Inside Scoop | Leadership

Key Factors That Affect EHR Implementation

  • Electronic health records have evolved to ease the process of researching information, patient demographics, physician orders, lab results, and so much more. 
  • Transitioning from paper to EHR implementation is a huge process, involving many steps of planning, organizing, and ultimately integration. 
  • In order to have a successful, seamless transition during EHR implementation, it is important to consider both a variety of organizational and human factors while planning the change. 

Amy White

MSN, RN – Chief Nursing Officer

July 25, 2022
Simmons University

In many parts of the US and other countries, healthcare providers are invested and committed to improving the quality and safety of care that is delivered to patients.  One of the ways to achieve this type of system is using electronic health records (EHR’s).   

Electronic medical records are designed to manage both information processing and distribution of this information including patient care records, patient demographics, laboratory results, physician orders, and even certain billing sources.   

It is naive for one to think that technology alone is sufficient for ensuring that potential benefits are achieved successfully in terms of effectiveness, efficiency, and quality of care. One should be fully aware that technology itself can encounter many malfunctions and disruptions that will need to be addressed.  

Due to these occurrences, some are resistant about EHR implementation for fear of the unraveling negative events that may occur.  Contrary, many organizations are eager to implement EHR’s due to the capabilities of enabling physicians to record patient histories, write prescriptions, enter orders, display test results, receive clinical reminders, and print patient instructions and educational materials.   

For EHR implementation to be effective, it is essential that administrators and planners understand the importance of both the human and organizational processes involved any time change is initiated. 

It is important to fully understand the following when considering EHR implementation: organizational factors, human factors, and other factors needed for successful EHR integration. 

EHR implementation barriers

Organizational Factors Involved with EHR Implementation

The widespread adoption of electronic medical records is important for maintaining patient care, but many times there are organizational contextual factors that affect the acceptance and adoption of EMR’s. 

Often times, factors such as management support, involvement of physicians, adequate training, autonomy among physicians, and the doctor-patient relationships serve as organizational factors that are found among facilities that implement EHRs.  If an organization lacks leadership or commitment among administration this factor alone can serve as a detriment to the implementation of EHRs.   

If a physician is not engaged and involved in the process of adoption, it makes it difficult for others to follow in acceptance.  The organization needs support from others at all different levels – executive, administrative, personnel, medical, and direct care staff in order to promote positive change.

Human Factors in EHR Implementation

Research from the Journal of the American Medical Informatics Association focus on how EHR’s vary in usage and how human factors along with specific standards contribute to patient safety.  

For human factors to be taken seriously, individuals must get actively involved in the design and implementation of EMR’s and usability flaws must be assessed.  Many times, usability flaws can have undesirable consequences on patient safety and organizations must have an accurate in-depth analysis.   

Human error can easily occur if the proper training has not been provided before, during, and after the transition of EHR implementation.  It is also imperative for organizations to realize that everyone has varying capabilities and levels of understanding when dealing with technology. What one individual grasps easily may be complicated for another.  

Due to this, it is crucial that an organization focus on training at varying levels for individuals that may need more hands-on training with utilization of the technology versus those that need more refreshers.  

It is extremely difficult to implement a new design or EHR when appropriate training has not been offered during all phases of the transition – before, during, and after EHR implementation. 

EHR implementation concerns

Other Factors in EHR Implementation

The most significant barriers that were noted with EHR’s include: lack of national standards, lack of funding, concerns about physician’s usage, technical issues, privacy and confidentiality, lack of informatics workforce, the exceeding number of vendors in the marketplace, attitude/behaviors of individuals, resistance to change, and lack of interoperability.   

Many of the healthcare organizations contend that EHR’s are a huge investment and can be more difficult to use than paper-based records. This often reduces productivity and can become a disturbance in workflow until the individuals become accustomed to using the systems.  There are many advantages of EHR’s, but there are also disadvantages that must be evaluated before EHR implementation is initiated.  

Despite the effectiveness and potential benefits, EHR implementation can be faced with many barriers and restrictions.  Each organization must carefully review the pros and cons of an EHR system in order to fully determine if this type of system will be the most beneficial for that particular organization. 


EHR implementation factors

The Bottom Line

Healthcare employees may experience great resistance to change and possess negative attitudes about the new system, so it is imperative that employees understand the rationales for implementing a new system and the benefits that will be produced both short-term and long-term.   

It is key that employees understand the support that will be provided if they experience difficulties or cannot retrieve the system due to technical issues. However, the importance and value of EHR’s can be emphasized and compared to other organizations that have already done EHR implementation and the overall benefits gained. 

Many times, a new system such as an EMR does not seem appealing at first because it is a change from the ordinary, but after much time and usage, the benefits can be seen more clearly, and the determination can be made if implementation has been effective.   

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