Question

What barriers might exist to providers’ adoption of computer-based algorithms when predicting health status of patients? How could these tools and information be presented in a way to make them actionable for physicians and their care teams?

Answer 1

1) Economic barriers

Time: Choosing an EMR system and learning how to use it takes time. The EMR market is extremely saturated, and navigating options and comparing costs and features is an overhead many family physicians do not have the time for. In addition to that, once an EMR system has been selected, use of it requires training, something some physicians do not feel they can aord extra time for.

Cost: Physicians must choose between purchasing an EMR system from a vendor or commissioning custom systems for their practices. Either way, use and maintenance of an EMR system accumulates costs that come not only from the system purchase, but also from training, maintenance, IT support, system upgrade and data storage, governance and migration costs. Therefore for small and medium sized practices, these costs accumulate to create a signicant barrier for adoption of the technology, as benets of EMR adoption would take too long to reap .

2) Barriers to adoption for clinicians

Poor design: The majority of legacy EMR systems in North America were designed with the primary functionality of record keeping for billing patients. Thus the primary functionality is not designed to assist a physician in best possible patient care, leading to frustrating and time consuming interactions between system and physician. In addition, vendors tend to underestimate complexity of patient assessment and care workows and procedures. Interviewing and administering care to patients is a very delicate interaction, and the added overhead of interacting with complex interfaces to record information is often hindering . Some physicians reported that they sometimes stop using EMRs because hunting for menus and buttons disrupts the clinical encounter and hinders doctor-patient interaction.

Lack of customizability: Physicians often avoid adoption of EMR solutions as every practice has dierent processes and work- ows that work, and physicians do not want to be constrained by rigid software systems

3) Infrastructure and regulations

Privacy & security: Non adopters of EMR technology often still believe that use of EMR solutions endangers patient privacy. This is not an entirely unfounded belief, as Forbes reports that in 2015 alone there were over 112 million data breaches in healthcare records in the United States alone .

System reliability: Physicians need reliable access to their patients data at all times, and they worry that patient data can be temporarily unavailable at a critical moment or even lost if computers crash, viruses attack, or the power fails .

Despite these barriers, adoption of EMR technology by physicians and health organizations such as hospitals and clinics is steadily increasing. This often occurs due to pressure from administration or government to modernize care, and not because barriers for technology adoption by physicians have been overcome. Physicians are forced to use products that they nd time consuming or disruptive of patient care, leaving many with a distaste and distrust for the technology.