Three challenges hospitals face when implementing an EHR

The challenges hospitals face when implementing an EHR differ, to a certain extent, from the problems smaller practices face.

The differences in challenges relate to the scale of implementation being conducted. Hospital EHRs are typically implemented on a larger scale than non-hospital practices. Given the scale of implementation, there are problems that are unique to implementing EHRs on a larger scale in a hospital setting.

The following represent three challenges hospitals commonly face when implementing an EHR.

1. A wider range of stakeholders to please

From an organizational perspective, implementation of an EHR in a hospital setting presents comparatively present more challenges due to the fact hospitals are larger and  more organizationally complex structure when compared to smaller practices.

As such hospitals must be able to align the interests of a wide range of stakeholders who may have different expectations regarding how an EHR fits into how they are carrying on their daily work.

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A comprehensive overview of these particular problems was discussed in a 2015 study, which identified four critical organizational challenges for hospitals implementing EHR:

  • Prior existence of appropriate hardware and network infrastructure
  • Availability of sufficient funds for investment in the implementation,
  • Alignment of the EHR with the organization's goals
  • Staff understanding of EHR's features and benefits.

2. Location and size

The location and size of a hospital can present challenges to EHR implementation that must be accounted for in implementation planning.

Put simply, smaller, rural practices often experience comparatively more difficulties in EHR implementation when compared to their larger, more urban peer institutions. Rural hospitals are often at a disadvantage when implementing an EHR given that proper functioning of EHR systems relies on quality broadband connection, which some rural areas due to a lack of demand for these services does not have in place.

In addition to limited communication infrastructure, these hospitals must also contend with trying to fit an EHR into already strained budgets. As reported in a research brief on EHRs in rural critical access hospitals many of these organizations reported significant financial challenges to EHR implementation and use.

The organizations surveyed reported the following challenges: 50% reported EHR implementation costs as the most significant while 35% availability of grants/loans to support EHR adoption and use, and 23% broadband implementation costs as pressing concerns.

3. Poor clinician buy-in

Buy-in among administrative and clinical staff is a challenge al practice face whether they are small or larger organizations. However, the challenge presented from a lack of buy-in to the EHR is made more difficult when it occurs on a larger scale and across a more complicated organization such as a hospital, which may have hundreds or thousands of employees spread across multiple departments.  

A 2016 study suggested that obtaining physician cooperation was one of the most significant challenges to EHR implementation. Moving beyond this study one can also point to the importance of overcoming buy-in from administrative and clinical staff as being a significant barrier to overcome.

The challenges facing hospitals implementing an EHR can be significant, and can spin out of control if they strategies to mitigate them are not considered in the implementation process. However, the challenges discussed above are ones that can be managed using adequate planning and enough foresight.

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Jeff Green

About the author…

Jeff Green, MPH, JD works as a freelance writer and consultant in the Healthcare information Technology Space.

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Jeff Green

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