Implementing an electronic health record (EHR) system presents significant cost and security challenges for healthcare organizations. Costs include high upfront expenses for purchasing and installing EHR software and hardware, ongoing maintenance fees, and staff training costs. Security risks involve the potential for data breaches through theft, hacking, or improper access of electronic health information. While EHRs allow for improved accuracy, efficiency and audit trails, the costs are often prohibitive, especially for small practices, and security remains a top concern due to numerous reported data breaches. Careful planning around funding, vendor selection, training, and security protocols is needed to maximize the benefits and minimize the risks of EHR adoption.

1. Cost and Security Challenges When
Implementing An Electronic Health Record
Blue Team: Jamie Jackson

2. Purpose
Purpose:
• Discuss the challenges with cost and security of implementation of
EHR
• Discuss the causes and effects of these challenges
• Discuss possible solutions

3. Problem Statement
• With the unrelenting pressure and demand for implementing EHR,
health care systems in the United States are facing many
challenges with this process.
• Two most critical factors underlying these challenges are cost of
implementation and security during and once implemented

4. Methodology
• Utilizing medical journals and other resources, as well as
interviews with administrators and staff from leading hospitals
and private practices, and health care organizations we were
able to analyze the effects of these challenges as well as come
up with possible solutions.

5. Healthcare
Organizations
Reviewed
• Medical Center of Lewisville
– 202 bed for profit community hospital
• Children’s Medical Center
– 559 bed not for profit pediatric hospital
• Baylor Hospital of Plano
– 112 bed not for profit county hospital
• Dallas Associated Dermatologist
– 50 year old dermatology facility
• Health Information Management Systems Society
– National Health Information Organization

6. Barriers to
Implementing EHR

7. Cost Analysis
• Lack of adequate funding was cited by 729
health care providers as the most significant
barrier to adopting electronic records
• Estimated that purchasing and installing EHR
will cost over $32,000 per physician
• Maintenance about $1,200 per month
• Vendor costs account for 60-80% of these

8. Cost Analysis
When implementing an EHR system there are
several costs to consider:
• Start Up Costs
• Software Maintenance Costs before, during, and
after implementation
• Training costs

9. Cost Analysis

10. Cost Analysis

11. Security Analysis
Michael Matthews, chief executive officer of health-information
technology firm MedVirginia, said security is on everyone's
mind.
"Many in the field will argue that data is actually more secure in
electronic format than paper," Matthews said. "There are audit
trails left every time an electronic health record is accessed,
who accessed it, what results within the record have been
accessed. Whereas with paper records, you have no idea who
has looked at it, who made copies, what has been taken out of
it."

12. Types of Breaches
U.S. Department of Health & Human Services
HHS.gov website gathered a list of breaches of unsecured
protected health information affecting 500 or more
individuals in the U.S.. They posted 108 reported types of
breaches (2009-2010).
-Types of breaches included: theft, improper disposal,
unauthorized access, loss, hacking/IT incident, Incorrect
mailing, other
- Location of breached information: laptop, desktop,
network server, email, portable devices, EHR, other

13. Security Analysis

14. Security Analysis

15. Security Analysis

16. Conclusions
• This project has provided an opportunity to
understand the EHR technology system and the
challenges during implementation as it relates to
cost and security. Understanding the benefits of
the technologies and the problems experienced
by doctors who use the technologies can help
others make a better decision for their practice.

17. Findings
• No true monetary savings due to the purchasing of new technology, software,
hiring and ongoing training
• Trade off: increased efficiency, accuracy and safety
• If any savings it would be among larger institutions, which already draw in
enough revenue for the funding of EHR systems
• Cost outweighed security as the largest concern to the implementation of EHR
• Vendors have taken advantage of the necessity of implementing EHR by
padding their prices
• Most security breaches are from carelessness among staff ,lack of training,
inadequate funding for security

18. Recommendations
• Quality leadership that embraces the goals of the organization
regarding EHR
• Training, training, training
• Factor in additional equipment costs needed in addition to EHR
product
• Do not try to change the organization to meet the needs of the HER
• Review and evaluate the organization as well as several different
products
• Make sure that EHR chosen is interoperable with technology
already being used; i.e. billing systems, EMR
• Look into discounts/perks offered by insurers for EHR use

19. References
• Breaches affecting 500 or more individuals. (2010). Retrieved from
http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/postedbreaches.html
• Ponemon Institute LLC, Initials. (2010, November 9). Dgs health law blog [Web log message].
Retrieved from http://www.dgshealthlaw.com/uploads/file/Ponemon_Benchma
k_Study_on_Patient_Privacy_and_Data_Security%5B1%5D%281%29.pdf

20. Questions/Answers