Week 8 ehr-issues_and_challenges
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There are several issues and challenges to implementing electronic health records (EHR) across different health institutions in a country. These include a lack of standard clinical terminology, health data that is not always accurate or accessible, resistance to new technology due to lack of computer skills, and high perceived costs. It is important to develop standard procedures, educate healthcare providers, address environmental limitations, and involve local stakeholders to help address these challenges during EHR implementation.
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- 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.