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Understanding EHR Adoption

August 31, 2021 - Parul Saini, Webmedy Team

Advanced technology like Electronic Health Records (EHR) has changed the way healthcare professionals operate. Gone are the days when medical records were mostly paper-based.

A recent article of the Journal of the American Medical Informatics Association highlighted that paper record-keeping was simple, accepted widely, and with a low cost of implementation. However, EHR can improve healthcare as paper records block healthcare services because of illegibility, high cost for storing files, and inconvenience to access files remotely. By implementing EHRs, physicians have organized records. Also, there is support for prescriptions, and orders to offer more efficient and quality patient care.

In this blog, you will get a brief about EHRs, their adoption, factors affecting the adoption of EHRs, and challenges regarding the adoption of EHRs.

What is EHR (Electronic Health Record)?

Are you wondering what is an EHR?. Standing for, Electronic Health Record, EHR is a collection of secure, real-time electronically stored health information records for a patient that make information available instantly and securely to authorized users. It is a digital version of a patient's paper chart and provides a comprehensive digital view of a patient's health history, diagnosis, allergies, medications, laboratory results, immunization dates, and more. These are instantly and easily accessible by authorized users for providing the right treatment in a hassle-free and time-saving manner.

Healthcare professionals are moving towards technology, and now numerous providers and health care facilities use an EHR. In 2017, according to the report of the National Coordinator of Health Information Technology, 86% of office-based doctors used EHRs.

Factors affecting adoption of EHRs

  • Social Influences

    Within technology acceptance research, social influence refers to the degree to which an individual perceives that most people who are important to him think he or she should use the new system. Many studies have demonstrated that social influence is a significant determinant of physicians' acceptance of EHR. Because physicians develop norms through professional socialization and have a strong bond with other physicians, physicians' decisions regarding EHR acceptance can be strongly influenced by their peers.

  • Computer Self-Efficacy

    Computer self-efficacy represents the self-evaluation by a person of his/her capacity to use the technology. Many studies reported the lack of physicians' ability and familiarity with computer technology to be a major obstacle hindering EHR acceptance and use.

  • Physician Participation

    Many studies reported that participation of healthcare professionals in the design of EHR or the implementation strategy were factors that contributed to successful implementation. In a study, it was founded that physician participation in the implementation process was significantly associated with psychological ownership of the system. This psychological ownership has a significant positive influence on the perception of the system's usefulness and ease of use. Consequently, involving physicians early in EHR selection and implementation could enhance the utility and usability of the system.

  • Confidentiality Concern

    Confidentiality concerns refer to the degree to which the physician believes that using EHR would impose risk to the confidentiality of patients' information. Many studies reported confidentiality of patient information to be a major obstacle impeding physicians and other healthcare professionals' acceptance of EHR and e-health technologies.

  • Investment Costs

    One aspect of adopting EHRs by physicians in small practices is the initial investment and continuous operational costs. The return on investment for an EHR system does not accumulate to the provider in the short run under many compensation schemes. Savings from advanced care performance and quality typically flow back to health care insurers or payers as a reduction in service use.

  • Vendor Failure

    Another significant obstacle to approval has been vendor transience, as early EHR companies are no longer in business or are in questionable financial positions. The adoption risk connected with vendor volatility could be mitigated if a common data model and uniform standards were achieved across the sector. There would yet be changeover costs in the case of vendor failure, but the initial cost of building the EHRs would not be lost. In addition to the financial costs, system changeovers negatively influence physicians' workflows and impact productivity.

  • Security and Privacy

    Security and privacy are important factors in the adoption of EHR and primary concerns in a healthcare organization. The need for physicians to have their patient information secure so that it cannot be accessed without permission is very demanding. Privacy improves the reliability of medical data and minimizes misuse by anyone.

  • Lack of Interoperability

    Interoperability is a determinant factor for adopting EHR systems. Interoperability could reduce rework by care providers and improve the dissemination and movement of new medical knowledge among physicians. Interoperability is important because it decreases the cost of electronic health records and makes it feasible for an individual or small group of physicians to acquire and adopt these systems.

Challenges in Adoption of EHR

Despite the positive results and effects of EHRs usage in healthcare, the adoption rate of EHRs is still very low, this is because hospitals and healthcare continuously face many challenges in adopting, maintaining their electronic health record systems. Challenges in the implementation of EHR can occur in different areas including problems such as training, data-sharing, lack of patient adoptions. Here are some of the challenges in the Adoption of EHR:

  • Time

    Many physicians having small practices admit that they fear losing their business as a result of their valuable time in deploying EHRs. Also, physicians fear putting additional time for data entry and record keeping.

  • Cost

    Few physicians don't have enough cash on hand to invest in an EHR system. Plus, there is an inability to calculate the total cost of training, support, and maintenance. For small practices, without enough IT budgets, the cost will always remain the biggest obstacle in the implementation of EHRs.

  • Interoperability

    Interoperability is the biggest challenge in the EHR space. Interoperability can reduce rework by physicians and also make it more feasible for small groups of doctors to adopt EHR with an assurance that their investment will be worthwhile and its system would be able to integrate and interoperate with other EHR systems.

  • Suitable Vendor

    One of the main challenges in the adoption of EHRs is the lack of technical training and support from vendors. Care providers are concerned that vendors are not suitable and qualified enough to offer proper service and technical support which results in a large financial loss. Adoption of Electronic Health records, just like any other technology depends on users that are willing to see how technology is useful and easily understood with little or no difficulty.

  • Training

    Hospital staff needs additional training related to the EHR practice management platform and its workflows. Efficiently training users and staff before and during the adoption of EHRs is important to reduce the challenges related to low productivity and avoiding a condition in which users become dissatisfied and frustrated due to lack of proper training.

  • Data Migration

    Moving towards an electronic system from a paper-based system could result in data loss. Data entry and scanning documents can be time-consuming tasks. The main purpose of moving towards an electronic system is not to archive all paper records, but to move critical information of patients' medical history for future access.

  • Patient Acceptance

    Practices usually adopt a new system to improve their quality and service by engaging patients, which can effectively improve patient outcomes. But any goal of improving patient engagement can't be achieved until and unless patients are willing to adopt EHR features such as patient portal, which improves patient engagement. Thus, it is equally important for patients to adopt EHRs.


Well, there are many benefits and challenges related to EHRs. As the healthcare sector is ready to transform, these growing difficulties will ultimately resolve. To have a positive impact on the EHR system, care providers should be able to use these systems effectively. By considering these factors care providers will be able to use EHRs effectively, which in turn will improve safety and quality of care. The focus should be reducing the clerical work of care providers while continuously improving safety, quality, communication, efficiency, and patient engagement.

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