Challenges and Issues involving Electronic Medical Records #MSHI #HealthInformatics

1. ELECTRONIC
MEDICAL RECORD
• It is an information system that conforms with nationally
recognized interoperability standards.
• It captures the health-related information of an individual
obtained from multiple clinic and hospital visits and
consultations from different health care providers
• These information can be created, managed, and
consulted by authorized health care providers across
more than one health care organization (Hoyt, 2009)

2. ELECTRONIC HEALTH RECORD
• FOUR HISTORIC CONSTRAINTS ON EHR
ADOPTION
1. Lack of standard terminologies and data-entry issues
2. Concerns of privacy, confidentiality, and security of
data
3. Resistance of the Health Care Providers in adapting
to data entry
4. Interoperability of different systems used by different
health care facilities

3. LACK OF STANDARD TERMINOLOGIES
Factors:
1. Different languages and dialects used in different
regions and countries to characterize given signs and
symptoms, chief complaints, diagnoses.
2. Lack of uniformity in identification and data-entry of
health-related information.
3. There are different commercial vocabularies and
medical coding language in the market.
4. Concepts evolve overtime

4. Privacy, Confidentiality, and Security
Factors:
1. Lack or weak implementation of legislative bodies when
it comes to Data Privacy and protection
2. There may be a need for certification of EMR software
for interoperability standards prior use of the healthcare
facilities.
3. Security of the data may be weak if the design of the
information system is not at par with the standards; IS
should be continually tested for quality assurance.
4. Social stigma of having personal information be leaked
or hacked
5. Emphasis on the importance of back-up system

5. Resistance of the Health Care Providers and Staff
Factors:
1. Requires intensive trainings on how to use and facilitate
the data-entry in the system
2. Computer illiteracy among the staff
3. Change in the work flow in the area and loss of
productivity (due to dual system of paper and HER on
the first few months)
4. Lack of proof of benefit
5. There are physicians that are not comfortable on data-
entry during the point of contact with the patient
6. Lack of staff with competitive and adaptive skills

6. Interoperability Concerns
Factors:
1. Lack of standards and certification of the software and
information system written in different programming
language
2. Initially, the IS were developed just for the purpose and
convenience of automation but flexibility, adaptability
and interoperability were not considered.

7. ELECTRONIC HEALTH RECORD
• Others Challenges:
1. Financial Barriers
2. High Cost of Infrastructure and Maintenance
3. Ability to be self-supporting
4. Environmental issues such as lack of supply of electricity
(especially in GIDA), spaces in the facility, etc
5. Lack of manpower
6. Lack of involvement of the clinicians, hospital staff, end-users in
the development of the information system design

8. ELECTRONIC HEALTH RECORD
References:
1. World Health Organization, 2006. Chapter 3. Issues and
Challenges in Electronic Health Records: A Manual for Developing
Countries. Tierney, William M., et al. "Experience implementing
electronic health records in three East African countries." Stud
Health Technol Inform 160.Pt 1 (2010): 371-5.
2. Sood, Sanjay Prakash, et al. "Electronic medical records: a review
comparing the challenges in developed and developing countries."
Hawaii International Conference on System Sciences, Proceedings
of the 41st Annual. IEEE, 2008.
3. Hoyt, R. E., Yoshihashi, A., & Sutton, M. (n.d.). Health informatics:
Practical Guide for the Healthcare Professionals (3rd ed.)
4. Coiera, E., & Coiera, E. (2003). Guide to health informatics (3rd
ed.). CRC Press.

9. Prepared by:
Tricia Joy Gervacio, RN
HI 201 Course
Masters of Health Informatics, Medical Informatics
University of the Philippines, Manila
September 2016