John Halamka, MD, is Chief Information Officer of Beth Israel Deaconess Medical Center and Chief Information Officer at Harvard Medical School. He recently asked his students of his healthcare I.T. class at Harvard to read his EHR implementation project and “then develop a list of barriers to EHR implementation in their organizations.” The result was the following top 10 barriers to successfully deploying an EHR:
10. Usability – products are hard to use and not well engineered for clinician workflow.
9. Politics/naysayers – every organization has a powerful clinician or administrator who is convinced that EHRs will cause harm, disruption, and budget disasters.
8. Fear of lost productivity – clinicians are concerned they will lose 25% of their productivity for 3 months after implementation. Administrators are worried that the clinicians are right.
7. Computer Illiteracy/training – many clinicians are not comfortable with technology. They are often reluctant to attend training sessions.
6. Interoperability – applications do not seamlessly exchange data for coordination of care, performance reporting, and public health.
4. Infrastructure/IT reliability – many IT departments cannot provide reliable computing and storage support, leading to EHR downtime.
3. Vendor product selection/suitability – it’s hard to know what product to choose, particularly for specialists who have unique workflow needs
2. Cost – the stimulus money does not flow until meaningful use is achieved. Who will pay in the meantime?
1. People – its’s hard to get sponsorship from senior leaders, find clinician champions, and hire the trained workers to get the EHR rollout done. (this was the #1 concern by far)
If you want to read more about the study, take a look at Dr. Halamka’s overview of the BIDMC/BIDPO EHR implementation project. Dr. Halamka writes for his blog, Life as a Healthcare CIO.