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Issues and Challenges
 Language is not uniform across all health
institutions across the country
Adopt or develop a standard vocabulary
Identify local terms and associate them with
standard terms
Health care providers should be educated on:
• Benefits of using standard terminology for clinical
decision making support
• Health record documentation
 Health data should be:
• Accurate and valid to the original source
• Complete
• Reliable
• Legible
• Accessible
• Current and timeless
 Assure that EHR can improve quality, accuracy, and
availability of health records
 Develop standard procedures for data input, storage,
and management
 Resistance to computer technology usually
because of lack of computer literacy
 Resistance to system change because of cultural
background
Introduction of a basic computer skills course for
personnel (health care providers, clerical staff,
etc.)
Consider culture of the personnel when
designing the EHR
Gradual introduction of EHR into the institution
 Developers have to understand clinical data
and how health professionals use that data in
decision making
 Lack of perceived benefits for users
Have personnel be involved in the discussion,
development, and implementation of EHR
 International experts hired to develop systems
eventually leave when project is finished
 Available staff but skills and knowledge not
adequate for tasks given
 Lack of trained and educated staff because of
limited teaching programs
Recruit experts to teach appropriate skills
• Medical terminology
• Computer programming
Form developer communities for online discussion
and consultation
 Availability of electricity
 Availability of space for equipment
• Clean, dust-free, temperature regulated area
 Availability of IT infrastructure
• Telecommunications give access to off-site data
Review present environmental conditions
Take into account environmental limitations
when designing EHR
Address limitations before implementation
Design contingency plan during disasters
 Perceived high costs of computers and computer
systems
 Must be self-supporting
• Funding is limited and healthcare costs are increasing
• Philanthropic and research funding are depleted eventually
Identify specific needs of the local healthcare
institution
Compare current systems costs plus perceived costs
against estimated benefits of the proposed system
Plan alternative ways to generate funds
Support from local public and private stakeholders
can help shoulder costs
 Health care providers worry of not being able
to access information at all times
 The community worries of data not being
maintained in a secure environment
• Leaked personal information leads to social stigma
Create data back-up system
Update local laws concerning EHR
Create password security and secure
workstations
Limit and monitor access of system
1) Electronic Health Records: Manual for DevelopingCountries. (2006).
World Health OrganizationWestern Pacific Region. Retrieved from
World Health OrganizationWestern Pacific Region website:
http://www.wpro.who.int/publications/docs/EHRmanual.pdf.
2) S.P. Sood, et al. Electronic Medical Records: A Review Comparing the
Challenges in Developed and DevelopingCountries. (2008). Proceedings
of the 41st Hawaii InternationalConference on System Sciences.
Retrieved from Institute of Electrical and Electronics Engineers
Computer Society website:
https://www.computer.org/csdl/proceedings/hicss/2008/3075/00/307502
48.pdf.
3) W.M.Tierney, et al. Experience Implementing Electronic Health Records
inThree EastAfrican Countries. (2010). Stud HealthTechnol
Inform;160(1):371-375. Retrieved from ReserchGate website:
http://www.researchgate.net/publication/46273445_Experience_implem
enting_electronic_health_records_in_three_East_African_countries.

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Week 8 ehr-issues_and_challenges

  • 2.  Language is not uniform across all health institutions across the country Adopt or develop a standard vocabulary Identify local terms and associate them with standard terms Health care providers should be educated on: • Benefits of using standard terminology for clinical decision making support • Health record documentation
  • 3.  Health data should be: • Accurate and valid to the original source • Complete • Reliable • Legible • Accessible • Current and timeless  Assure that EHR can improve quality, accuracy, and availability of health records  Develop standard procedures for data input, storage, and management
  • 4.  Resistance to computer technology usually because of lack of computer literacy  Resistance to system change because of cultural background Introduction of a basic computer skills course for personnel (health care providers, clerical staff, etc.) Consider culture of the personnel when designing the EHR Gradual introduction of EHR into the institution
  • 5.  Developers have to understand clinical data and how health professionals use that data in decision making  Lack of perceived benefits for users Have personnel be involved in the discussion, development, and implementation of EHR
  • 6.  International experts hired to develop systems eventually leave when project is finished  Available staff but skills and knowledge not adequate for tasks given  Lack of trained and educated staff because of limited teaching programs Recruit experts to teach appropriate skills • Medical terminology • Computer programming Form developer communities for online discussion and consultation
  • 7.  Availability of electricity  Availability of space for equipment • Clean, dust-free, temperature regulated area  Availability of IT infrastructure • Telecommunications give access to off-site data Review present environmental conditions Take into account environmental limitations when designing EHR Address limitations before implementation Design contingency plan during disasters
  • 8.  Perceived high costs of computers and computer systems  Must be self-supporting • Funding is limited and healthcare costs are increasing • Philanthropic and research funding are depleted eventually Identify specific needs of the local healthcare institution Compare current systems costs plus perceived costs against estimated benefits of the proposed system Plan alternative ways to generate funds Support from local public and private stakeholders can help shoulder costs
  • 9.  Health care providers worry of not being able to access information at all times  The community worries of data not being maintained in a secure environment • Leaked personal information leads to social stigma Create data back-up system Update local laws concerning EHR Create password security and secure workstations Limit and monitor access of system
  • 10. 1) Electronic Health Records: Manual for DevelopingCountries. (2006). World Health OrganizationWestern Pacific Region. Retrieved from World Health OrganizationWestern Pacific Region website: http://www.wpro.who.int/publications/docs/EHRmanual.pdf. 2) S.P. Sood, et al. Electronic Medical Records: A Review Comparing the Challenges in Developed and DevelopingCountries. (2008). Proceedings of the 41st Hawaii InternationalConference on System Sciences. Retrieved from Institute of Electrical and Electronics Engineers Computer Society website: https://www.computer.org/csdl/proceedings/hicss/2008/3075/00/307502 48.pdf. 3) W.M.Tierney, et al. Experience Implementing Electronic Health Records inThree EastAfrican Countries. (2010). Stud HealthTechnol Inform;160(1):371-375. Retrieved from ReserchGate website: http://www.researchgate.net/publication/46273445_Experience_implem enting_electronic_health_records_in_three_East_African_countries.