NURS 601B Week 5 Assignment APRN Bridge course

The Institute of Medicine reported to Err is Human that building a Safer Health System cites one of the most extensive adverse drug event studies, the Harvard Medical Practice Study, and notes that 58 percent of adverse events due to errors in the study were preventable, 27.6 percent were due to negligence, and 19 percent were due to drug complications which were the most common adverse event. In order to: 1) reduce medical errors, 2) provide more effective methods of communicating and sharing information among clinicians, and 3) better manage patient medical records, we need to embrace information technology in healthcare. Since medical errors are a leading cause of death in the United States and since paper records can be easily lost, misplaced, or are often illegible, the use of electronic health record technology would eliminate many of these issues and lead to major improvements in the health and safety of patient care ().

Electronic Medical Records (EMRs) are computerized medical information systems that collect, store and display patient information. They are means to create legible and organized recordings and to access clinical information about individual patients. The EMRs and Electronic Health Records (EHRs) are viewed as interchangeable synonyms in most health informatics. Other similar expressions exist albeit with a sometimes slightly restricted focus ().

The Institute of Medicine and others have suggested that the wide-scale adoption of the EHRs could be pivotal for improving patient safety and health care quality. EHRs may also reduce the costs of providing ambulatory care. However, despite emerging evidence about the benefits of EHRs, there are considerable barriers to adoption ().

The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted. Physicians have a central role in the use of the EHRs, as they are who provide much of the information that the systems handle in their automated processes ().

Despite broad agreement on the benefits of electronic health records and other forms of health information technology, health care providers have moved so slowly to adopt these technologies. Lack of readiness causes weakness of organization to undergo transformation during the implementation of the EHRs (). According to Meinert, the slow rate of adoption suggests that resistance among physicians must be strong because physicians are the main frontline user-group of EMRs. Whether or not they support and use EMRs will have a great influence on other usergroups in a medical practice, such as nurses and administrative staff. As a result, physicians have a great impact on the overall adoption level of EMRs ().

Mille and Sim stated that based on a qualitative study of physician practices that had implemented an EMR, quality improvement depends heavily on physicians’ use of the EMR and not paper for most of their daily tasks (). The adoption and meaningful use of electronic health records (EHRs) is a major US national policy priority for improving the quality and efficiency of the healthcare system. This topic has received bipartisan support and led to the US Congress allocating close to $30 billion in 2009 to promote adoption of interoperable, certified the EHRs ().

According to Randeree, as technology continues its impact in healthcare, the adoption of new IT options has been able to reduce costs and increase efficiencies. Health care professionals now turn to various patient-centric technologies, including computerized patient records (CPR), document management systems, data warehouses, point-of-care applications, distributed networks, and telematics (Telematics typically is any integrated use of telecommunications and informatics, also known as ICT (Information and Communications Technology), to provide the information they need when they need it ().

Simon et al. argued that physicians who had adopted an EHR consistently reported more positive views of the potential effect of computers on health care than physicians who did not yet ().

Miscommunication, misinformation and misinterpretation between vendors, clinic executives, IS leaders, and end-users (physicians and staff) has contributed to a myriad of problems in the marketing, selection, implementation and utilization of the EMRs ().

The aim of this study was, to identify and discuss about barriers for adopting Electronic Health Records (EHRs) by physicians.

2. METHODS

This study was un-systematic review which the literature on physicians’ resistance in adoption of Electronic Health Records on a formal research framework. We used a sub-systematic method, which was divided into three phases: literature collection, assessing, and selection. The literature search was conducted The literature was searched on barriers perceived by physicians to the adoption of the EHRs with the help of library, books, conference proceedings, data bank, and also searches engines available at Google, Google scholar. For our searches, we employed the following keywords and their combinations: Physicians, electronic medical record, electronic health record, barrier, adoption in the searching areas of title, abstract and full text.

More than 100 articles were collected. After exclude duplicated articles, some articles were excluded base on the following criteria: 1) article related to barriers linked to physicians no to other medical staff, 2) article focused on EHR, not involving other electronic systems. After filtering 27 articles were selected. We investigated all of them to identified barriers to the acceptance of EHRs by physicians. Then we studied how these barriers affect on physicians’ resistance using EHR. Finally we proposed some useful interventions that can act as references for implementers of Electronic Health Records.