering data not directly related to patient care/outcomes.
Disrupting practice workflow
Not allowing eye contact with patients during exams
*No Answer: 1%
● Adoptability of EHR remains a struggle for hospitals due to obstacles in the implementation. But there are a few solutions which can make it easy to adopt.
● There should be a good network available in the health center to send and receive the data from patients. Due to non-necessary administrative details which makes data heavy, while good internet speed can make it easier to transfer the data.
● More device accessibility should be easy so doctors can access the data at any place where they want it. The health centers should not expect from the doctors that they will go to the place where a laptop or system will be available with EHR availability.
● It is very difficult to enter the data from the patient's manual charts to an EHR system. So the organization should make it easier for the staff to enter the data. The process can be done slow. The patient's charts need to be prioritized to determine how far back data should be saved in EHR. The data entries should be saved from recent to past orders.
● Health Centers should extra pay their staff to overcome the resistance while implementing an Electronic Health Record system. Because when saving the data and adopting the new system staff needs to give overtime to the organization.
● All staff should be given proper training of IT usability before implementing the EHR system. Staff and EHR users often find difficulties when they have less information on technology uses and implementations.
● Every hospital or health care center has its workflow and system. A specific type of EHR system can't be implemented everywhere. So it is very necessary to work on customizable EHR system. So health care centers should be in contact with vendors of an EHR system.
● One of the biggest barriers in EHR implementation is typing. Physicians find it's very difficult to type while finding the required data and it disturbs their workflow. Nowadays, speech recognition software are very common. By installing such software the use of EHR can be made more beneficial. The other problem with continuous typing is that physicians lost their eye contact with the patients. With the help of third-party speech recognition software, the problem can be solved.
● EHR systems should be able to track referrals, consultations, and all other necessary records so physicians can easily follow the patient progress during treatment.
● Data lock and secrecy should be avoided for full interoperability of EHR system. Data should be open so it can be exported and exchanged to other health centers easily.
● Patients should be engaged with the EHR system easily. It should be easy to use on mobile and their laptops without any hurdle.
● The most important point is that EHR systems should be used which are certified. It should give users an option to automatically collect the feedback to improve the system performance.
This guide can help users minimize the major barriers to EHR interoperability and take the most out of their EHR implementation.