Basically EHR is just like a ticking time bomb. Why do we say it is a time bomb? It's because like any typical software,then it is no guarantee that it will not be crashed,hacked,being infected with virus & other software complications.When that happens, the so called time bomb explodes causing damages & distress seen as data loss,cost of repair,cost of time & social arrest.At the end of the day it is a total system breakdown.
- Excessive cost-Due to the high usage of electricity, maintenance & repair works in which needs to keep the EHR functioning. Also medical personnel have to go for IT courses to keep intouch of the new technology. Even setting up a program costs approximately 1/2 million dollars. For example: Just imagine that the "PDA accidentally thrown or dropped into toilet bowl.Imagine the cost of repairing the damages of any electronic devices or even getting it replaced with the new one.
- Time consuming - Once device/system breaks down there is loss of productivity.Time is being taken up for repair;basically we have to wait for the system or devices to be operational again.Not only that, doctors or nurses still uses pens & paper to scribble the results values in which data transferring causing double entry & time were wasted.
- Disrupt care between the patient & health care professionals - Generally the observation & feedback from medical staff, patient & relatives remark that doctors pay less attention towards patient feelings & problems.They are more concern about keying data into the system.This causes the loss of therapeutic touch as doctors become more factual rather than then having good rapport within patient themselves.Just like the picture above which depicts the doctor idling away & have no eye contact involvement or acknowledge to wards her patient commonly seen at A & E.
- Dependence on software- The new generations of nurses or doctors may be depending on the system which may contains all the information rather than the older generations who prefer written work.What if the EHR systems is crashed & everything have to be done by writing. Maybe other healthcare professionals can't perform the simplest task without looking into the system example the hospital protocol.
- Difficulty in adding older records to EHR system- Surveys suggest 22-25% of physician are less satisfied with the record system that scanned documents which may due to the blurring images.For typed documents,accurate recognition may only achieved 90-95% in which requires extensive corrections.Furthermore,illegible handwriting is poorly recognized by optical readers which may lead to inaccurate information.
- Synchronization of record - When care is provided at 2 different facilities,it may be difficult to update records at the locations in a co-ordinate manner. Synchronization programs for distributed storage are only useful when record of standardization has occurred.Long term storage of EHR are complicated by the possibility that the records might one day be longitudinally & integrated across sites of care.
- Employee Acceptance & Adaptation -Electronic documentation systems maybe designed for people with technical skills. A computer technician knows the system well because it works technogically maybe unusable to clinician. Nursing are more increasingly more comfortable with complicated equipment that is use to care for clients. Therfore with this new technology, nurses are unwilling to accept EHR. On top of their busy schedule, they have to find a suitable timing (sometimes after work/when they are off duty) to attend to the traning for the new system.And thus these factors affect employee acceptance & adaptation.
- System can be confusing - EHR is not only system that is adopted in hospital. Another system is known as EMR (Electronic Medical Record). EHR holds all of a patient information while EMR is the specific patient information from one healthcare provider. These differences will confuse the healthcare workers.
- Slow data entry - Many health care systems care being convert from paper to EHR.How many nurses are good in typing? We, ourselves are not good in typing and still using one finger at a time to type. Lastly, most doctors & nurses are better in writing then typing, therefore these factors makes slow data entry.
- Loss or corruption of data - Even with good data back-up and anti-virus protection,system failures do occur making data inaccessible for doctors or nurses.As in the pictures above, the "surgeon" is trying to fix the computer brain, so that the system is able function again but this will take up time and cost and it won't give 100% that the data of patient will be retrieve.With the loss or corruption of data , we can't implement care to patient because we have lack of information example patient haa a condition that needs attention so the doctor will tend to refer to older records for references.Because of the technical problems, there will be delay in treatment.Old notes(paper format) are still needed so if there is loss or corruption of data, the doctors or nurses able to refer to them instead of wasting time waitng for the system to restart again.
- Security concerns - Exposing patient's privacy & confidentiality.With centralized & distributed databases & linkages between the various electronic systems, the chances of unauthorized person or known as hackers may gain access to large volume of patient's information despite security precautions.And due to these, the hackers may then release confidential information to others or even carry out crimes..For example: The hackers may make a threat to the patient in exposing his conditions such as HIV, to the loved ones.There is another risk of internal hackers such people within the healthcare settings who makes use of EHR to obtain information that is not health related.
- Confidentiality -Healthcare professionals may makes full use of EHR to obtain medical reports eventhough a particular staff is not in charge of the patient for certain benefits.As in the past, medical reports (past & present) are only obtained by doctors or nurses, but now everyone in healthcare settings are able to. So the risk of exposing patient confidentiality is high.