Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Saturday, February 13, 2010

Great Summary of the Barriers to Health IT.

The US uber Health CIO –Jon Halamka has been doing a bit of Harvard research and teaching.

He wrote up one of the more interesting outcomes a few days ago.

Blog: The top 10 barriers to EHR implementation

February 02, 2010 | John Halamka, MD, CIO, CareGroup Health System, Harvard Medical School

Last week I taught Module II of Leadership Strategies for Information Technology in Healthcare at the Harvard School of Public Health.

My students included administrators, clinicians, CIOs, CMOs, and policymakers.

On the first day, I gave them a homework assignment - read my overview of the BIDMC/BIDPO EHR implementation project and then develop a list of barriers to EHR implementation in their organizations.

Here's the crowd sourcing results of the top 10 barriers to successfully deploying an EHR:

10. Usability - products are hard to use and not well engineered for clinician workflow.

9. Politics/naysayers - every organization has a powerful clinician or administrator who is convinced that EHRs will cause harm, disruption, and budget disasters.

8. Fear of lost productivity - clinicians are concerned they will lose 25% of their productivity for 3 months after implementation. Administrators are worried that the clinicians are right.

7. Computer Illiteracy/training - many clinicians are not comfortable with technology. They are often reluctant to attend training sessions.

6. Interoperability - applications do not seamlessly exchange data for coordination of care, performance reporting, and public health.

5. Privacy - there is significant local variation in privacy policy and consent management strategies/

4. Infrastructure/IT reliability - many IT departments cannot provide reliable computing and storage support, leading to EHR downtime.

3. Vendor product selection/suitability - it's hard to know what product to choose, particularly for specialists who have unique workflow needs

2. Cost - the stimulus money does not flow until meaningful use is achieved. Who will pay in the meantime?

1. People – it’s hard to get sponsorship from senior leaders, find clinician champions, and hire the trained workers to get the EHR rollout done. (this was the #1 concern by far)


John Halamka, MD, blogs regularly at Life As a Healthcare CIO.

For the key list of 10 random but associated ideas from the session go here:


Sadly this list misses out on what I think are the biggest issues in Australia, mainly because they have been addressed as far as this group are concerned.

They are, as everyone knows by now, political commitment, skilled leadership, appropriate funding and a sensible well designed incentive program to achieve clinician adoption.

The US has made a serious attempt at these – we are sadly yet to start.


1 comment:

Anonymous said...

Hi David,

I agree with your comments particularly in relation to the need for incentives for Australia.

I had the fortune of attending this Harvard course, which concludes in May with the final two modules. As the only Aussie on this course my perspectives were somewhat different to the US where the Recovery Act health IT funding and 'meaningful use' is all consuming.

In my top 10 challenges (relevant to my organisation), I also listed:
. governance of clinical data
. measuring and communicating benefits
. evolving IT service delivery models to meet changes in demand and expectations
. engaging VMOs (private specialists) in private hospitals
. embedding EMR training into hospital teaching programmes for medical students and registrars involving short rotations.