2. Issue and Challenges in Implementing Electronic
Health Records
ISSUE:
1. Clinical data entry issues and lack
of standard terminology
Challenges
1. To Identify broad statements ex.
“patient has red spots”. We must
be able to identify or specify this.
2. Develop a data dictionary to
promote uniformity in
documentation, data processing
and maintenance.
3. Educate providers on:
Benefit of using standard
terminology for clinical decision
making.
Educate and train user in preparing
them for the implementation
3. Issue and Challenges in Implementing Electronic
Health Records
ISSUE:
2. Resistance to Computer Technology and
Lack of Computer Literacy
ISSUE:
3. Strong Resistance to Change by Many
Healthcare Providers
Challenges
1. Educate user in the benefits of using
Computer technology
2. Training on how to use the computer
and other devices.
3. User Acceptance training
Challenges
1. Intensive training of Healthcare
practitioners to help them become
more comfortable and acceptance of
new technology
2. Develop a strategy:
Involving them in discussion on the
development and implementation.
Training for the new technology.
4. Issue and Challenges in Implementing Electronic
Health Records
ISSUE:
4. High Cost of Computers and
Computer Systems and Funding
Issues
Challenges:
1. Identifying specific requirements and
clinical practice guidelines.
2. Compare current system cost plus
percieved cost against the propsed
benefit to determine long-term value.
5. ISSUE:
5. Concern by providers as to whether the
information they generate will be
available on request
Issue and Challenges in Implementing Electronic
Health Records
Challenges
1. Assurance that while the information
will not only be readily available at all
times, they will be be able to access it
more efficiently.
2. Inform that there are other source of
information ex: pathology, radiology,
pharmacy.
ISSUE:
6. Concerns raised by providers, patients
and the general community about the
privacy, confidentiality and quality of
informationgenerated .
Challenges
1. Assurance that all data generated is
maintained in a secure environment.
2. Local laws to cover EHR which address such
concern must be up-to-date and in place.
3. Durability of the electronic medica must also
be tested and documented.
6. ISSUE:
7. Quality of electronic healthcare
information and accuracy of data
entries.
Challenges:
1. Ensure that characteristics of data quality
should include:
Accuracy and validity of the original source
data;
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 the point of care; and
Accessibility – data is available to authorized
persons when and where needed.
Issue and Challenges in Implementing Electronic
Health Records
7. Issue and Challenges in Implementing Electronic
Health Records
ISSUE:
8. Lack of staff with adequate knowledge of
disease classification systems
Challenges
1. Recruit and espert to offer coding
programs.
2. Training session in medical terminology
and user of coputer assisted coding
system.
ISSUE:
9. Manpower issues – lack of staff with
adequate skills
Challenges
1. In-service training program to develop
skills required.
2. Give incentives to motivate and
improve their skills.
8. Issue and Challenges in Implementing Electronic
Health Records
ISSUE:
10. Environmental issues
Challenges
1. Available and reliable supply of
electricity in the healthcare facility
2. Available space for computer and
other equipments.
9. Issue and Challenges in Implementing Electronic
Health Records
ISSUE:
11. Involvement of clinicians and hospital administrators
Challenges
1. Understanding of clinical data and how health professionals use that data in clinical
decision making. In addition, the involvement of clinicians and hospital administrators
in the identification of information/data is essential. Their specifications and input are
important for their acceptance of the system especially issues relating to ownership of
the information.
“If the system does not meet expectations and
users have a bad experience, overcoming that
experience could be a greater challenge than
overcoming other issues.”
10. Safeguards that 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
use the system and to identify when changes
are made in the record.