Study Highlights Implementation Gaps As EHR Adoption Pressure Grows

By Christine Kern, contributing writer

Study finds a list of challenges, workarounds, and gaps as healthcare organizations struggle with EHRs.

The use of EHRs to track patient care was mandated by the 2009 HITECH Act, designed to promote the adoption and meaningful use of health information technology. The rationale behind the implementation of EHRs to help standardize care, improve communication between doctors, and allow for enhanced analysis of treatment and disease.

Critics and a number of stakeholders have argued EHR implementation actually is counterproductive, with the mandated use of the technology leading to numerous challenges including decreased relational time with patients and added care provider workloads. To date, however, little real analysis exists examining the perceptions of doctors regarding how EHRs impact patient care or the ways in which the system can be reformed to improve utilization.

Now, a new multi-university team of researchers has released the findings of a qualitative study analyzing physician perceptions of EHRs, the positive outcomes of the technology, and remaining challenges and areas for improvement. The study found significant gaps remain for healthcare organizations implementing EHRs.

“There has been a lot of data collected about EHRs but little analysis of how the people using the technology actually feel about it,” notes Tracy Porter, college associate lecturer within the Department of Management at Cleveland State University and co-author of the study. “Our work indicates there are clear problems being identified by the EHR user but due in part to workarounds and the culture of silence these issues are not being properly addressed, reducing the benefits of the technology and potentially leading to additional problems.”

Among the accepted challenges of EHR products on the market, as Health IT Outcomes wrote, are the fact they are “cumbersome from a data entry perspective, counter-intuitive to clinical workflows, and aren’t conducive to interoperability.” As the study noted, this means many healthcare workers are finding ways to work around the system, rather than utilizing it to be more productive.

Survey responses revealed a number of clear challenges associated with the use of EHRs including: increased workload for care givers; issues around trust, both of the technology itself and information inputted by other physicians; perceived over-reliance on technology; and problems with user training. In addition, findings indicate many doctors simply created workarounds that circumvented EHRs all together, while many medical professionals were reluctant to speak up about their issues with the technology due to a culture of silence present at many medical institutions.

Porter argues the data collected can be used to increase communication between physicians and administrators, help break down the culture of silence, and directly address the issues medical professionals are experiencing. Her team will next seek to conduct a larger study including nurses as well as doctors to assess how different care givers perceive EHR costs and benefits.