Perceptions Regarding Electronic Health Record Implementation among Health Information Management Professionals in Alabama: A Statewide Survey and Analysis

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Perceptions Regarding Electronic Health Record Implementation among Health Information Management Professionals in Alabama: A Statewide Survey and Analysis

Introduction

This paper describes the results of a survey performed in Alabama in the pre-HITECH era regarding perceptions of electronic health record (EHR) implementation. The goals were to learn: • status of implementation of EHRs throughout the state of Alabama • factors associated with choosing to implement an EHR • perceived benefits, risks, and barriers to EHR implementation

Background

As one of the poorest states in the country, Alabama faces many health challenges associated with the low socioeconomic status of its residents. Also, 45% of the population lives in rural areas, which creates further barriers to access to healthcare. The researchers believe that EHR implementations can improve care in Alabama through increased availability of records and improved continuity of care.

Methods

Surveys, based on the Medical Record Institute’s annual survey of EHR trends, were sent to each hospital in Alabama. The survey asked about the status of the facility’s EHR implementation, roles of decision-makers, especially those within the health information management (HIM) department, the driving factors and perceived risks, benefits and barriers to implementation. Questions were mostly closed-ended with some fill-in-the-blank type questions.

Results

The survey received a 69% response rate with 93% of respondents being HIM directors. Just over half of the respondents had little or some input in the selection of the EHR. At the time of the survey, only 12% of the hospitals had actually implemented an EHR while 36% of respondents were in the process of implementing an electronic system. Implementation drivers cited included: • improve clinical processes or workflow efficiency • need to share information more broadly • need to improve healthcare quality These responses were consistently among the top three for all respondents (ie, those who had and had not implemented EHRs). For those facilities that had implemented an EHR, they were more likely to cite cost reductions in the HIM department as a driving factor. Among benefits cited, 93% of respondents felt the EHR would improve workflow. Other benefits mentioned in the survey included: • reduced medical errors • reduced cost and treatment time • increased revenue • improved continuity of care Overwhelmingly, the respondents felt that the largest barrier to implementation was lack of funds and insufficient resources. Other barriers included lack of: • knowledge of EHRs • support from medical staff • structured technology • employee training

Discussion

This survey, taken in the pre-HITECH era, sought to better understand the barriers to EHR implementation among hospitals throughout Alabama. In this study, rural hospitals lagged behind suburban and urban facilities in their overall adoption of electronic records. Previous studies have identified factors that influence EHR adoption, including financial incentives and barriers, laws and regulations, the state of the technology and organizational culture. This survey showed similar responses but financial barriers were the single largest hindrance to technology adoption in Alabama.

Conclusion

At the time of this study, nearly half of Alabama’s hospitals, including private, governmental, for-profit and teaching hospitals, had not implemented EHRs, although many were in the process of doing so. The low socioeconomic status of many of its residents increase the barriers to quality healthcare, which could be partially alleviated through technology, but the lack of resources also impacts the state’s ability to counter these effects. Among the respondents, HIM directors had very little or only some impact on the selection and implementation of EHRs.

Comments

This study showed that among those hospitals in the process of selecting and implementing an EHR, there did not appear to be an inclusive, interdepartmental approach. Many of the respondents felt that their hospital lacked both financial and human resources as well as technical skills to begin selection and implementation. I was hoping this paper would include more discussion on the selection process and the personnel involved in the process.

Perceptions Regarding Electronic Health Record Implementation among Health Information Management Professionals in Alabama: A Statewide Survey and Analysis: Second Review


Introduction

The article shows the transition to the International Classification of Diseases, Tenth Revision code set. The purpose of this study was to show the issues faced while transitioning to this new code set. The experience gained from this study can serve as a resources for anyone needing assistance in their own transition.

Methods

This study was conducted at Georgetown University. The groups were mixed with undergraduate and graduate students from the Department of Health Systems Administration. These students were paired with professionals from a consulting firm to conducts interviews with seven healthcare organizations To asked questions on the impact of the transition. Questions on subjects like organizational awareness, leadership support as well as other things were all asked in the survey.

Results

The study showed that the healthcare providers that were interviewed during this survey were in the process of making people in their organization aware of the transition. Most of the providers were very aware of the development of the ICD-10 transition. Most of the organizations had made budgets for the transition, with almost all of them agreeing that the training for this transition would be the most costly part of this process. Some of the challenges faced in this transition were getting physicians on board with the new system, as well as dealing with the loss of productivity due to the training.

Conclusion

The survey fulfilled the purpose of identifying the issues and challenges that the health organizations faced during their transition. One the issues faced during the survey was the variety of answers that each organization gave during the survey. Although they were legitimate concerns, the concerns were unique to that particular organization. With some of the organizations not revealing their identity during the survey there was no way to tell that if those concerns were something that others may face, or if it was unique to that particular organization.


References

Houser, S. H., & Johnson, L. A. (2008). Perceptions Regarding Electronic Health Record Implementation among Health Information Management Professionals in Alabama: A Statewide Survey and Analysis. Perspectives in Health Information Management / AHIMA, American Health Information Management Association, 5, 6. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2394577/