Healthcare Informatics: Foundations and Concepts

With the implementation of the Affordable Health Care Act, there is a growing number of people to be given cost-effective healthcare. Healthcare providers and government are promoting online health services, including electronic health records (EHRs) and patient portals (PPs) to give high-quality care to active and more demanding people. The given essay discusses the challenges and opportunities associated with the adoption of EHRs and PPs in a public hospital.

Being often overburdened with uninsured people, public hospitals are entirely run on government funding and public contributions. Traditional organizational chart of a public hospital includes administration desk, informational services, therapeutic services, diagnostic services, and support services. Implementation of EHRs in a public hospital includes creating an implementation team of physicians, nurses, administrative staff, and medical assistants.

Lead physicians should guide the organization throughout the process of deployment, serving as a link between the users and software developers. When the implementation team is created, the software should be configured, hardware needs identified, all data transferred, and pre-launch workflows optimized. After that nurses, physicians, and administrative staff should go through training and professional practice management consultation to learn how to use EHRs effectively.

Implementing a PP is not the same as implementing an EHR as it involves new stakeholders with new needs. PP deployment should include creating a portal implementation team, defining metrics to evaluate progress, collecting e-mail addresses of patients, determining workflow changes, and identifying tasks and responsibilities. One should also consider establishing new policies, such as time interval between appointment request and appointment, a protocol for unanswered messages, and releasing lab results. Enrollment and patient-training should be integrated into the new workflow. On the post-implementation stage, it is crucial to gather feedback from patients and providers.

Switching to new hospital-wide EHR systems is an uneasy task that involves a range of administrative and technical factors. The common challenge for adoption EHR in public hospitals remains its high financial cost. To be specific, the Michigan Center for Effective IT Adoption estimates the cost of EHR implementation to be between $15,000 and $70,000 per provider (Reisman, 2017). Another challenge with EHR systems is that they lack interoperability which makes it impossible to exchange and then use data between providers. The third barrier is an EHR system usability which may influence the quality of care.

Hardware or software issues may lead to loss of entered data, incorrect default doses, incomplete patient data presentation, and inadequate interpretation of quality measurement data. Physicians and staff will need to spend additional time and effort using the technology instead of working on other necessary tasks which may lead to temporary reductions in care quality (Thirukumaran, Dolan, Webster, Panzer, & Friedman, 2014). Other challenges include cybersecurity threats and difficulties associated with managing information and physician burnout.

Challenges with the PP include a low percentage of signed up patients, safety and security issues, and lack of user-friendly interface. Portals can be difficult to navigate, and patients may struggle to understand the medical information. According to Giardina, Modi, Parrish, and Singh (2015), test result display and user interface seem confusing to patients. The difficulty with password reset process and mobile device compatibility may also be serious challenges to the use of the PP by patients.

However, implementation of EHRs may be beneficial for a public hospital. In particular, EHRs may be helpful in improving the level of care and productivity of caregivers and saving time for administrative stuff on polling charts. The EHRs system may also reduce the amount of paperwork and enable physicians to serve a greater number of patients, receive information on time in the form of electronic reports, and facilitate care coordination (Davis, Stremikis, Squires, & Schoen, 2014). A decrease in paperwork and elimination of workflow redundancies may lead to cost savings. Therefore, EHRs may contribute to dynamic modernization and value-based and cost-effective care of public hospitals.

Opportunities associated with the implementation of the PP include better patient communication as a patient will be able to use the portal to make appointments and request referrals. This, in turn, will enable hospital staff to concentrate on patients with more urgent needs. The possibility of filling the registration forms through the PP may contribute to the efficiency of front-office work. The PP streamlines patients engagement in their healthcare as they can access the information more readily.

EHRs are being implemented by a growing number of US hospitals as a result of government initiatives and financial stimulations. Large amounts of paperwork, lack of care coordination, and an increase in a number of medical errors speak of the importance of a comprehensive and automatized EHR system. Implementation of EHRs in hospitals may also be explained by enhanced integration and availability of patient data, as well as cost-effectiveness (Boonstra, Versluis, & Vos, 2014). Implementation of the PP in a public hospital may streamline patient registration and administrative task, which is vital for the facility as it deals with a great number of patients on a day-to-day basis.

To sum up, in the given essay the challenges and opportunities related to the implementation of EHRs and the PP in a public hospital have been discussed. These electronic automatized tools may improve the quality of care and productivity of the hospital personnel, as well as minimize care costs. Even though EHRs and PP are expected to have several positive effects on the performance of hospitals, their implementation may be associated with several challenges.


Boonstra, A., Versluis, A., & Vos, J. F. (2014). Implementing electronic health records in hospitals: A systematic literature review. BMC Health Services Research, 14(1). Web.

Davis, K., Stremikis, K., Squires, D., & Schoen, C. (2014). Mirror, mirror on the wall, 2014 update: How the U.S. health care system compares internationally. Web.

Giardina, T. D., Modi, V., Parrish, D. E., & Singh, H. (2015). The patient portal and abnormal test results: An exploratory study of patient experiences. Patient Experience Journal, 2(1), 148-154.

Reisman, M. (2017). EHRs: The challenge of making electronic data usable and interoperable. P&T, 42(9), 572-575.

Thirukumaran, C. P., Dolan, J. G., Webster, P. R., Panzer, R. J., & Friedman, B. (2014). The impact of electronic health record implementation and use on performance of the surgical care improvement project measures. Health Services Research, 50(1), 273-289. Web.