In his 2008 inaugural address, President Obama introduced his mandate for a nationwide EHR system by 2014. Although significant progress has been made towards the accomplishment of that goal, barriers still exist that challenge EMR/EHR implementation; overcoming these areas of resistance is critical for successful implementation and management of EMR/EHR's.
Physician and staff resistance to change:
Mark Twain once said, "It isn't the progress I mind, it's the change I don't like". Change is the great constant in both our personal and professional lives. While healthcare professionals recognize the value EMR/EHR implementation brings to their industry, widespread adoption of a new system poses a potential challenge. EMR/EHR systems impact increasingly large, heterogeneous workforces and more areas of the organization, requiring leaders to acquire change management skills to assist their team with EMR/EHR implementation. Leadership that recognizes the potential psychological impact of a new information system to its workforce and practices strong change management skills will find this barrier to implementation lower than organizations that fail to account for this phenomenon.
Physicians' concern about the integrity of EHR Implementation: Although the HIPAA privacy rule was enacted in 2003, concerns regarding electronic medical record confidentiality persist today. Prior to HIPAA setting a national standard for accessing and handling medical information, state law prevailed, and their laws varied. With HIPAA, states may now only adopt laws increasing privacy, but may not fall below the national minimum standard. Although healthcare providers, Plans, and health care clearinghouses are subject to HIPAA laws anytime they transmit health information electronically, there are many entities to whom the data may be made available. Some of these entities include but are not limited to:
- Life Insurance companies
- Workers Compensation
- Agencies that administer and provide Social Security and Welfare benefits
- Automobile insurance plans that include health benefits
- Internet self-help sites
- Entities that collect health data that you willingly furnish for surveys or research
- Screening services at pharmacies, shopping centers, or other public place for blood pressure, cholesterol, spine, etc.
- Researchers who obtain health data directly from providers
- Law enforcement agencies
Require the entity to sign a liability agreement binding them to HIPAA privacy laws. To further alleviate physician concern about potential violation of patents' rights, select an EHR system with a compliance program and enforce it vigorously.
A thoughtful, comprehensive approach to EMR/EHR implementation will assist your organization in overcoming barriers and result in a better outcome for your system.
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