Slides on challenges to electronic health record use in Philippine primary health care settings

1. Electronic Health Record
Issues and Challenges in
Primary Care Settings
Dr. Rose Anne Q. Rosanes
HI 201

2. Primary care
• First point of contact a person has with the health system
that usually refers to family practice
• In the Philippines this is the barangay (village) health centers
Electronic Health Record (EHR)
Patient-centered document that may contain information from
health care providers from multiple sites where health care is
provided (not only physicians)

3. Benefits / Advantages of EHR use
• Allows for health
information exchange
between health providers
within and outside a
health facility
https://www.healthit.gov/sites/default/files/nlc_whathie.docx.

4. Benefits of Health Information Exchange

5. Issues with EHR implementation in
Philippine Primary Care settings
Human
Resource
Cost
Security,
Privacy and
Confidentiality
IT
infrastructure
EHR

6. Issues with EHR implementation in
Philippine Primary Care settings
•Human resource
• Acceptance of user
• Old system works well / Resistance to change
• Tasking of users of EHR within health facility (additional
workload?)
• May use for compliance but not to EHR full potential
• Training for EHR users
• Resistance to computer technology / lack of computer literacy
• Access to IT personnel (Tech support)

7. Issues with EHR implementation in
Philippine Primary Care settings
• IT infrastructure
• Availability of computers / devices (hardware & software)
• Availability of internet access
• Type of EHR to use
• Compatibility with other EHRs

8. Issues with EHR implementation in
Philippine Primary Care settings
• Security, Privacy, Confidentiality
• Concerns when electronically exchanged with other
health providers
• Who else has access to the information
• (Retention of) accuracy of information

9. Issues with EHR implementation in
Philippine Primary Care settings
• Cost
• Hardware, software and peopleware
• Capital outlay for setting up and sustaining system
• Additional salary for additional personnel

10. Meeting the challenges in EHR
Implementation
• Get best practices of other PC facilities
• Bottom-up approach in implementing changes
• While health facility supervisor (physician or
administrator) leads the project, important to engage
other health staff
• Assess readiness of personnel and meet needs
accordingly

11. Readiness scales for Adoption of EHR
• TAM - Davis' Technology Acceptance Model
• UTAUT - Unified Theory of Acceptance and Use of
Technology
• ITPOSMO (Information, Technology, Processes, Objectives,
Staffing and Skills, Management System, and Other
Resources)

12. Recommendations
• The health facility administration needs to plan, advise, and
educate staff, and work with providers and patients to
ensure a smooth transition to EHR implementation.
• Make sure to address the needs and challenges to
implementation before full commitment to the EHR system
• Provide proper training to EHR users and other personnel to
maximize benefits of the system
• Interdisciplinary approach is critical during EHR design,
development and implementation phases

13. References:
• World Health Organization. (2006). Electronic Health Records Manual For Developing
Countries. Retrieved from http://www.wpro.who.int/publications/docs/EHRmanual.pdf
• Ludwick & Doucette (2008) Adopting electronic medical records in primary care: Lessons
learned from health information systems implementation experience in seven countries.
Graphics:
• Health Information Exchange. Retrieved from https://www.healthit.gov/sites/default/files/nlc_whathie.docx.
• HIE benefits retrieved from https://wordpress.com/post/dentphi.wordpress.com/75.