There are several key issues and challenges in implementing electronic health records in primary care according to the document. These include clinical data entry issues due to unreliable data sources and lack of standard terminology. There is also resistance to computer technology among some medical professionals who prefer paper records or find electronic systems difficult to use. Additionally, high costs of computer systems and lack of funding present obstacles. Privacy, security, and accuracy of patient information stored electronically are additional concerns that must be addressed. Personnel shortages with the necessary IT skills to utilize electronic systems effectively also pose a challenge.

1. What are the issues and challenges
in implementing electronic health
records in primary care?

2. Clinical Data Entry Issues
 Reliability of Data source
 Lack of standard terminology

3. Resistance to Computer Technology and
Lack of Computer
Literacy
 prefer to write by hand, finding it difficult or
uncomfortable using electronic media.
 Lack of computer literacy in medical, nursing and other
health personnel.
 Difficult or non-user friendly interface.

4. High Cost of Computers and Computer
Systems and Funding Issues
 Perceived high costs of computers and computer systems
and lack of funds for healthcare.
 Different funds = different EHR system

5. Concerns raised by providers, patients and
the general community about the privacy,
confidentiality and quality of information
generated
 Everyone involved, including the patient, healthcare
professional and the general population, needs reassurance
that all data generated is maintained in a secure environment.
 Local laws to cover electronic health records which address
such concerns must be up-to-date and in place.

6. Quality of electronic healthcare
information and accuracy of data entries
 Accuracy and validity of theoriginal sourcedata; Electronic Health
records
 Reliability – data is consistent and information generated is understandable
 Completeness – all required data is present
 Legibility – data is readable;
 Currency and timeliness – data is recorded at thepoint of care; and
 Accessibility – data is available to authorized persons when and where
needed.

7. Manpower issues – lack of staff with
adequate skills
 Lack of staff with adequate knowledge of disease classification
system.
 Availability of a well-trained workforce
 Coding training programs isextremely limited.

8. Environmental issues
 Available and reliable supply of electricity
within the healthcare facility.
 Amount and quality of available space needed for
computers and other equipment.

9. Involvement of clinicians and hospital
administrators
 Willingness byhealthcare providers to collaborate and share data
with other providers.
 Patients willingness to collaborate with health care provide and to
provide his/her own health data

10. Safeguards which may also need to be
addressed
 Data back-up as in any computer system, there must be an efficient back-up system
available.
 Contingency plans for disaster recovery also need to be in place in the case of an
electrical breakdown or other emergency
 Securing workstations and requirement of passwords for all users. The passwords should be
changed regularly to maintain security
 Access control to ensure health records are available when needed for patient care and
other official purposes but may not be accessed by unauthorized persons
 Audit controls where access may be monitored to ensure only authorized persons usethe
system and to identify when changes are made in the record