Provider Age, Aversion to Tech Remain as EHR Obstacles

May 31, 2013

One of the anticipated costs of EHR implementation is helping those who are struggling to adapt, most notably older providers.

I listened to a speech by HHS Secretary Kathleen Sebelius at the American Academy of Physician Assistants annual conference this week, and she reported that 50 percent of U.S. healthcare providers are using EHRs. This is very optimistic and reassuring to me. However, if we have any hope of gathering and sharing data in a seamless way we need across-the-board adoption and 100 percent use.

I had the chance to dwell on this thought on my cross-country flight home with other medical providers who discussed their own experiences with EHR integration. I know I’ve written before about the bumps and triumphs of my own facility’s journey to a fully integrated EHR. Yet as I talked with my fellow passengers and listened to their perspectives and insights into their worlds, an immediate parallel arose in my mind to a problem that I have seen in the integration of our facility's EHR.

The pace of technological and scientific change in every area of our society has been staggering over the last 10 years. This pace of change, and introduction and adoption of technological solutions to workplace problems has accelerated to light speed. This can create tremendous workforce challenges as our human resources become increasingly diverse in understanding of current and emerging technology.

I hate to put this in terms of age, but it is apparent to a lot of us that the younger you are, the more adept you’re likely to be with current technology and the more accepting you are to introduction and implementation of emerging technologies in the workplace. This is just a fact of life that must be factored into any information technology planning.

The generational gap to embracing technology is apparent. Most of the enhanced computerized physician order entry (CPOE) assistance has gone away, and many providers with years of healthcare experience are struggling with the EHR and CPOE. We have a significant number of providers who don't have computer skills and don't have any hope or desire to develop them. They see the EHR and CPOE as an intrusion into the practice of medicine as they have always done it their entire career.

We had significant training available through our EHR adoption, yet providers on the medical staff are extremely busy at our facility, and it is hard for them to schedule even a couple of hours of training away from patient care. Also, the time between training and launch of the implementation was way too long. Most training was forgotten by the time that we actually started using CPOE, and it increased the frustration and difficulty of order entry.

In a recent meeting with the CEO of my hospital, I noted that administrators deployed a significant and appropriate amount of human and tech resources to help the medical staff transition to full usage of the EHR. Yet there will always be providers who refuse to alter the way they record information on patients and procedures.

If given another chance to meet with the CEO, I would be compelled to advise him that there cannot be a total and complete implementation of the EHR as there are providers who will not embrace digital technology. After all, this group of older medical providers embraced a different kind of technology and was seen as "upstarts" by their older peers at some point. Yet can you imagine practicing without MRI machines or even digital thermometers?

I can see a day in the not-too-distant future when the entire healthcare team of physicians, physician assistants, and nurse practitioners are those who were raised with the Internet and technology.

For the time being, we have to help, continuously and indefinitely, the providers having difficulty with the EHR and CPOE. This is one of the unanticipated costs of EHR implementation but one way to ensure that everyone on the healthcare team is practicing to their fullest extent.

The EHR is here to stay. However, change is a difficult journey.

This blog was provided in partnership with the American Academy of Physician Assistants.