Factors and Forces Affecting Ehr System Adoption: Report of a 2004 Acmi Discussion

In a healthcare world that operates on stringent budgets and margins, we begin to see the need for a higher capacity healthcare delivery system. This in turn puts pressure on the healthcare organizations to ensure higher standards of patient care, and compliance with the reform provisions. However, these are the harsh realities of today’s healthcare environment, a setting in which value does not always equal quality. The use of technology can help to amend some of this by providing higher capacity care without compromising quality; this can be done with the use of such technology as electronic health records (EHRs). This paper will aim to address how EHRs influence healthcare today by expanding upon topics such as funding sources, reimbursement methods, economic factors, socioeconomic factors, business influences, and cost containment.

The purpose of this discussion board is to describe the Electronic Health Record (EHR), the six steps of an EHR and how my facility implements them, describe “meaningful use” and how my facility status is in obtaining it, and to further discuss the EHR’s and patient confidentiality.

The American Recovery and Reinvestment Act made an investment in the year 2009 to encourage the adoption and implementation of the electronic health records (EHRs)(Cite). EHRs incentive payments were authorized through Medicare and Medicaid to clinicians and hospitals when they privately and securely used EHRs for achieving improvements in care delivery by the Health Information Technology for Economic and Clinical Health Act (HITECH). The healthcare organizations are expected to demonstrate meaningful use of EHRs. This rule of meaningful use has been implemented to strike a balance between acknowledging the urgency of adopting EHRs for improving the healthcare system and identifying the challenges that would be put forth

Hence, EHR 's are inherently complex amalgamations of diverse subsystems targeted toward varied users. The stakeholders are the users and must have a role in implementing any IT or EHR system into its work flow. An EHR can be customized to accommodate any environment depending on the level of expertise of the vendor and how long they have been in the business of creating an optimum system that 's customized to fit the organizations needs. For the most part, EHR 's must be designed for efficient, error free use. Ideally, an EHR is a system that encompass all the subsystems that make a hospital meet "meaningful use" criteria to acquire incentives for adopting EHR into practice. In the next five years, EHR adoption will no longer be a luxury, it will be a "MUST". EHR 's and other health information technology will be a necessity to practice medicine (econsultant.com, 2010). Rather than purchase several standalone systems, it would behoove one , in my opinion , to purchase an EHR that would satisfy all the needs of the stakeholders, the physician , nurses and other hospital staff and all parties involved in the tertiary practice too. Although LWMS 's budget is not large enough to accommodate the full cost of implementing an EHR,

EHRs adoption is an essential part of improving patient safety and the quality of health care by reducing errors, allowing access to complete and accurate medical information to produce better patient outcomes. Although, it seems like a win/win situation there are still some challenges that appear when implementing an EHR. Some challenges would be Time, Cost, Work- Flow Distribution, Security/Privacy, and Interoperability just to name few. Interoperability is defined as the ability of a computer system or software to exchange or make use of information, which can create a major issue for any organization if these systems are not communicating properly. Security and Privacy are always a concern because implementing HIPAA measures is not an easy task. Not only do you have to comply with the federal level organization still need to recognize state laws which can often be more stringent. Especially, when you need to cover areas such as mental health, drug and alcohol services, genetic testing, HIV, and family planning issues. Change management would be enacted to overcome any issues involving process change resistance. It is a methodical approach and application of knowledge that use tools and resources to deal with this type of change. Methodologies would

Electronic Health Records (EHRs) are an important component in health care reform, but do they really bring efficiency to the practice? The extent to which practices use EHRs vary from the very basic (entering clinical notes and viewing results) to the intermediate (using e-Prescribing to indicate adverse drug prevention and provide suggestions for alternative drugs) to the advanced use (including lab and radiology order entry with testing guidance, capture of electronic charge, and evidence-based guidelines).

In efforts to reform the United States healthcare system and create a nationally unified data exchange system the federal government has established an incentive program to eligible professionals and hospitals. The federal government has turned to certified electronic health record (EHR) technology to help facilitate the process of broadening health IT infrastructures. The federal government views EHR system used in meaningful ways as the key to reforming the healthcare systems. Meaningful use of the EHR systems can also improve the overall quality of healthcare, insure patient safety, as well as reduce the cost of healthcare to individuals (Bigalke & Morris, 2010, p. 116).

Over the previous eight years, there has been a significant investment of private and public funds to upsurge the adoption of Electronic health records (EHRs) across the nation. The extensive adoption and “meaningful use” of electronic health records is a national priority. EHRs come in various forms and can be utilized in distinct organizations, as interoperating systems in allied health care units, on a regional level, or nationwide. The benefit of utilizing an EHR depends heavily on provider’s uptake on technology. Benefits related to electronic health records are numerous and may have clinical, organizational and societal outcomes. However, challenges in implementing electronic health records has attained some attention, the implementation

Resistance towards EHR systems tends to run high among physicians. The increase in the adoption of EHR in health systems has its challenges and concerns. Many physicians complain of negative impact on workflow, productivity disruption, and most importantly the physician-patient relationship. Earnest et al. (2004) concluded that physicians’ had initially thought information technology would be an obstacle to their workflow. Also, federal mandates with deadlines have created an environment where many physician practices have adopted an EHR strictly for compliance without any thought to the ongoing needs of the system (Porter, 2015). The EHRs that were quickly brought to market have been the source of ongoing frustrations and issues since they had the sole purpose of meeting

Getting successful universal EHR is not just technology selection, implementation question it needs to address many other aspects such as physician’s acceptance, policy/laws, incentives, security, and privacy and training issues before we can concentrate or focus on technology selection and implementations. The ecosystem should be ready with all these critical elements addressed only then successful EHR implementation can sustain in US. First and foremost there is a need to have consistency around the state/federal and HIPPA regulations which defines security and privacy issues in US. Due to conflicting requirements in these regulations mass acceptance of any medical system/technology cannot be effectively done. Second biggest issue for universal EHR adoption is the acceptance of EHR by physician’s communities. The benefits of EHR has been identified and acknowledged by medical communities at large however the rate of adoption and use after implementation is sluggish. The biggest common contributor for implementation, design and use of EHR systems is physician. Physicians should be properly trained and emphasis on continual education should also be placed through continuing education credits. Unless small physician office (stand-alone offices) buy-in the adoption of EHR no matter what technology and processes we have in place, EHR won’t be universally accepted and the entire benefit and value associated with EHR can be realized with universal acceptance of EHR. Thus need for

Giving the facts from the Real-World Case by purchasing the same EHR system as Community Hospital, physicians have confidence that they will have better control of care over their patients. In addition, they will be able to write orders, advise medications and also have the capability to get into the providers EHR systems while covering in other specific areas of the hospital. For this reason, some pros of the EHR consist of better patient care, better-quality care coordination, upgraded diagnostics and patient outcomes and the applying of a computerized physician order entry; this allows in the decrease of transcript mistakes related to poor writing on behalf of the physicians for either procedures or prescriptions. (HealthIT, 2015) Regrettably, there is also a downside, as not all areas of the hospital, such as the Physical Therapy unit, Nurse’s station and Nutrition department are ready to engage with the new technology.

There are certainly diverse reviews from staff and practitioners alike on the advantages and challenges of electronic health records (EHR). The transition from paper to EHR is involved and perplexing. There are many incentives, both from a financial and production perspective, but the route to implementation of an EHR system can be daunting to a hospital or practice group. Both staff and patients can be effected, both positively and negatively. As you stated in your post, physicians will not be obligated to wait for patient charts or outside records and reports. A physician can simply log in and all the information is readily available to him. But many physicians, staff and patients have become cumbersome. The transition to EHR has required

The Electronic Health Record (EHR) and associated technologies have had a dramatic impact on the UC Davis Health System (UCDHS). UCDHS has realized significant returns on the clinical technology investment in the form of enhanced revenues and reduced costs. The new perspective and approaches enabled by UCDHS‟ EHR are driving improvements in clinical quality and cost reduction. There is no question that these new tools will enable dramatic improvements in care delivery and care quality that were simply not possible in the legacy fragmented paper-based care processes. UCDHS had a clear goal to deploy the EHR across all venues of care (inpatient, emergency department, ambulatory clinics, home health, and Telehealth encounters). Other key goals included secondary use of clinical content, leveraging EHR data to support transitions of care, and to provide better access to clinical data for

The survey found that overall adoption by physicians is 62.8%, and that, in general, the larger the practice, the (not surprisingly) higher the adoption rates, with 77.2% of docs at medical groups of 25 or more members using EHRs – this is compared to only 54.5% of solo practitioners adopting the technology.

Electronic health records (EHR’s) have many advantages, but there are plenty of disadvantages. EHR’s were created to manage the many aspects of healthcare information. Medical professionals use them daily and most would feel lost without it. Healthcare organizations were encouraged to adopt EHR’s in 2009 due to the fact that a bill passed known as The Health Information Technology for Economic and Clinical Health Act (HITECH Act). “The HITECH Act outlines criteria to achieve “meaningful use” of certified electronic records. These criteria must be met in order for providers to receive financial incentives to promote adoption of EHRs as an integral part of their daily practice”, (Conrad, Hanson, Hasenau & Stocker-Schneider, 2012).