Online Program

A Qualitative Analysis of the Status, Benefits, and Barriers of Electronic Health Record Implementation in Local Health Departments

Monday, November 2, 2015

Karmen Williams, MSPH, MA, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA
Akrati Gupta, BDS, MPH, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA
Gulzar Shah, PhD, MStat, MS, Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA
JP Leider, PhD, de Beaumont Foundation, Bethesda, MD
Background: Electronic Health Records (EHRs) are changing the operations within local health departments (LHDs). The collection of EHRs allow for information analysis, reporting, sharing, transmission, and processing. The barriers in implementing EHRs can prevent and challenge LHDs in experiencing the benefits and efficiency of their use. 

Research Objective: Analyze the status, benefits, barriers, and ways of overcoming challenges of implementing EHRs in LHDs.

Methods: This project used primary, key-informant interview based study design of 50 leaders from local health departments across the United States. These qualitative interviews were about current practices, capacities, and needs in the realm of public health informatics in the fall of 2014. Qualitative data analysis focused on major drivers of EHR implementation, or lack of implementation.

Principal Findings: Preliminary results exhibit variability in implementation status, benefits, and barriers of EHRs in LHDs. Implementation status varied from fully implemented in clinical settings, investigated or planning to implement, and no implementation but use of electronic medical records (EMRs). The barriers included costs, low capacity, lack of trained staff, staff resistance, complexities in current systems, and concerns about past investments in technology. Benefits were acknowledged by LHDs that have implemented and those who had not implemented EHRs as the ability to pull and have accurate records, ease of reading records, ability to share with partners, ease of searching, time saving, simplicity of budgeting and estimating revenues, staff satisfaction, and HIPAA compliance.

Conclusions:  Despite financial, capacity, and operational constraints, leaders interviewed as part of this project were optimistic about the future of EHRs in local health departments. Implementation of EHRs tends to be easier to implement with resources, staff buy-in, and leadership involvement. EHRs have multiple benefits that impact the operations and delivery of care in LHDs, affecting the health of the populations they serve.

Learning Areas:

Administration, management, leadership
Communication and informatics
Public health administration or related administration

Learning Objectives:
Differentiate between the status and characteristics of local health departments in the implementation of electronic health records. Describe the barriers and benefits in the implementation of electronic health records for local health departments. Discuss the potential ways to overcome challenges in the implementation of electronic health records in local health departments.

Keyword(s): Information Technology, Local Public Health Agencies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a research assistant for the dean of research on public health services and systems research for almost two years now. We have published several manuscripts and conducted research on local health departments and implementation of health informatics. I personally have begun research on electronic health records for my dissertation project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.