October 25, 2004
JAMIA Reviews Issues in EHR Adoption
Several articles published last week in the Journal of the American Medical Informatics Association (JAMIA) examine ways to boost expansive adoption of electronic health records.
The first article traces the history of EHR adoption in the United States since the 1960s. According to the article, "prospects seem good for widespread use of EHRs in the U.S." The authors suggest that considerable effort will be required to overcome resistance to making such a fundamental change" in health care.
Another article states that "the single most important barrier" to implementing EHRs is a "misalignment" of financial incentives from returns on investment from an EHR or computerized physician order entry system. The article also looks at several trends affecting EHR system adoption, including environmental, organizational, personal and technical issues. Organizational factors present "significant" barriers to EHR implementation as they pose a financial risk as well as "great social and behavioral risks," according to the article. The article states that "physicians are not resistant to technology" but notes that they are "reluctant" to adopt methods that impede their work flow or detract from their time with patients.
Although technology "facilitates patient care enormously" by providing clinicians with the ability to remotely enter orders and check results, interoperability and privacy issues present significant barriers to implementation of EHR and CPOE systems.
A separate article presents four recommendations on how to spur EHR adoption by providing market incentives; setting and adopting EHR functional and informatics standards; creating EHR adoption policies; and providing educational, marketing and supporting activities.
The authors suggest that it is import to reward providers directly and indirectly for using health IT. Some of the ways include low-interest loans or one-time grants to help them adopt technology. There are also suggestions for implementing an EHR certification process and lowering the price of technological devices.
Posted by rsk at October 25, 2004 09:13 AM