Hospitals in the UK have been slow to adopt electronic health record (EHR) systems due to cost constraints, new research published online in the Journal of the American Medical Informatics Association (JAMIA) reveals.
The researchers, from the Wolfson Research Institute at the University of Durham in Stockton-on-Tees, England and Brigham and Women's Hospital in Boston, Mass., looked at the effectiveness of the UK's three centrally procured EHR applications: iSOFT's Lorenzo Regional Care; Cerner's Millennium; and CSE's RiO. These three were selected procured as part of the UK's £12.7 billion (US$20 billion) National Programme for IT (NPfIT).
The researchers look at the three systems in 12 diverse healthcare locales, in three different regions of the country, and at different stages of implementation. Along with this research and substantive interviews at these locales, they found four overall cost categories associated with implementing an EHR system. Those include:
- Infrastructure (such as hardware and software)
- Personnel (such as a project managers and training teams)
- Estates/facilities (furniture, fittings and space), and
- Other (such as training materials)
The researchers say that numerous factors were felt to impact on these costs, with different hospitals choosing varying amounts and types of infrastructure, diverse training approaches for staff, and different software applications for integration. Of the four categories, hospitals were most likely to cut back on training and implementation. Many hospitals, the researchers found, didn't appreciate the need to fill back staff for lost productivity or test the system.
"With cost considered one of the most significant barriers, it is important for hospitals and governments to be clear from the outset of the major cost categories involved and the factors that may impact on these costs," the authors wrote in the study.