Issues and Challenges in Implementation

1. Electronic Health Records in
Primary Care
ISSUES AND CHALLENGES IN IMPLEMENTATION
Angeline-Therese M. Santiago MD
MSHI 201

2. ELECTRONIC HEALTH RECORD (EHR):
digitally stored healthcare information
throughout a patient’s lifetime
Primary Care: first point of contact a
person has with the health system
Ludwick DA, et al. Int J. of Med Informatics. 78 (2009)
Electronic Health Records Manual for Developing Countries. WHO 2006

3. Benefits of EHR Implementation
EHR
Improve
accuracy &
quality of data
Healthcare
practitioner’s
access to
information
Improve
Quality of Care
Increase
Efficiency of
Health Record
Services
Contain
healthcare
costs
Electronic Health Records Manual for Developing Countries. WHO 2006

4. Main Issues and Challenges in EHR Implementation
GOVERNANCE
INFRASTRUCTURE
USERS ATTITUDES &
SKILLS
QUALITY & SAFETY OF
DATA
MANPOWER,
TECHNICAL SUPPORT

5. • Clear laws and policies
• Standardization
• Incentives for Use
• Monitoring & Support
• Training
• Funding
• CAPACITY BUILDING

6. INFRASTRUCTURE
• Physical Space for the
computer/EHR system
• Electricity
• Internet Connectivity

7. Users Attitudes and Skills
• Strong resistance to change
• Resistance to computer technology
• Poor computer literacy/aversion to
technology
• Perceived disruption of flow of
physician-patient communication
• Perceived additional work burden

8. Manpower and Technical Support
• Lack of staff with adequate
technical skill
• Technical support important
especially during the
transition/initial
implementation stages

9. Data Quality and Safety
• Completeness & accuracy
• Validity & reliability
• Accessibility & retrievability
• Privacy, safety, confidentiality
• Follow standards

10. References
1. Ludwick, D. A. & Doucette, J. Adopting electronic medical records in primary
care: Lessons learned from health information systems implementation
experience in seven countries. Int. J. Med. Inform. 78, 22–31 (2009).
2.Ajami, S. & ArabChadegani, R. Barriers to implement Electronic Health Records
(EHRs). Mater. Socio Medica 25, 213 (2013).
3.Chapter 3. Issues and Challenges in Electronic Health Records: A Manual for
Developing Countries. World Health Organization, 2006.
http://www.wpro.who.int/publications/docs/EHRmanual.pdf