Question

Identify some of the potential barriers that hinder implementation of EHR systems and propose solutions to counter the barriers.

Answer 1

The potential barriers that hinder implementation of EHR are:

1. Lack of knowledge and experience to use computers
2. Complexity of EHR software
3. Lack of backup plans
4. Resistance to use new technologies
5. Security concerns in accessing EHR
6. Instability of EHR vendors
7. Lack of adopting standardized and uniformed system

The solution for each barrier are explained as follows.

1. Lack of knowledge and experience to use computers: If a hospital wanted to adopt it, there are a few steps to be considered, before, during and after the system is implemented. First, the hospital management need to undertake an assessment to determine the level of staff knowledge and computer literacy in the context of EHR implementation. Then, an appropriate training package need to be selected based on the identified staff needs. Finally, there is a need also for a post-training and implementation user evaluation to identify any additional training needs. This would be an important step to ensure that education sessions have fulfilled the stated purposes and goals, delivering improved productivity, efficiency, and effectiveness. Alternatively, governments could consider developing and facilitating EHR education and training sessions through professional development courses at all healthcare departments/schools of universities. Doing so would reduce the training barrier and eventually would eliminate it, since everyone, who graduates to get work in any healthcare organization, will have basic knowledge about using computers and EHRs.
2. Complexity of EHR: Testing the software performance and quality, prior to the implementation process, is a crucial step. This testing process should also be based on specific staff needs. The other solution is conducting interviews with users to investigate if the software meets their needs or not.
3. Lack of backup plans: Implementing safeguard procedures for the EHR system, including a backup system for all information stored in the system. Another procedure is to develop short- and long-term technical support plans, including regular system evaluation to avoid any potential breakdowns.
4. Resistance to use new technologies: An adequate, strong, committed and positive leadership team is a critical success factor for EHR implementation. It is also worth-mentioning that the team should consist of an EHR implementation leader, engineers, training supervisors, and client support personnel. By considering all these aspects and issues, it is more likely to reduce and resolve the resistance barrier, while also implementing the system in an optimistic, welcoming environment. The second solution was conducting education and training sessions to instruct the users.
5. Security concerns in accessing EHR: Authorisations and password access is the most secure procedure, as a feature offered by an EHR system. Password access should be addressed by the government through a regulation, and as an essential requirement to be applied by any healthcare
   organizations planning to implement an EHR. Offering a secure and safe transmission procedure for patients' information is essential for EHR implementation, to ensure such information confidentiality.
6. Instability of EHR vendors: Choosing an effective and qualified vendor that offers all the required features. In order to ensure selecting a qualified vendor, several questions need to be asked before deciding and selecting a software vendor. For example, if the vendor have the following characteristics: PCs, wireless internet broadband and scanners; Ongoing services such as maintenance, consultations, and upgrades; and Initial training programs offered to all, or some of, the potential users. Another preferred solution, to overcome the barrier of instability of EHR vendors, was conducting regular minor improvements and updates to the system. All users should be well-informed and retrained if necessary
   about the new updates to avoid any further complications.
7. Lack of adopting standardized and uniformed system:  The only offered solution was selecting software that offers standardized medical terminologies, terms and codes. To ease the selection and identification of the best software that offers these standards, government bodies should be part of this, and be responsible for such investigations based on hospital needs and requirements. This will assist all hospitals achieve interoperability, easily spreading nationwide, and overcoming the lack of adopting a standardized system barrier as well.