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Electronic Health Records Implementation Essay

Institutional Affiliation

Course

Instructors Name

Due Date
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Human Factors, Usability and Electronic Health Records

Introduction

Implementation of electronic health records significantly improves the quality of care,

timely access to a patient's health information, and customer orientation (Khubone et al., 2020).

In recent years many hospitals have implemented electronic health records, with some of the

initiatives being driven by government regulations. The promise to increase the availability of

patient data, enhanced integration, cost-effectiveness, and improved efficiency have been the key

drivers of electronic health records implementation (Lewkowicz et al., 2020). They are designed

to enable the management, processing, and distribution of information during healthcare

provision.

Electronic health records take various forms relating to different electronic information

systems used in healthcare that can be used in individual organizations, regional levels, affiliated

health centers, or at a national level (Lamas et al., 2018). Implementation of electronic health

records involves various technical and organizational factors that include culture, financial

resources, human skills, coordination, and organization structure (Dornan et al., 2019).

Implementation of electronic health records results in improved health care outcomes in a cost-

effective and timely manner. The technological systems alone are not sufficient to ensure the

benefits of electronic health records, thus requiring human and organizational processes to

motivate change and adaptation (Hulsen et al., 2019). Electronic health records are an essential

improvement in the healthcare sector, but their implementation is complex and challenging

despite their potential benefits, with its access depending on many factors.
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Staff Acceptance

To keep up with a constantly evolving world, organizations often need to implement

changes that affect their processes, people, and products, which can sometimes be difficult, and

staff members often resist it (Vanclay, 2019). High-income countries have extensively

implemented electronic health records to improve healthcare delivery and patient care (Abul-

Husn & Kenny, 2019). Electronic health records reduce medical errors, provide financial returns

and patient medical information in real-time. Implementation of EHRs guarantees faster access

to patients' medical information and histories by hospital personnel, thus increasing accuracy and

efficiency of diagnosis (Ahmadi & Aslani, 2018). For electronic health records to be adopted

effectively, staff members need the training to switch from traditional paperwork to electronic

health records.

Despite the vast benefits of implementing electronic health records, healthcare providers

have slowly adapted the technological systems with a lack of readiness resulting in weaknesses

in healthcare organizations' transformation to the new systems (Al-Anezi, 2021). The slow rate

of adaptation of the electronic health records has been suggested to result from resistance from

healthcare workers, especially physicians in the frontline group of users (Kruse et al., 2018). This

resistance, in turn, affects other user groups found in the healthcare system, such as the

administrative staff and nurses. This means that physicians have a significant impact on the

adaptation of EHRs. According to a qualitative study carried out by O'Donnell et al. (2018), the

quality of patient care improvement significantly depends on the physician's adaptation of EHRs

compared to the use of paperwork to conduct daily tasks.

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The resistance faced in adopting EHRs by staff members in the healthcare system was

significantly contributed by the lack of computer skills lack of time and finances to facilitate the

training process (Zayyad & Toycan, 2018). Studies conducted indicate that physician resistance

to electronic health records is the primary barrier to implementing information systems in

healthcare facilities (Zhang et al., 2019). Nurses also show resistance to nursing information

systems, which later affects the large-scale implementation of information technology systems in

healthcare facilities. Resistance of EHRs is not restricted to refusal to adopt the approach; thus, it

is essential to understand user acceptance. Staff acceptance does not imply that there is no

resistance, especially when it comes to mandatory systems.

The acceptance or non-acceptance of information systems occurs when there is a

voluntary system, especially for personal use such as emails, with resistance manifesting when

the system is mandatory (Cho et al., 2021). Previous studies regarding the successful adaptation

of electronic health records have shown that healthcare workers exhibit resistance to electronic

health records due to technical factors and underestimating its impact on behavioral, cultural,

social, and managerial aspects (Cantor & Thorpe, 2018). Thus, staff resistance to information

technology should indicate how successful EHRs implementation is.

Management Support

In the workplace, change brings about anxiety; thus, management plays a significant role

in taming the fears that arise during the necessary alterations (Miech et al., 2018). Implementing

EHRs is an expensive affair, hence the need to have management fully involved in the strategic

planning. During the implementation of electronic health records, the project manager is tasked

with creating an implementation plan to ensure that it will further the organization's strategic

goals. Implementing information systems in healthcare facilities is more complex than in other
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sectors due to the complexity of medical data, confidentiality, and security. According to

Rajkomar et al. (2018), the major challenge faced in implementing electronic health records is

the lack of management support and management programs. Disagreement among senior

managers in healthcare facilities results in most projects failing.

The involvement of top management in the implementation of electronic health records is

necessary to ensure that the right combination of information technology and business can

resolve any conflicts that occur (Granja et al., 2018). The top management can facilitate staff

training to ensure a smooth transition. Management support allows healthcare's structured

functioning, which makes the delivery of services easy and smooth Administrative support

assists employees in their everyday activities and ensures that all activities run smoothly. De

Pietro & Francetic (2018) said all relevant healthcare stakeholders should be involved and

committed to successfully implementing electronic health records. Change management and

leadership are vital aspects to consider when executing information technology systems with

successful implementation requiring good communication and staff cooperation. The success of

electronic health record systems in a healthcare facility is accessed on an organizational level,

thus the need for an efficient management team.

Leadership issues, in most cases, derail the adoption and implementation of EHRs

(Lerman & Jameson, 2018). Therefore, good leadership and commitment by management are

critical for success to be recognized (Farahnak et al., 2019). In this situation, management fosters

a collaborative culture. It would be easy to make decisions together, thus identifying individual

and group needs and views on the adopted systems. All the staff involved in using the new

information system technologies must support and understand the institution's objective (Saeed

Mohamed et al., 2020). Effective communication, a balanced and empowered team, and
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dedicated leadership are essential when making a change. Limited resources and inadequate

finances also significantly contribute to delays that occur during the implementation of electronic

health records systems, thus requiring a considerable investment ranging in millions that need

management support that believes in the process.

Employment of Medical Informatics Professionals

The emergence and growth of big data and an increased number of people with medical

insurance have resulted in a growing need to analyze and organize health information, thus the

burgeoning of health informatics careers (Courtemanche et al., 2018). The health informatics

specialist focuses on the capturing and transmitting of health records. They use their healthcare

knowledge, information systems, and information technology security to gather, interpret and

store patient information during care provision (Masic & Pandza, 2018). Since information

systems have been integrated with the healthcare system recently, the field of health informatics

specialists is still young, with most specialists being pioneers. This aspect poses a challenge in

fully implementing electronic health record systems due to a well-trained informatics workforce

shortage.

The high cost of software and investment of time to train staff and physicians have

created a barrier to the effective implementation of electronic health records systems

(Jouparinejad et al., 2020). Informatics professionals face difficulties with organizational roles,

software to hardware problems, and interactions with other disciplines (Fernandez-Luque et al.,

2020). More informatics nurses need to be employed to teach and convince other healthcare

professionals on the importance and benefits of electrical documentation of patient health

records.
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Healthcare informatics professionals are a booming and essential professional. Still,

financial barriers make this process challenging to adapt and implement since it requires a

professional with a solid knowledge base in healthcare and how it can be applied in the

informatics field. The administration should be ready to invest in potentially increased pay and

additional support while implementing electronic health record systems in an organization.

Leadership and Governance

Organizations have been forced to start operating a global technological market with

competitors entering continually. Technological advancements are essential for organizations to

maintain a competitive edge and improve outcomes. Despite this, some leaders in the healthcare

sector seem to be unaware of these essential technological changes and resources (Oleribe et al.,

2019). Some of these leaders are also unfamiliar with developing strategies to develop and

implement required technological changes. Good and effective leadership has significantly been

associated with increased patient satisfaction and decreased adverse healthcare outcomes (Karaca

& Durna, 2019). While some leaders are genuinely uninformed about technological changes such

as electronic health records, others lack the necessary knowledge on managing change.

In contrast, others are non-receptive of the change. Other researchers indicate that some

hospital leaders face difficulties in implementing and sustaining change in the organization

(Figueroa et al., 2019). The Affordable Care Act(ACA) has significantly promoted the recent

development and adaptation of electronic health records by healthcare institutions (Colicchio et

al., 2019). The Affordable Care Act has promoted the implementation of EHRs in hospitals to

decrease the cost of healthcare while improving its quality. Leaders that do not comply with the

federal mandates are at a risk of facing financial penalties.

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As stated by Lye et al. (2018), leaders that have taken the step to implement EHRs have

significantly reduced the cost of duplicated procedures and process cycle times. Mazur et al.

(2019) note that some hospital leaders do note the importance of change in the organization

regarding the implementation of EHRs systems. The author's further state that some

organizational leaders understand the correlation between implementing cost-effective strategies

for organizational change and effective performance outcomes (Scott et al., 2018).

Transformational leadership can be described as the ability to inspire staff members and

colleagues to take place in change processes actively.

The change management process requires commitment from the hospital leaders to

sustainability to prepare the organization for significant changes (Kho et al., 2020). However,

some leaders have been slow in the implementation of EHRs despite the potential of the systems

increasing the quality of healthcare outcomes and reducing cost (Moll et al., 2018). The lack of

organizational readiness for change has been a key contributing factor to the failure in the

implementation of EHRs (Afrizal et al., 2019). According to Kotter, Hassan (2018),

organizations need to create a communication strategy that ensures a constant and shared vision

is attained by utilizing the available communication channels and revamping those based on not

essential communication. The strategy for implementing electronic health records requires the

integration at a high level at department and management levels (Sutton et al., 2020).

Organization officials and human resource functions are crucial to change initiatives (Mannion &

Davies, 2018). Transformational leaders are in a position to motivate their staff members

towards change while determining how the change management will influence new systems

(Khan & Khan, 2019). Training is an essential strategy for successfully implementing electronic

health record systems. Thus, hospital leaders should develop courses that assist healthcare
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professionals in understanding the benefits of the EHRs and the role they play in its

implementation.

Conclusion

Despite the significant befits of electronic health records systems, their implementation is

still facing immense challenges, with the human factor being key. Other restrictions and barriers

include cost constraints, individual attitudes, technical limitations, and organizational constraints.

Implementation of electronic health records is a challenge for hospitals and physician offices.

The transition to electronic health records has faced many challenges in adoption and usability.

A common complaint from healthcare workers is the mandate to use a new system that they do

not fully understand due to inadequate training. Physicians have different beliefs about the

implementation of electronic health record systems. To increase the success rate of EHRs

implementation and patient outcomes, understanding the necessary strategies that hospital

leaders use is necessary. Most of the studies have shown that resistance to change has been a

critical barrier to the implementation of electronic health records compared to other limitations.

Effective healthcare leadership should promote high levels of employee satisfaction and better

training. A hospital leade that breeds a culture of communication and employee feedback tends

to be more successful, especially when dealing with change. Hospital leaders are responsible for

identifying and implementing strategies that facilitate the effective implementation of electronic

health record systems.

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