Electronic Health Record System: Vendor Analysis and Challenges

This report provides a comprehensive analysis of Electronic Health Record (EHR) systems, focusing on the Australian context. It begins with an introduction to EHRs, highlighting their role in modern healthcare and the importance of secure and instant access to patient information. The report then delves into a vendor analysis, specifically examining EPIC Systems Corporation, detailing its market share, data models, and competitive landscape. It also explores the challenges associated with EHR implementation, such as staff resistance, loss of productivity, data migration issues, and legal/regulatory requirements, including data security concerns. The report concludes by emphasizing the need for strategic planning and execution during EHR implementation, covering aspects like software, hardware, training, cost estimation, and workflow adjustments. Overall, the report offers valuable insights into the complexities and considerations of adopting and managing EHR systems in healthcare settings.

Running head: ELECTRONIC HEALTH RECORD SYSTEM
Electronic Health Record System
[Name of the Student]
[Name of the University]
[Author note]

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Introduction:
EHR or the Electronic Health Record is the digital version of the patients paper chart.
EHR is considered to the real-time, patient centered records which is associated with making the
information available instantly and in a secure way only to the authorized users. The EHR is not
only associated with containing the medical and the treatment histories of the patients but is also
built for the purpose of going beyond the standard clinical data which is collected in the office of
the provider and might be associated with including the broader view of the care provided to the
patients. The EHR is associated with containing the medical history of the patients along with the
medication history, and many more (Ankem, & Dhawan, 2017). This in turn is associated with
allowing the access to the various evidence based tools which can be used by the providers for
making decisions related to the patients care. This report would be associated with discussing
about the EHR vendor of Australia along with the solutions that they provide which includes the
functionality, IT infrastructure, cost, risk and security and many more.
Discussion:
About the vendor:
The EHR adaptation in Australia has been seen to be significantly slower than the other
European countries and the role and the usage of the health information system for the prupose
of supporting the healthcare industry is considered to be very important. The vendor which has
been selected is the EPIC Systems Corporation (Zive et al., 2016). EPIC is a privately owned
healthcare software company. EPIC is primarily associated with the development,
manufacturing, licensing, supporting and selling of the trademarked electronic health record
software application which in whole is known as the Epic or an Epic EHR. The vendor is

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associated with the offering of an integrated suite of healthcare software which is seen to be
centered in the Chronicles of the database management system (Hicks et al., 2016). The
applications of Epic is associated with supporting the different functions of the patient care,
which includes the registration, scheduling, clinical system for the doctors and the other
healthcare providers and many more.
Fig 1: EHR Vendor market share
Source: (Palvia, Jacks & Brown, 2015)
The vendor is also associated with providing of the hosted solutions which can be used
by the customers who are not having the wish of maintaining their own servers and the besides
this the short-term optimization along with the implementation consultants by means of the
wholly owned subsidiaries are associated with boosting up of the services.
Epic systems has been voted as the top overall software in the year of 2018 best in the
KLAS awards and besides this the company has also won awards in consecutive 8 years and has
also been capable of taking the top spot for the entire physician practice vendor in the year of
2018 and has also received the Best in the KLAS awards in 7 segments.

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Fig 2: Epic Data Model Archive
Source: (Palvia, Jacks & Brown, 2015)
Market analysis of the vendor:
The main competitors of this vendor includes the Cerner, MEDITECH, Allscripts,
athenahealth and units of IBM, McKesson, Siemens and the GE Healthcare. The vendor has been
selected in different parts of the world for example the Partners Healthcare began adopting the
Epic system in the year of 2015 and had initially been associated with reporting the fact that it

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cost around $1.2 billion which has been decried by the critics and this is seen to be greater than
the cost of any of its building. By the year or 2018 the total expense of the entire project turned
out to be around $1.6 billion along with the payments for the software itself which amounted to
less than $100 million and most of the cost was mainly caused because of the lost patient
revenue, tech support and the other implementation works.
Challenges faced by the HER:
While implementing the HER system certain unexpected challenges are always faced below are
some of the major challenges which are faced during the implementation of the EHR system.
Resistance from the staffs:
Accepting the change at a quick rate is seen to be very much challenging for the people
who would be using the new EHR system mainly in the work environment. So for this reason
there would be existing a resistance to the changes brought because of the EHR implementation
(Palvia, Jacks & Brown, 2015). This resistances are mainly seen to be received from the hospital
staffs and from the support staffs as well as from the board members and the stakeholders as
well. So it is necessarily to be made sure that the implementation process is being delivered
along with a marketing and a promotion plan so as to champion the changes that has happened.
It is essentially to be made sure that while implementing the EHR an acceptance is being
built along with positivity all around the change as well as across the entire body of the staffs.
The entire implementation is to be done in a slow and steady way along with providing of
comprehensive training (Singh et al., 2015). It is also to be made sure that the healthcare practice
staffs are being provided with the assurance that even after the implementation would be capable
of doing the work in the same amount of time. Besides this it is essential to make sure of the fact

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that the staffs are understanding the fact that the changes are going to bring a better business
model as well as an improved job satisfaction.
Loss of productivity or the lack of full implementation:
The implementation of the new system is likely to be associated with the anticipation of
the reduction in the staffs’ productivity as well as in the number of patients seen and the
efficiency of the workflow (Van den Hooff & Hafkamp, 2017). In addition to this the
administration should also be prepared for paying for the overtime along with being prepared for
providing additional support. So it is essential to consider the hiring of the healthcare consultant
along with seeing the fact that the vendor is capable of offering a go-live support at the time of
implementation (Bajwa, Singh & De, 2017). Hiring of the temporary staff is also suggested for
the purpose of performing more mundane work duties.
However it is unfortunate that even after the practice has been implemented the new EHR
system, the staff members might be capable of finding out ways for continuing the usage of the
old system or might be avoiding the usage of the EHR system in an effective manner (Friend,
Jennings & Levine, 2017). This might be including the writing down of the patient’s information
and the data rather than logging of the notes into the system which in turn creates a double work
and increased time in the end.
This seems to be very much concerning when the main motives associated with the
implementation of the system is aimed at increasing the efficiency. The objectives of the project
would not be achieved if the staffs are associated with finding out of workarounds for avoiding
the usage of the current system.

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The intension of the HER program is associated with including the streamlining of the
basic operations as well as the communication however if the staffs are associated with the
continued usage of the old ways then it would be entirely impossible to accomplish the goals
(Velinov et al., 2015). For this reason it is very much essential to make sure of the fact that
everyone is receiving an ample amount of training before usage of the full EHR system and
besides this the staffs should also be shown the fact that the documentation is faster and easier
and is also responsible for improving the patient care.
Data migration:
The migration of the existing data to the new EHR is a time consuming process along
with being tedious. In addition to this it is also associated with containing the private as well as
the sensitive information which also needs to be migrated in an accurate manner so as to make
sure that there exists continued patient care. Records would also be needing prioritization for the
purpose of determining how far back the data needs to be migrated. So it is recommended to start
from the most recent file and continuing with the work way backwards so as to be sure that the
most recent information are available in the EHR system (Crowley et al., 2019). Another
suggestion for this problem is the assigning of the point person who would be responsible for the
uploading of all the new information which are faxed or id delivered by means of paper. All this
information are to be stored into the new system in a prompt way so as to make the usage of the
new EHR system much easier for everyone.
Legal and regulatory requirements:
The implementation of the new EHR system would be associated with raising numerous
legal as well as regulatory concerns and this also includes the fulfillment of the HIPAA standards
for the electronic information and the role that the personal health application with the caregivers

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of the patients. The EHR system is also associated with posing several challenges to the privacy
of the patients (Storm, Ryou & Thompson, 2019). This challenges are associated with including
the design of the functionality which in turn is associated with allowing the patients in releasing
of only the relevant information to the reliable partners. Besides this there also exists the risk
related to the appropriateness of the round-the-clock data monitoring along with the legal and
ethical issues which surrounds the disclosure of the health related information on the social
networking sites.
Personal health records along with the applications record sensitive personal information
across a wide variety of devices much as the mobile devices. Ensuring the robust security along
with the ease of usage are some of the major challenges which are faced by the designers of the
EHR. The security of the data is one of the major issue which is to be faced by the EHR system
while being implemented and the reason behind this is the requirement related to storage and the
manipulation of the sensitive personal information. The EHR is often associated with the usage
of the portable devices for storage and application platforms from where the security challenges
faced by the data is much more formidable. So it is essential to provide a robust authentication
along with access controls in accordance to the sensitivity of the data. One of the greatest
challenge is balancing of the protection against the ease-of-use which is likely to be faced.
Conclusion:
Electronic health record implementation would be consisting of a set of strategies as well
as steps which is to be used by the healthcare organization while being prepared and executing
the adaptation the electronic based health care system. The format as well as the content of the
EHR implementation plan would be varying based upon the expected results and on the
organizational needs however the plan of implementing the EHR would be mostly associated

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with the incorporation of the information related to the software and the hardware software along
with the time frames which are expected along with the methods that have been chosen for
providing of training accompanying the adaptation, the estimation of the costs, labor distribution
and the responsibilities and the changes in the workflow are some of the factors.

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References:
Ankem, K., & Dhawan, A. (2017). Electronic Health Record System Implementation in a Health
Informatics Program Research-in-Progress.
Bajwa, N. K., Singh, H., & De, K. K. (2017). Critical Success Factors in Electronic Health
Records (EHR) Implementation: An Exploratory Study in North India. International
Journal of Healthcare Information Systems and Informatics (IJHISI), 12(2), 1-17.
Crowley, K., Mishra, A., Cruz-Cano, R., Gold, R., Kleinman, D., & Agarwal, R. (2019).
Electronic Health Record Implementation Findings at a Large, Suburban Health and
Human Services Department. Journal of Public Health Management and Practice, 25(1),
E11-E16.
Friend, T. H., Jennings, S. J., & Levine, W. C. (2017). Communication patterns in the
perioperative environment during epic electronic health record system
implementation. Journal of medical systems, 41(2), 22.
Hicks, J. K., Stowe, D., Willner, M. A., Wai, M., Daly, T., Gordon, S. M., ... & Moss, T. (2016).
Implementation of clinical pharmacogenomics within a large health system: from
electronic health record decision support to consultation services. Pharmacotherapy: The
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Palvia, P., Jacks, T., & Brown, W. S. (2015). Critical Issues in EHR Implementation: Provider
and Vendor Perspectives. CAIS, 36, 36.

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Singh, R. P., Bedi, R., Li, A., Kulkarni, S., Rodstrom, T., Altus, G., & Martin, D. F. (2015). The
practice impact of electronic health record system implementation within a large
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Storm, A. C., Ryou, M., & Thompson, C. C. (2019). Multicenter Implementation of a New
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Van den Hooff, B., & Hafkamp, L. (2017). Dealing with dissonance: misfits between an EHR
system and medical work practices.
Velinov, G., Jakimovski, B., Lesovski, D., Panova, D. I., Frtunik, D., & Kon-Popovska, M.
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Zive, D. M., Cook, J., Yang, C., Sibell, D., Tolle, S. W., & Lieberman, M. (2016).
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