Three Common Barriers to EHR Implementation and How to Avoid Them


This is a contributed post from EHR in Practice.

Many practices would agree that switching to a new electronic health record (EHR) system is no easy task. By working closely with the best EHR vendor based on a medical practice’s needs, the transition can be smooth and the first step in helping prevent many of the common challenges that can arise when switching EHR vendors or transitioning off of paper.

Three of those common challenges with implementing electronic health records include:

  • Cost of an EHR system
  • Buy-in for an EHR system
  • EHR system usability and training

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Common challenges to EHR system implementation often times occur when clinicians and other key staff are not directly involved in the vetting and implementation process. This can cause them to feel less compelled to fully accept and adopt the new technology and may be more challenging when it comes to training, thus not maximizing the true benefit and potential of the EHR system.

EHR system costs, lack of buy-in, along with usability and training often come up as barriers to implementation. The following post will discuss these challenges and ideas on how they may be overcome.

Cost of an EHR System

Concerns regarding costs vs. benefits represent one of the most common challenges to EHR implementation.

One way to overcome this challenge is to engage a thorough and long-term cost-benefit analysis or ROI forecast which links desirable outcomes to the EHR implementation and utilization of a new EHR system. The practice should plan accordingly to build an accurate EHR system budget and have open discussions around the topic.

With the industry shift to value-based care under Medicare Access and CHIP Reauthorization Act (MACRA) and Merit-based Incentive Payment System (MIPS), employing an EHR system that tracks provider and practice performance in real-time adds value and may be able to generate financial benefits for the provider and the practice. MIPS reporting built directly into an EHR system differentiates EHR vendors.

Other EHR system benefits such as time-savings, mobility, accessibility, population health and improved patient engagement should continue to increase over time when a practice implements the best EHR system for their needs.

Ask to speak with practices currently using the EHR software for real and honest feedback as to how the system may have improved their bottom line. It takes time to reap the benefits and selecting a technology vendor is certainly a long-term investment.

Buy-In for an EHR System

The potential lack of buy-in regarding EHR systems often stems from this technology being viewed as disruptive, complicated and distracting from the actual practice of care delivery, but not all EHR systems are created equal.

A few of the steps that can help increase buy-in from the practice’s staff include:

  • Gathering clinician and staff input when selecting an EHR system. Allow them to take an active role in the process.
  • Assessing current workflows during the sales and implementation process to ensure the best software selection with guidance from your EHR vendor.
  • Training clinicians and staff on how to make the best use of the EHR system for their practice. This includes both training from the EHR team as well as having super users in the practice help train new staff members.

EHR System Usability and Training

A third barrier to implementing a new EHR system involves a perception that an EHR system is difficult to use either due to design flaws or inadequate training. Often times the thought is that clinicians and staff will need to spend additional time and effort using the technology instead of working on other necessary tasks.

In order to benefit users, EHR systems should be designed specifically for the physician’s workflow. An orthopedic surgeon’s workflow is quite different from that of a dermatologist. One size does not fit all. Thus, an EHR system designed by practicing physicians helps to increase the usability factor and specialty-specific workflow.

Taking the time to invest in proper training provided by your EHR system vendor, whether on-site or web-based, is time well spent and should be on-going. During the vendor selection interviews, ask about the process and steps taken for implementation to help ensure it can be tailored to fit your practice’s needs.

In many respects, usability challenges can be overcome through a proper selection process that matches EHR functionality with how the practice operates and can be determined through involving critical stakeholders along the way.

These common barriers may be alleviated through proper planning from both the practice and the EHR vendor including input from stakeholders, training and making a clear case for the value EHR systems can bring to a healthcare practice.

This article was originally published on April 12, 2018 and updated on May 7, 2019.

Jeff Green

Jeff Green

Jeff Green writes for EHR in Practice. He is a consultant in the healthcare information technology space.

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