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Challenges to EHRs Adoption and Usage as well As Its Impact on Patient Care

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Table of Contents

Executive Summary……………………………………………………………………….3

Introduction …………………………………………………………………………….....4

Literature Review………………………………………………………………………….4

Data Collection…………………………………………………………………………….5

Data Analysis……………………………………………………………………………...6

Conclusion and Recommendations………………………………………………………..6

Ethical, Legal, Financial, and Economic Considerations………………………………….7

References …………………………………………………………………………………8

Appendix…………………………………………………………………………………..10

Executive Summary

The utilization of Electronic Health Records (EHRs) has the capacity to enhance patient care through the provision of precise and prompt information to healthcare providers regarding their patients. Notwithstanding their potential advantages, the implementation and utilization of Electronic Health Records (EHRs) have been gradual and inconsistent, as certain healthcare providers continue to depend on physical documentation. The aim of this study is to recognize the obstacles that impede the adoption and utilization of Electronic Health Records (EHRs) and their effects on patient care. Additionally, this research endeavors to devise suggestions for resolving these challenges.

The scholarly discourse pertaining to the adoption and utilization of Electronic Health Records (EHRs) highlights a number of obstacles, such as economic expenses, technological complexities, and concerns regarding user-friendliness. The financial expenses encompass the procurement and execution expenses of Electronic Health Records (EHRs), along with the recurring expenses of upkeep. Technical difficulties encompass issues related to the compatibility of systems, the protection of data, and the occurrence of system downtime. Usability concerns encompass challenges related to the input of data, navigation, and documentation.

The obstacles associated with the adoption and utilization of Electronic Health Records (EHRs) have noteworthy consequences for the provision of healthcare services to patients, such as operational inefficiencies, inaccuracies, and financial burdens. The aforementioned challenges have the potential to lead to diagnostic delays or inaccuracies, medication mistakes, and diminished levels of patient contentment. The utilization of Electronic Health Records (EHRs) may have both favorable and unfavorable effects on the provision of healthcare services to patients. Favorable outcomes encompass enhanced patient safety and care quality, whereas unfavorable outcomes entail augmented workloads for healthcare providers and diminished in-person interactions with patients.

The exorbitant expenses associated with implementing electronic health records (EHRs) represent a significant obstacle to their widespread adoption and utilization. The successful deployment of Electronic Health Records (EHRs) necessitates substantial investments in technological resources, infrastructure development, and personnel education. Small and medium-sized healthcare providers may face a significant financial burden as a result of this. Healthcare providers exhibit resistance to change, which poses another challenge. Numerous healthcare providers exhibit a preference for the conventional paper-based system and display hesitancy towards transitioning to electronic health records (EHRs). The reason for this hesitancy can be attributed to a deficiency in understanding the advantages of Electronic Health Records (EHRs) and apprehensions regarding their effect on operational processes.

Introduction

Electronic health records have transformed healthcare greatly. They have enabled healthcare professionals and patients to access and share information easily thus facilitating effective decision-making. Other benefits that the healthcare industry has experienced as a result of electronic health records include the reduction of medical errors which has been facilitated by the availability of patient records (Alanazi et al, 2020). However, there are notable barriers to the adoption and utilization of electronic health records which in turn affect patient care.

Literature review

Medical errors are a leading cause of death in healthcare and to reduce medical errors, there must be better ways to store and share patients' medical information. Unlike paper records that can be illegible, and easily get lost or misplaced, electronic health records facilitate better collection, storage, and display of patient information. The Institute of Medicine has noted that adopting Electronic Health Records widely can help to positively transform healthcare (Alanazi et al., 2020).

According to Bersani et al. (2020), despite the benefits of Electronic Health Records usage in healthcare, the adoption rates of these systems are still low and there is a lot of resistance from physicians. Electronic health records act as an essential tool for improving the quality of healthcare and the safety of patients but to accrue these benefits, physicians must be willing to use them. However, there is considerable evidence that healthcare professionals have moved slowly in adopting EHRs mainly due to a lack of readiness to transform (Bersani et al, 2020).

Jung et al. (2020) argued that healthcare professionals who had adopted electronic health records reported positive healthcare outcomes compared to those who did not. Additionally, they noted that miscommunication and misinterpretation between healthcare professionals have contributed significantly to the barriers to the adoption and utilization of electronic health records (Jung et al., 2020). This study will identify the barriers to the adoption and utilization of EHRs and how they affect patient care.

Data collection

Data was collected from existing research materials which included peer-reviewed articles and other publications. Archival materials were chosen as the means of data collection because they allowed for a lot of data to be collected and analyzed within a short time. Certain keywords such as 'barriers to adoption of EHRs', 'barriers to utilization of EHRs', and 'effects of poor EHRs utilization' were used as the inclusion criteria for the research materials. Although many articles were collected, after filtering, only five articles were selected and used in the research.

Data analysis

Content analysis and thematic analysis were the main methods of data analysis in this research. The data from the materials were closely examined for common themes related to the research questions. The following were the results of the data analysis:

Title	Author	Results
Application of Electronic Health Records in Polyclinics: Barriers & Benefits.	F. Elharish et al.	Lack of time Poor communication among users Inadequate financial resources
Perceptions of healthcare professionals about the adoption and use of EHR in Gulf Cooperation Council countries: a systematic review.	Alanazi et al.	High cost Negative attitudes towards EHRs Lack of computer skills
Effects of electronic health record implementation and barriers to adoption and use: a scoping review and qualitative analysis of the content.	Tsai et al.	Start-up and ongoing financial costs Traditional work environment Lack of access to computers
Seven years after Meaningful Use: Physicians’ and nurses’ experiences with electronic health records.	Rathert et al.	Poor patient outcomes Lack of patient-centered care
Barriers to patient portal access and use: evidence from the health information national trends survey.	El-Toukhy et al.	Inability to support patient involvement. Lack of interdisciplinary collaboration

Conclusions and recommendations

From the data analysis, a viable conclusion would be that the main barriers to the adoption of electronic health records are cost-associated and skills-associated. Attitude also plays a critical role in the adoption and utilization of EHRs as healthcare workers with a negative attitude toward these records are unlikely to use them. Moreover, the traditional work environment in most healthcare organizations is a barrier to the use of EHRs because it does not support technology. From the analysis of the effects of these barriers on patient care, the conclusion is that they make it hard to provide patient-centered care since patients cannot access their health information and make informed decisions. It is recommended that healthcare facilities train their staff on the use of EHRs and provide the required materials such as computers.

Ethical, legal, financial, and economic considerations

Ethical issues on the safety of patient data are likely to occur with the use of EHRs considering that it is increasingly becoming difficult to protect data. Legal and regulatory requirements by HIPAA require that healthcare organizations protect health information and therefore this should be considered. Additionally, the expected financial and economic implications of the recommendations are that the organizations will have to spend more on setting up electronic health records and training employees on how to use these records.

References

Alanazi, B., Butler-Henderson, K., & Alanazi, M. (2020). Perceptions of healthcare professionals about the adoption and use of EHR in Gulf Cooperation Council countries: a systematic review. BMJ Health & Care Informatics, 27(1). https://doi.org/10.1136%2Fbmjhci-2019-100099

Bersani, K., Fuller, T. E., Garabedian, P., Espares, J., Mlaver, E., Businger, A., ... & Schnipper, J. L. (2020). Use, perceived usability, and barriers to implementation of a patient safety dashboard integrated within a vendor EHR. Applied clinical informatics, 11(01), 034-045. DOI: 10.1055/s-0039-3402756

El-Toukhy, S., Méndez, A., Collins, S., & Pérez-Stable, E. J. (2020). Barriers to patient portal access and use: evidence from the health information national trends survey. The Journal of the American Board of Family Medicine, 33(6), 953-968. https://doi.org/10.3122/jabfm.2020.06.190402

F. Elharish, S., Denna, I., M. Maatuk, A., & K. Elberkawi, E. (2021, April). Application of Electronic Health Records in Polyclinics: Barriers & Benefits. In International Conference on Data Science, E-learning and Information Systems 2021 (pp. 40-46). https://doi.org/10.1145/3460620.3460628

Jung, S. Y., Lee, K., Lee, H. Y., & Hwang, H. (2020). Barriers and facilitators to implementation of nationwide electronic health records in the Russian Far East: A qualitative analysis. International Journal of Medical Informatics, 143, 104244. https://doi.org/10.1016/j.ijmedinf.2020.104244

Rathert, C., Porter, T. H., Mittler, J. N., & Fleig-Palmer, M. (2019). Seven years after Meaningful Use: Physicians’ and nurses’ experiences with electronic health records. Health care management review, 44(1), 30-40. DOI: 10.1097/HMR.0000000000000168

Tsai, C. H., Eghdam, A., Davoody, N., Wright, G., Flowerday, S., & Koch, S. (2020). Effects of electronic health record implementation and barriers to adoption and use: a scoping review and qualitative analysis of the content. Life, 10(12), 327. https://doi.org/10.3390/life10120327

Appendix 1

Table of the Frequencies of the Different Barriers to EHRs Adoption and Usage Reported in the Five Articles

Barrier	Frequency
Lack of time	2
High cost	2
Poor communication among users	1
Negative attitudes towards EHRs	1
Inadequate financial resources	1
Lack of computer skills	1
Start ups and ongoing financial costs	1
Traditional work environment	1
Lack of access to computers	1
Poor patient outcomes	1
Lack of patient centered care	1
Inability to support patient involvement	1
Lack of interdisciplinary collaboration	1