Writer’s choiceResearch Study “Barriers to Accepting Health Information Technologies”

Barriers to Health Information Technology (HIT) Implementation
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Abstract
Technological advancements have become essential tools in the workplace. They assist in minimizing labor tediousness and saving time. Besides, efficiency and accuracy of service delivery are improved. However, sometimes, the advancements are not met with positive enthusiasm. The health care sector is one area where numerous barriers have impeded effective interaction between practitioners and Health Information Technology (HIT). The aim of conducting the research was to determine the barriers that inhibit a positive experience in integrating technology in health care. This research was accomplished through extensive literature review on peer-reviewed articles concerning barriers to HIT integration. In addition to this, a web-based survey would be conducted on a cross-section of health practitioners from various types of health facilities to determine rate of ease when interacting with HIT. This will be partially a quantitative design since the data received from the survey will generate some statistical results. The research established numerous barriers which include cost, interoperability challenges, technical hitches, the maturity of the product, limited skilled human resource and e-data transfer insecurity. Also, most physicians were resistant to technological changes perceiving it as a complex and unnecessary interruption to their workflow. The broad range of data collected ensured the adequacy of the research and an analysis using statistical and qualitative software such as SPSS would be used to generate results.

The research hypothesizes that ii is necessary for the health care fraternity to perceive technological change as a vital and necessary change to accommodate it in their endeavors. There is also a necessity to streamline the developments to economical models that are accessible and user-friendly.

Introduction
Technological advancement is a global phenomenon that cuts across every sector. Many institutions have therefore had to shift their working to accommodate technological improvements. At times, the developments are embraced enthusiastically while on other occasions; the events are accepted at a slower rate if not out rightly rejected. The medical fraternity is not different. In fact, the health system presents an attractive sector when it comes to accepting health information technology. This is because the sector has been traditionally among the least volatile fields. (“Barriers to HIT Implementation | AHRQ National Resource Center; Health Information Technology: Best Practices Transforming Quality, Safety, and Efficiency”, 2016) Accepting change is thus rare and quite often an extraordinary progress.
Despite these facts, there is the sector has continued to witness advanced technological developments in the recent past. A majority of these advancements have been in the electronic health records (EHR) and the computerized physician order entry (CPOE) departments. Health records electronic systems are systems that are used to ease the process of registering patients and keeping their information. On the other hand, CPOE is systems that are used to order prescriptions and record doctor instructions rather than using the traditional paper sheets. (Ajami & ArabChadegani, 2013) These technologies seem simple enough and have documented immeasurable success wherever they are used. Regardless of their numerous benefits, these developments still encounter substantial resistance in field operations.
Garrett reports that there are only an approximate 10% of the hospitals in the US that are using HER. He also states that it is only 19% of the health care providers and about 5%of all clinicians that utilize HIT. These figures are grossly small, and there is the need to identify the chief cause for this repulsion to a technology that has been established to be so beneficial in the caregiving process.
Variables
Independent variable: Health Information Technology (HIT) in a health facility
Dependent variable: Barriers to use of identified HIT.
Hypothesis
Regardless of the numerous benefits of HIT use in health care systems, the developments still encounter substantial resistance in field operations.
Methods
Survey design
An extensive literature review on content related to the issue at hand was investigated. In addition, an online survey sent via email was issued with the following questions:
What are the available HIT systems in the facility where you work?
Which departments are affected by these systems?
What is the general reaction of staff to upcoming HIT systems at your workplace?
Does HIT improve quality of work and efficiency?
On a scale of 1 to 5 how would you rate the efficacy of the systems in increasing customer service?
What are the helpful features in the HIT systems?
Which features are difficult to use?
Which departments are more resistant to change in relationship to HIT use?
Which improvements would you like to see in future developments of HIT systems?
What do you think are the risks associated with increased HIT use on healthcare facilities?
The research will be conducted on a sample of approximately 200 health care practitioners across the globe. This will be achieved through online survey sent via email. The research team will lease with health care organization to use work emails to solicit response for staff. A mock trial will be conducted through sending a sample survey to members of the department to access the ease of access and responding to the survey.

Cover page
The barriers to health information technology depend on the nature of the technology and the individuals affected by the change. The health records art of HIT affects every person in the health facility. Electronic health records are accessed by the reception to book in a patient, and they are used by the doctor to determine the background of the patient and then by the pharmacy to determine the prescribed medication. The linking capacity that allows electronic health records to be updated simultaneously across all departments in a health facility minimizes the tedious nature of medical record keeping. However, there is still resistance towards the adoption of these registers. (Ajami & ArabChadegani, 2013)
The purpose of this study is therefore to investigate the barriers to HIT integration among a broad range of health professions. This will help demonstrate the hypothesis that regardless of the numerous benefits of HIT use in health care systems, the developments still encounter substantial resistance in field operations. An identification of a problem is the initial step to its resolution and thus this research will enable stakeholders to engage in measures that can increase HIT use and thus improve efficacy in health care institutions.
Because the survey is sent through email, it is possible to trace any response to an individual. However, the information gathered will be used solely for the purpose of this research and will be discarded within three months after receipt. Individuals who do not feel free to respond through their emails can upload the questionnaire directly to our website. This survey should be completed within two weeks after receipt.
Your compliance will be vital in improving the nature of our healthcare system. Your assistance is therefore highly regarded and esteemed by the research team and the entire people whose services will be enhanced though action on these results.

Title of Project: Barriers to Health Information Technology (HIT) Implementation
Purpose of the Project:
The aim of this project is to gather a broad range of data regarding resistance among health care professionals to use HIT systems at work. The research will analyze barriers that make it harder for these systems to be accepted by the healthcare fraternity. This will include structural, sociological, economic and cultural barriers to the systems’ integration.
Survey Instruments or Data Collection Methodology to be used.
Literature review on available materials, filled questionnaire survey.
Regular mail sent via work email addresses. Online library search.
A survey questionnaire is developed to assist in responding to the research questions.
Research Design including population and sample, if applicable.
Health care staff from various health centers with coordination with these health facilities administration.
B. Sample Size_ the research team anticipates a response of about 200 survey respondents.
C. Information collected will solely concern barriers that hinder successful HIT integration in health facilities.
D. Only data from the respondents will be used for the study.
E. The information shared is solely for the use of the research and will not be disclosed to any third part. It will also be discarded after three months when the analysis and conclusions are drawn.
F. all files will be downloaded by a single person and then analyzed anonymously without access to the source to ensure minimal disclosure of the respondents’ information.
Results
The primary barrier towards the implementation of the health records has been the cost associated with the development. An entire HR system for a health center is approximated at over a million dollars. This is a cost that most health centers would consider exorbitant since the process can be accomplished manually by employees already employed by the facility. (“Barriers to HIT Implementation | AHRQ National Resource Center; Health Information Technology: Best Practices Transforming Quality, Safety, and Efficiency”, 2016) The expensive nature of the EHR is not only reflected in the necessary initial costs for the purpose and implementation of the project. In most cases, the system requires an extra support staff to handle the problem.
This was a big challenge for US health facilities where most institutions are operated privately as single physician entities. These facilities cannot afford an extra member of the staff because of the recurrent monetary aspect of salaries and also the administrative costs that sustaining the additional staff entrails. (Garrett, Brown, Hart-Hester, Hamadain, & Rudman, 2006) Besides, the payoffs that can be anticipated from the installation of such systems are slow and in many cases benefit individuals who do not bear the direct impact of EHR. For example, among the most heralded advantages of using EHR is the minimization of time spent in queues by the patient. It is anticipated that the utilization of the records minimizes client to stay at a facility up to 50%. (Ajami & BagheriTadi, 2013) However, of these, the actual benefit that trickles down to the health facility is estimated at 11%, this discourages health facility managements from installing electronic records since they benefit external beneficiary at the extent of the direct user.
Apart from this, the rise of EHR created major concerns regarding the safety can confidentiality while handling patient’s information on EHR. Patient’s records and the information is one of the most privately regarded aspects of a health facility. Doctors work under oath to keep the health discussions strictly between them and a patient. (Anwar & Shamim, 2011) It is, therefore, a punishable offense in the law to let a third party snoop into the medical files of an individual. Electronic hacking is a vice that is almost as wide as the packaging of electronic tools. Although it is a voice, there are individuals who dedicate the entirety if their lives to hacking. Health facilitates are, therefore, very sensitive when accepting computer change instructions. Hacking involves an external threat. The EHR challenge creates a deeper problem within the facility, in most cases, the system is consists of features that allow the access of information by multiple individuals in the health center organizations. (Anwar & Shamim, 2011) These include such individuals as the reception team tasked with the booking clients all the way to the pharmaceutical department which dispatches the given prescription. However, all these individuals are not supposed to see the patient’s report. Furthermore, when records are electronic, they are more easily accessible. This means that a loop of five minutes can allow someone to access data for thousands of people. For this reason, there is resistance within the medical fraternity about the use of EHR.
Other barriers arise from the standardization problem. To communicate effectively between departments, numerous health facilities and even with insurance and other stakeholders, there is a need for proper normalization of the code of use. If this is not achieved, there will be sending of arbitrary messages that do not have any meaning to the recipient. In this case, the recipient could interpret the message erroneously or taken an even longer time to clarify the case.
Interoperability is another essential factor in the acceptance of hit. Interoperability in medical circles refers to the ability to pool various functionalities together in a dynamic system. In a health care setting, it would allude to a systems capability to combine data and information from a wide range of resources, communicate efficiently and produce consistent results. Medical functionalities can be very different from each other. (Garrett, Brown, Hart-Hester, Hamadain, & Rudman, 2006) This is because there is vast coding in measuring results, assigning acronyms to drugs and even in the regular reporting. As a result, in many cases, developers target a single challenge without considering the impact of this on other systems. The result is that a facility could have to run numerous programs simultaneously. This is expensive, tedious, and has the risk of becoming even more disastrous if the systems become overwhelmed by the number of software installed. (Khalifa, 2013) Besides, regardless of the number of software installed, if there does not exist a user-friendly user interface, then the software will not achieve its mandate. The majority of physicians have demonstrated a resistance to systems that are complex in reference for those whose usability is straight forward.
Because of the challenge that exists in developing these tools, the maturities of the products have all been a barrier to implementation. In many cases, developers concentrate on one aspect over the others. The final product, therefore, is often not capable of withstanding the immense task of healthcare operations. There are also numerous bugs that make such programs unsustainable and unreliable. Although technology is advancing gradually, it is not efficient for a hospital to keep changing its software every other time. In any cases, health facilities try out the first product and then give up all together in attempting to find a more versatile solution.
Physicians have in particular rebelled against the use of CPOE. In most cases, this is because it requires processes that the doctors are not used to. It is thus considered to affect their workflow in comparison to traditional worksheets adversely. If the CPOE are implemented, then the physician had to use a considerable amount of time in education to catch up with sub new technologies. In the recent past, nurses and other medics have had to take other courses in the new recording and reporting methods. This consumes a lot of time for personnel in the hospitals. In many cases, the healthcare practitioners in the US are less than the recommended patient to caregiver ratio. It is thus considered an unnecessary burden to have some of the caregivers commit to education for something that is not regarded as vastly essential in the health care practice.
Finally, there is also the problem of social change resistance. As mentioned before, the health care fraternity has been used to working in the comfort zone. Since the emergence of newer drugs or treatment methods is rather rare, the physicians get used to repeating the same things. This can make them acutely resistant to changes within the society. Also, due to the immense importance of their programs, they are likely to view any other change as trivial. On the other hand, there is a significant portion of health caregivers and physicians who perceive any IT department as complex and impossible to learn or keep up with. Experts have argued that to ensure the successful incorporation of HIT in health care, the practitioners have to begin by looking at the technology as an intrinsic part of social change that is necessary and inevitable. In any case, other stakeholders are already moving towards this dimension and will, therefore, force the sector towards it. For example, the insurance agencies have shifted wholesomely to digital information transfer. This will force health facilities to find methods of electronically transmitting information to the agencies. This is an indirect route towards the dreaded electronic health records. In fact, e-data exchange is one of the most contentious issues with HIT acceptance. The resistance originates from the already discussed fear of hacking and snooping which can lead to compromising of patient records. Since the staff is not used to the new system, it is also easy to make a mistake. If one mistake is made in electronic health record transfer, it is transmitted to the rest to the system with possible magnification. A mistake in some operations such as inputting a prescription could result in a fatal mistake that would eventually lead the facility into endless legal battles.
Discussion and Conclusions
The resistance to HIT can, therefore, be seen as a cautious step of a community that is not accustomed to change. It is encouraged by the fact that inadequate knowledge of health facility operations by software developers does not encourage actual coherence in product development. Most of the available products are therefore laden with technical hitches that render them ineffective. Even when effective, the products are often immature and can only accomplish a minuscule portion to the complete tasks involved in health care management. For this reason, there is often need for two or more programs which make coordination quite ineffective. Social and structural challenges impose a barrier to this process through the fear of breaching privacy and confidentiality. More importantly, the cost implications of changing into electronic systems are beyond most facilities. This is regarding financial expenditure as one CPOE system is approximately 3 to 10 million dollars depending on the size and previous status of a facility. It is also regards the human resource. Most health care facilities in the US are private practices that are solo practitioners and thus learning the techniques would consume too much valuable time. However, despite all these barriers, HIT needs to be recognized as a continuous social change process that is inevitable. Health care communities should thus begin the process of gradual change before social forces advance the change in an unsustainable speed that will be more costly.
References
Ajami, S. & ArabChadegani, R. (2013). Barriers to implement Electronic Health Records (EHRs). Materia Socio Medica, 25(3), 213. http://dx.doi.org/10.5455/msm.2013.25.213-215
Ajami, S. & BagheriTadi, T. (2013). Barriers for Adopting Electronic Health Records EHRs by Physicians. Acta Informatica Medica, 21(2), 129. http://dx.doi.org/10.5455/aim.2013.21.129-134
Anwar, F. & Shamim, A. (2011). Barriers in Adoption of Health Information Technology in Developing Societies. International Journal Of Advanced Computer Science And Applications, 2(8), 4045.
Barriers to HIT Implementation | AHRQ National Resource Center; Health Information Technology: Best Practices Transforming Quality, Safety, and Efficiency. (2016). Healthit.ahrq.gov. Retrieved 4 December 2016, from https://healthit.ahrq.gov/health-it-tools-and-resources/health-it-costs-and-benefits-database/barriers-hit-implementation
Garrett, P., Brown, C., Hart-Hester, S., Hamadain, E., & Rudman, W. (2006). Identifying Barriers to the Adoption of New Technology in Rural Hospitals: A Case Report. Ncbi, 3(9).Khalifa, M. (2013). Barriers to Health Information Systems and Electronic Medical Records Implementation. A Field Study of Saudi Arabian Hospitals. Procedia Computer Science, 21, 335-342. http://dx.doi.org/10.1016/j.procs.2013.09.04476200391886DEPARTMENT
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20791703918860Appendix 1: Survey
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What are the available HIT systems in the facility where you work?
Which departments are affected by these systems?
What is the general reaction of staff to upcoming HIT systems at your workplace?
Does HIT improve quality of work and efficiency?
On a scale of 1 to 5 how would you rate the efficacy of the systems in increasing customer service?
What are the helpful features in the HIT systems?
Which features are difficult to use?
Which departments are more resistant to change in relationship to HIT use?
Which improvements would you like to see in future developments of HIT systems?
What do you think are the risks associated with increased HIT use on healthcare facilities?