REC: EHR implementation is a 'psychological roller coaster'

Electronic health record adoption is a "psychological roller coaster" for small physician practices, according to a report by the Washington Idaho Regional Extension Center (WIREC). The process involves unrealistic expectations that reach a peak right before implementation, a plunge into a "trough of disillusionment" and then a recovery phase involving a lot of hard work, according to WIREC officials.

The report, made public by the Office of the National Coordinator for Health IT late last week, outlines WIREC's experiences and challenges in helping its physicians adopt EHRs. WIREC delivers health IT consulting services to over 3,300 primary care providers in more than 630 locations. The average size of each practice is four providers.   

WIREC noted that some practices make errors that impede their implementation of EHRs and can mean the difference between EHR success and failure. The most common errors contributing to practice disruption include leadership issues, workflow issues, training issues, provider issues and data and user interface issues, according to the report.

"Healthcare organizations of all sizes encounter major challenges in the course of EHR implementation," WIREC officials said. "At its worst, these challenges result in wasted resources, frustrated or alienated providers, loss of confidence by patients and families and patient safety issues. The experience of the Regional Extension Centers has produced sufficient information to describe important patterns contributing to practice disruption that have emerged in smaller practices, many of which also apply to larger organizations."

The report provides recommendations to avoid or resolve common errors. The REC also suggests that practices conduct groundwork in advance of actual implementations, such as setting expectations, planning for change management and prepping for workflow changes.

Last summer, regional extension centers reported that many physicians still were encountering problems overcoming barriers to meeting the Meaningful Use requirements. The RECs reported 15,946 issues impacting 45,863 providers, and said that four key barriers included practice issues, vendor issues, attestation process problems and Meaningful Use measures.

To learn more:
- read the report