We have all been hearing “Change Is Coming” and they say if you want faster change, a positive reinforcement can help you easily pave the way to that change. At year 2009, HITECH or Health Information Technology for Economic and Clinical Health Act was signed into law – with explicit intention of accelerating the adoption and promoting meaningful use of electronic health record by physicians’ in the United States through appropriation of financial incentives. This incentive is for eligible health care providers implementing electronic health record, with aid of Medicare and Medicaid Electronic Health Record Meaningful Use Program.
EHR use reinforcement was done by US government to promote faster adoption to use of EHR for paperless transaction, and improved exchange of data for knowledge management and clinical decisions in a national level. Interestingly, this coursework given to us this week for our Clinical and Laboratory Information System class is very relatable to my current situation at work as we are in the campaign stage of a project that we need every healthcare provider in our institution to commit into using it.
The study Impact of HITECH Act on Physicians’ Adoption of Electronic Health Record of E Ford et al  wanted to evaluate EHR adoption projection with the passing of HITECH Act, and they have found out that skyrocketed adoption to any EHR system was largely driven by an imitation effect as physicians are striving to keep up with their peers in the use of EHR, rather than adopting due to an external influence such as advertising (or giving incentives); and MU programs did not directly affected, or has an ambiguous effect in the increase of adoption to use of EHR in the United States.
Although technology is somewhat becoming a necessity more than a luxury, the challenge in implementing an EHR is still there – especially in the Philippine setting. To support this claim, EHR usage is still scarce in the Philippines as we can only name a very few hospitals who currently implements one, and these are mostly the big ones you can find in the metro. Yet according to Frost & Sullivan  that the Asia-Pacific market will continue to grow to 2018 – which we hope applies to Philippines, however there are specific hurdles that are present in our country as we are still ranked 103rd of 166 countries in Information Communication Technology access and usage. If you think we are already advanced, think again. We are still taking our romantic walk alone in the park.
According to a systematic review by Kruse et al  that (1) Initial Cost of implementing EHR is still consistently considered the number one barrier in implementing it, followed by (2) Technical Support, (3) Technical Concerns, (4) Maintenance Cost, and (6) Available training which are all related to the number one problem which is financial and human resource, (5) Resistance to change in work habit (9) Workflow Challenges, and (11) Productivity loss are all related to fear of disordering what has been accustomed to practice or the traditional way of health care delivery, whilst (7) Insufficiency in time is a personal challenge of the end user to juggle time learning and continuing with their usual routine, and (8) Privacy Concern is also in the list as there are alarms regarding lost information that may be due to natural disaster or cyberhacks, and finally, (10) Financial Incentives which is actually almost last in the list.
These barriers identified in the study of Kruse et al  is very applicable in the Philippine setting as cost being the chief concern in the implementation of an Electronic Health Record. As much as I wanted to consider that if our government would just give much more attention and support to eHealth Strategies and Plan, and perhaps implement such incentive drive like HITECH Act to further advance adoption of EHR in our country, it does not appear to be valid yet in our scenario. Although it might encourage, but scarcity in financial and human resource must be addressed first in most institutions. Also, the study is ambiguous of the idea that HITECH Act actually helped in the promotion of EHR use, however, incline cause is that physicians are keeping up with their peers. In my assessment, as big hospitals are being the main target market in the Metro are now implementing and using EHR, soon other hospitals and even small scale ones will follow the lead, but might take some more time.
- Mennemeyer, S., Menachemi N., Rahurkar S., & Ford E. (2015). Impact of HITECH Act on Physicians’ Adoption of Electronic Health Record. Oxford University Press. American Medical Informatics Association. 23:375–379. doi:10.1093/jamia/ocv103
- Frost & Sullivan. (2013). EHR and EMR Market in APAC: Electronic Health Records Will Pave the Way for Healthcare Transformation.
Retrieved from: Frost & Sullivan
- Kruse, C. S., Kristof, C., Jones, B., Mitchell, E., & Martinez, A. (2016). Barriers to Electronic Health Record Adoption: a Systematic Literature Review. Journal of Medical Systems, 40(12), 252. http://doi.org/10.1007/s10916-016-0628-9