Barriers for Adopting Electronic Health Records (EHRs) by Physicians
Identifieur interne : 000010 ( Pmc/Curation ); précédent : 000009; suivant : 000011Barriers for Adopting Electronic Health Records (EHRs) by Physicians
Auteurs : Sima Ajami ; Tayyebe Bagheri-TadiSource :
- Acta Informatica Medica [ 0353-8109 ] ; 2013.
Abstract
CONFLICT OF INTEREST: NONE DECLARED
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. Despite of the positive effects of the EMRs usage in medical practices, the adoption rate of such systems is still low and meets resistance from physicians. The EHRs represent an essential tool for improving both in the safety and quality of health care, though physicians must actively use these systems to accrue the benefits. This study was unsystematic-review.
The aim of this study was to express barriers perceived y physicians to the adoption of the EHRs.
This study was non-systematic reviewed which the literature was searched on barriers perceived by physicians to the adoption of Electronic Health Records (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, and adoption in the searching areas of title, keywords, abstract, and full text. In this study, more than 100 articles and reports were collected and 27 of them were selected based on their relevancy. Electronic health record use requires the presence of certain user and system attributes, support from others, and numerous organizational and environment facilitators.
Url:
DOI: 10.5455/aim.2013.21.129-134
PubMed: 24058254
PubMed Central: 3766548
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<author><name sortKey="Ajami, Sima" sort="Ajami, Sima" uniqKey="Ajami S" first="Sima" last="Ajami">Sima Ajami</name>
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<author><name sortKey="Bagheri Tadi, Tayyebe" sort="Bagheri Tadi, Tayyebe" uniqKey="Bagheri Tadi T" first="Tayyebe" last="Bagheri-Tadi">Tayyebe Bagheri-Tadi</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Barriers for Adopting Electronic Health Records (EHRs) by Physicians</title>
<author><name sortKey="Ajami, Sima" sort="Ajami, Sima" uniqKey="Ajami S" first="Sima" last="Ajami">Sima Ajami</name>
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<author><name sortKey="Bagheri Tadi, Tayyebe" sort="Bagheri Tadi, Tayyebe" uniqKey="Bagheri Tadi T" first="Tayyebe" last="Bagheri-Tadi">Tayyebe Bagheri-Tadi</name>
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<front><div type="abstract" xml:lang="en"><p>CONFLICT OF INTEREST: NONE DECLARED</p>
<sec><title>Introduction</title>
<p>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. Despite of the positive effects of the EMRs usage in medical practices, the adoption rate of such systems is still low and meets resistance from physicians. The EHRs represent an essential tool for improving both in the safety and quality of health care, though physicians must actively use these systems to accrue the benefits. This study was unsystematic-review.</p>
</sec>
<sec><title>Aim</title>
<p>The aim of this study was to express barriers perceived y physicians to the adoption of the EHRs.</p>
</sec>
<sec><title>Method of the study</title>
<p>This study was non-systematic reviewed which the literature was searched on barriers perceived by physicians to the adoption of Electronic Health Records (EHRs) with the help of library, books, conference proceedings, data bank, and also searches engines available at Google, Google scholar.</p>
</sec>
<sec><title>Discussion</title>
<p>For our searches, we employed the following keywords and their combinations: physicians, electronic medical record, electronic health record, barrier, and adoption in the searching areas of title, keywords, abstract, and full text. In this study, more than 100 articles and reports were collected and 27 of them were selected based on their relevancy. Electronic health record use requires the presence of certain user and system attributes, support from others, and numerous organizational and environment facilitators.</p>
</sec>
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<pmc article-type="other"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Acta Inform Med</journal-id>
<journal-id journal-id-type="iso-abbrev">Acta Inform Med</journal-id>
<journal-id journal-id-type="publisher-id">AIM</journal-id>
<journal-title-group><journal-title>Acta Informatica Medica</journal-title>
</journal-title-group>
<issn pub-type="ppub">0353-8109</issn>
<issn pub-type="epub">1986-5988</issn>
<publisher><publisher-name>AVICENA, d.o.o., Sarajevo</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24058254</article-id>
<article-id pub-id-type="pmc">3766548</article-id>
<article-id pub-id-type="doi">10.5455/aim.2013.21.129-134</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Paper</subject>
</subj-group>
</article-categories>
<title-group><article-title>Barriers for Adopting Electronic Health Records (EHRs) by Physicians</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ajami</surname>
<given-names>Sima</given-names>
</name>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Bagheri-Tadi</surname>
<given-names>Tayyebe</given-names>
</name>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
</contrib-group>
<aff>Department of Health Information Technology, Health Management & Economics Research Center,<institution>School of Medical Management and Information Sciences, Isfahan University of Medical Sciences</institution>
,<addr-line>Isfahan, Iran</addr-line>
</aff>
<author-notes><corresp id="cor1"><bold>Corresponding author: Tayyebe Bagheri-Tadi. School of Medical Management and Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail: bagheri774@yahoo.com.</bold>
</corresp>
</author-notes>
<pub-date pub-type="epub"><month>6</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub"><year>2013</year>
</pub-date>
<volume>21</volume>
<issue>2</issue>
<fpage>129</fpage>
<lpage>134</lpage>
<history><date date-type="received"><day>15</day>
<month>1</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>26</day>
<month>3</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>© 2013 AVICENA</copyright-statement>
<copyright-year>2013</copyright-year>
<copyright-holder>AVICENA, d.o.o., Sarajevo</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<uri xlink:type="simple" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</uri>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>CONFLICT OF INTEREST: NONE DECLARED</p>
<sec><title>Introduction</title>
<p>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. Despite of the positive effects of the EMRs usage in medical practices, the adoption rate of such systems is still low and meets resistance from physicians. The EHRs represent an essential tool for improving both in the safety and quality of health care, though physicians must actively use these systems to accrue the benefits. This study was unsystematic-review.</p>
</sec>
<sec><title>Aim</title>
<p>The aim of this study was to express barriers perceived y physicians to the adoption of the EHRs.</p>
</sec>
<sec><title>Method of the study</title>
<p>This study was non-systematic reviewed which the literature was searched on barriers perceived by physicians to the adoption of Electronic Health Records (EHRs) with the help of library, books, conference proceedings, data bank, and also searches engines available at Google, Google scholar.</p>
</sec>
<sec><title>Discussion</title>
<p>For our searches, we employed the following keywords and their combinations: physicians, electronic medical record, electronic health record, barrier, and adoption in the searching areas of title, keywords, abstract, and full text. In this study, more than 100 articles and reports were collected and 27 of them were selected based on their relevancy. Electronic health record use requires the presence of certain user and system attributes, support from others, and numerous organizational and environment facilitators.</p>
</sec>
</abstract>
<kwd-group><title>Key words</title>
<kwd>physicians</kwd>
<kwd>electronic health record</kwd>
<kwd>barrier</kwd>
<kwd>adoption</kwd>
</kwd-group>
<counts><fig-count count="0"></fig-count>
<table-count count="1"></table-count>
<equation-count count="0"></equation-count>
<ref-count count="27"></ref-count>
<page-count count="6"></page-count>
</counts>
</article-meta>
</front>
<floats-group><table-wrap id="table001" orientation="portrait" position="float"><label>Table 1.</label>
<caption><p>Some experienced barriers to Adopt EHRs by physicians</p>
</caption>
<table frame="box" rules="all"><thead><tr><th align="left" rowspan="1" colspan="1">Title</th>
<th align="left" rowspan="1" colspan="1">Author</th>
<th align="left" rowspan="1" colspan="1">Expected or experienced barriers</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">What factors affect the use of electronic patient records by Irish GPs?</td>
<td align="left" rowspan="1" colspan="1">Meade B et al. (10)</td>
<td align="left" rowspan="1" colspan="1">Lack of time;<break></break>
Lack of financial resources;<break></break>
Absence of computer skills;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Results of a survey of an online physician community regarding use of the EMRs in office practices.</td>
<td align="left" rowspan="1" colspan="1">Ross (11)</td>
<td align="left" rowspan="1" colspan="1">High cost;<break></break>
Loss of autonomy;<break></break>
Workflow disruption.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Correlates of EHRs Adoption in Office Practices: A Statewide Survey</td>
<td align="left" rowspan="1" colspan="1">Simon et al. (3)</td>
<td align="left" rowspan="1" colspan="1">Start-up financial costs;<break></break>
Ongoing financial costs;<break></break>
Loss of productivity.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Doctors' use of the EMRs systems in hospitals: cross sectional survey</td>
<td align="left" rowspan="1" colspan="1">Lærum et al. (12)</td>
<td align="left" rowspan="1" colspan="1">Access to computers and computer literacy;<break></break>
Flexibility of paper records;<break></break>
Traditional work routines.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">A knowledge-based taxonomy of critical factors for adopting EHR systems by physicians: a systematic literature review</td>
<td align="left" rowspan="1" colspan="1">Castillo et al. (4)</td>
<td align="left" rowspan="1" colspan="1">User attitude towards;<break></break>
information systems Workflow impact;<break></break>
Interoperability;<break></break>
Technical support;<break></break>
Communication among users;<break></break>
Expert support.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">If the EMRs are so great, Why family physicians don't use them?</td>
<td align="left" rowspan="1" colspan="1">Loomis et al. (13)</td>
<td align="left" rowspan="1" colspan="1">Data entry;<break></break>
Less confidence in the security and confidentiality;<break></break>
Concern about the cost for installation and ongoing usage of EMRs.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Primary Care Physicians' Experience with EMRs: Barriers to Implementation in a Fee-for-Service Environment</td>
<td align="left" rowspan="1" colspan="1">Ludwick et al. (14)</td>
<td align="left" rowspan="1" colspan="1">Training and after-sales experience with the vendor;<break></break>
Technical support from the vendor;<break></break>
Extra time needed for data entry;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><break></break>
</td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Time constraint in procurement and<break></break>
Implementation;<break></break>
Computer skills of the physicians;<break></break>
Disruption of the flow of information.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Use of EMRs in Oman and Physician Satisfaction</td>
<td align="left" rowspan="1" colspan="1">Farsi (15)</td>
<td align="left" rowspan="1" colspan="1">Malfunction;<break></break>
Concern about privacy;<break></break>
Cost.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">An organizational learning perspective on the assimilation of the EMRs among small physician practices</td>
<td align="left" rowspan="1" colspan="1">Reardon et al. (16)</td>
<td align="left" rowspan="1" colspan="1">Investment cost;<break></break>
Productivity loss;<break></break>
Lack of financial incentives.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">System downtime;<break></break>
Increase in physician workload;<break></break>
Providers have inadequate computer skills;<break></break>
Increase in staff workload;<break></break>
Staff have inadequate computer skills;<break></break>
Patient confidentiality;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Adoption of EHRs in Primary Care Pediatric Practices</td>
<td align="left" rowspan="1" colspan="1">Kernper et al. (17)</td>
<td align="left" rowspan="1" colspan="1">Expense of implementation:<break></break>
Lack of clear return on investment;<break></break>
No improvement in patient care or clinical outcomes;<break></break>
Interference with doctor-patient relationship;<break></break>
Inability to find an EHRs that meets the pediatric<break></break>
practice's requirements;<break></break>
Inability to interface with existing practice systems;<break></break>
Transience of vendors 70.1;<break></break>
Bad previous experience with EHRs.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">EHRs in small physician practices: Availability, use, and perceived benefits.</td>
<td align="left" rowspan="1" colspan="1">Rao et al. (7)</td>
<td align="left" rowspan="1" colspan="1">Capital needed to acquire and implement;<break></break>
Uncertainty about return on investment;<break></break>
Resistance to adoption from practice physicians;<break></break>
Capacity to select, contract and install the EHR;<break></break>
Concern about loss of productivity during transition;<break></break>
Concern about inappropriate disclosure of patient information;<break></break>
Concern about illegal record tampering/hacking;<break></break>
Concern about the legality of accepting the EHR from a hospital;<break></break>
Concern about physician's legal liability Finding an EHR that meets your needs;<break></break>
Concern that the system will become obsolete;</td>
</tr>
<tr><td rowspan="8" align="left" colspan="1">EHRs: Use, barriers and satisfaction among physicians who care for black and Hispanic patients</td>
<td rowspan="8" align="left" colspan="1">Jha et al. (18)</td>
<td align="left" rowspan="1" colspan="1">Computer skills of you and/or colleagues/staff;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Computer technical support;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Lack of time to acquire knowledge about system;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Start-up financial costs;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Ongoing financial costs</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Training and productivity loss;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Physician skepticism;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Privacy or security concerns;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Exploring Physician Adoption of EMRs: A Multi-Case Analysis</td>
<td align="left" rowspan="1" colspan="1">Randeree (8)</td>
<td align="left" rowspan="1" colspan="1">1) Cost;<break></break>
2) Increase in staff workload;<break></break>
2) Supplier presence;<break></break>
3) Vendor trust;<break></break>
4) Customizability;<break></break>
5) Reliability.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Physicians and EHRs A Statewide Survey</td>
<td align="left" rowspan="1" colspan="1">Simon et al. (19)</td>
<td align="left" rowspan="1" colspan="1">Costs;<break></break>
Quality of health care;<break></break>
Interactions with the health care team;<break></break>
Patient-physician communication;<break></break>
Patient privacy</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Adopting EMRs primary care: Lessons learned from health information systems implementation experience in seven countries</td>
<td align="left" rowspan="1" colspan="1">Ludwick et al. (20)</td>
<td align="left" rowspan="1" colspan="1">Privacy;<break></break>
Patient safety;<break></break>
Provider/patient relations;<break></break>
Staff anxiety;<break></break>
Time factors;<break></break>
Quality of care;<break></break>
Finances;<break></break>
Efficiency;<break></break>
Liability.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Physicians In Non-primary Care And Small Practices And Those Age 55 And Older Lag In Adopting EHR Systems</td>
<td align="left" rowspan="1" colspan="1">Decker et al. (21)</td>
<td align="left" rowspan="1" colspan="1">Practice size;<break></break>
Physician age;<break></break>
Ownership status;</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Physicians' Use Of EMRs: Barriers And Solutions</td>
<td align="left" rowspan="1" colspan="1">Miller et al. (6)</td>
<td align="left" rowspan="1" colspan="1">High initial financial costs;<break></break>
Slow and uncertain financial payoffs;<break></break>
High initial physician time costs;<break></break>
Difficulties with technology;<break></break>
Complementary changes and support;<break></break>
Electronic data exchange;<break></break>
Financial incentives.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Resistance Is Futile: But It Is Slowing the Pace of EHR Adoption Nonetheless</td>
<td align="left" rowspan="1" colspan="1">Ford et al. (22)</td>
<td align="left" rowspan="1" colspan="1">Uncertainty about implementation costs, causes and effects;<break></break>
Uncertainty about shifting standards;<break></break>
Uncertainty about potential policy interventions.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Resistance to EMRs:<break></break>
A Barrier to Improved Quality of Care</td>
<td align="left" rowspan="1" colspan="1">Meinert (5)</td>
<td align="left" rowspan="1" colspan="1">Learning curve;<break></break>
Impact on productivity<break></break>
Response time;<break></break>
Cost;<break></break>
Security;<break></break>
Patient acceptance;<break></break>
Privacy;<break></break>
Complexity;<break></break>
Training needs.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">What Stands in the Way of Technology-Mediated Patient Safety Improvements? A Study of Facilitators and Barriers to Physicians' Use of EHRs</td>
<td align="left" rowspan="1" colspan="1">Holden (23)</td>
<td align="left" rowspan="1" colspan="1">Learning;<break></break>
Typing proficiency;<break></break>
Understanding the EHR system;<break></break>
Motivation/initiative;<break></break>
Strategies/workarounds;<break></break>
Supporting hardware/software system;<break></break>
Speed;<break></break>
Functionality;<break></break>
Usability;<break></break>
Formal technical support;<break></break>
Formal training;<break></break>
Informal support from colleagues;<break></break>
Time allowance;<break></break>
Inter-institutional integration;<break></break>
Physical space;<break></break>
Electricity;<break></break>
Wireless connectivity;<break></break>
Social environment.</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</pmc>
</record>
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