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At present, we are witnessing an interesting situation: on the one hand, patients are eager to see their health records compounded in one place, digitized and made accessible 24/7. Physicians also approve of moving towards more open and patient-centric health records system.
On the other hand, the rates of EHR adoption are still lower than expected.
EHR implementation, however promising it is, presents multiple challenges that are sometimes hard to identify and handle. Drops in revenue and productivity, typical for the initial phase of new technology implementation, are added to clinical staff scepticism and patient dissatisfaction, leading to a lower quality of care.
Health practices need to acknowledge them to be able to take adequate measures.
EHR: Types of Challenges
Challenges related to EHR implementation occur in a number of areas, including lack of training and consequent absence of buy-in among clinical staff, problems with data sharing, and slow paced patient adoption.
These problems are often left unaddressed, leading to lower EHR solution implementation and efficient use rates.
Does it mean that the healthcare industry of today can’t overcome them?
Of course, no.
Any new technology implementation demands preliminary training of the personnel in order to minimize risks of lost productivity and overall dissatisfaction with the novelty.
However, proper training often stays disregarded and is left without proper investment. And that’s a big mistake, as implementation and post-implementation training of the staff is an essential part of the overall technology strategy of any medical institution interested in EHR.
So how to train them to make the EHR implementation more efficient and less time-consuming?
- Assessing the level of computer literacy. Many great initiatives fail because of the inability of their final users to employ them. If computer skills of the clinical staff are not refined enough, it may be useful to provide additional training for advancing the computer literacy level, before organizing trainings on a new EHR usage.
- Organizing focused training. It is another common mistake: trying to train the entire staff on all the aspects of the EHR use. Every department needs a particular scope of the EHR functionality, and making them study the technology thoroughly will end in time and financial losses which won’t pay off. Concentrate on specific trainings, tailored to the needs of each particular department.
- Keep going. Training is an ongoing process, not limited solely to the initial implementation phase. If your aim is to keep the staff constantly updated on the EHR functionality, you’d better plan for a continuous training process instead of one, two or even ten training sessions.
- Working on a high-quality curriculum. Researchers at Kaiser Permanente, Mid-Atlantic States (KPMAS) conducted a study of EHR training programs. The training course content included the following sections, consisting of short lecturers and hands-on activities:
(a) Common support questions.
(b) Operational efficiency training content from health care community.
(c) Recently added EHR enhancements.
(d) Survey data from expert users.
Here is a good example to follow: in 2017, Vanderbilt University Medical Center started converting from paper charts to a new EHR system. To make the transition process pass smoothly, the center invested heavily into a user-centered training plan – and managed to reduce the losses associated with the implementation of the new technology.
Here are the key activities undertaken by them:
- Employing 1,000 members in charge of preparing and organizing the training process for the clinical staff during the implementation phase and after the go-live period.
- Providing familiarization sessions along with formal EHR training sessions, to make the staff more computer literate, and the transition process – smoother.
- Offering interactive events called “space stations” to familiarize the staff with the new system in a more engaging way.
- Focusing on department-level targeted training for better outcomes.
A buy-in issue regarding the adoption of EHR is a remarkable one, and some stats from the Future of Healthcare Survey prove it:
- 54 percent of physicians believe EHRs have had a negative impact on the physician-patient relationship.
- 61 percent of physicians believe EHRs are having a negative impact on their workflow, with many suggesting that EHR requirements are a major cause of burnout.
According to a research published in the “Health Affairs” journal, “[…] It is critically important to reach close to nationwide adoption of these systems to gain the network benefits of EHR adoption. However, with the ‘early majority’ having adopted, the remaining hospitals may be those with the biggest challenges and, therefore, least likely to join in. This potential leveling off of adoption, if real, would hinder the goals of a true nationwide health information infrastructure.”
Given such a negative attitude toward EHR use from medical specialists, the challenge of a clinical staff buy-in becomes evident.
In this case, it gets essential for a healthcare organization, turning to an electronic health record system, to make the case to its staff what real-life benefits a new EHR system can bring to them and that it is a tool that helps deliver better care results when used properly, and not just a regulatory mechanism.
EHR Interoperability Challenges
Another major pitfall for healthcare organizations interested in the EHR implementation, is sharing of clinical data within an organization and with outside providers.
So far this issue causes a lot of trouble in clinical practice.
32% of patients state that they have experienced a gap in their health data exchange, be it a necessity to redo a test or procedure because the previous results were not available, to wait longer than looked reasonable, or bring prior test results to an appointment.
The most evident solution to the problem – establishing universal industry standards for healthcare data exchange – hasn’t proven to be an attainable solution. Disparate vendors use different clinical standards, which means that data has to be manipulated and sanitized before it can be imported into another system.
As a result, we see additional barriers to improved patient experiences and better healthcare outcomes.
One of the ways to reduce the risks of the chosen EHR solution inability to function in line with other system’s elements is getting in touch with an experienced IoT healthcare company, who will choose the right tech stack and enable a seamless data exchange between the newly implemented EHR and other healthcare systems.
EHR & Patient Adoption
Not only clinicians need to adopt and actively use an EHR on their side. Patients should also display readiness to get engaged with the new technology, otherwise its implementation will come to naught.
Compared with physicians, patients have a more positive vision of EHR systems. A survey conducted by Medscape, states that four out of every five patients believe that EHRs make the work of the clinical staff more efficient.
However, the same respondents state that EHR features, aimed at improving patient engagement, such as patient portals, still pose a problem for patients, who seem reluctant to get use of them.
Only 19% of patients regularly use patient portals, though more than half of them (56%) have this option.
Like with the adoption of any technology, patient adoption of EHR depends on making certain users able to see that the technology is useful and can be understood and used with little difficulty.