Overcoming Barriers to Experience Benefits: A Qualitative Analysis of Electronic Health Records and Health Information Exchange Implementation in Local Health Departments

Abstract

Introduction: Electronic Health Records (EHRs) and Health Information Exchanges (HIEs) are changing surveillance and analytic operations within local health departments (LHDs) across the United States. The objective of this study was to analyze the status, benefits, barriers, and ways of overcoming challenges in the implementation of EHRs and HIEs in LHDs. Methods:This study employed a mixed methods approach, first using the 2013 National Profile of LHDs survey to ascertain the status of EHR and HIE implementation across the US, as well as to aid in selection of respondents for the second, interview-based part of project. Next, forty-nine key-informant interviews of local health department staff were conducted. Data were coded thematically and independently by two researchers. Coding was compared and re-coded using the consensus definitions.Results: Twenty-three percent of LHDs nationwide are using EHRs and 14 percent are using HIEs. The most frequently mentioned benefits for implementation were identified as care coordination, retrieval or managing information, and the ability to track outcomes of care. A few mentioned barriers included financial resources, resistance to change, and IT related issues during implementation.Discussion: Despite financial, technical capacity, and operational constraints, leaders interviewed as part of this project were optimistic about the future of EHRs in local health departments. Recent policy changes and accreditation have implications of improving processes to affect populations served. Conclusions:Overcoming the challenges in implementing EHRs can result in increased efficiencies in surveillance and higher quality patient care and tracking. However, significant opportunity cost does exist.

Understanding health information management practices in public hospitals in Kuwait

“…To achieve these targets, the successful and effective adoption of health information technology (IT) solutions, such as electronic health records (EHRs), by healthcare institutions becomes paramount (Buntin et al, 2010; Koru et al, 2016). These solutions can enable the healthcare organisation to better manage the information and improve care coordination among healthcare providers (Williams et al, 2017). Additionally, health IT solutions can collect and monitor dynamic quality measures over time (Buntin et al, 2010) as well as eliminate duplication and waste in healthcare by making the results of prior diagnostic tests and interventions available at all points of care (Koppel et al, 2005).…”

Staff expectations for the implementation of an electronic health record system: A qualitative study using Normalisation Process Theory

“…Global evidence exists for the potential impact of EHR implementations to improve record quality, increase administration efficiency, and support better quality, safety and coordination of care [1,3,4]. However, there is growing recognition that implementing an EHR across complex hospital care systems remains a major challenge world-wide [1,[5][6][7][8][9][10], with it estimated that more than half of all systems fail, or fail to be properly utilised [11]. Progress in EHR implementation in the United Kingdom (UK) secondary care hospitals has been particularly slow [11][12][13][14][15], with previous negative experiences contributing to a disengaged workforce.…”

Staff expectations for the implementation of an electronic health record system: A qualitative study using Normalisation Process Theory

“…Global evidence exists for the potential impact of EHR implementations to improve record quality, increase administration efficiency, and support better quality, safety and coordination of care (1,3,4). However, there is growing recognition that implementing an EHR across complex hospital care systems remains a major challenge world-wide (1,(5)(6)(7)(8)(9)(10), with it estimated that more than half of all systems fail, or fail to be properly utilised (11).…”