The key electronic health record challenges that providers face in 2018 relate to security, interoperability, and physician burnout. Security breaches continue to plague the healthcare industry and reducing the benefits of EHRs. Achieving true interoperability between health systems is difficult due to a lack of standardization and high costs. Physician burnout is also a major problem caused by the increased workload of maintaining patient records in EHR systems.

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Overcoming Major Electronic
Health Record (EHR)
Challenges in 2018
In 2018, the key electronic health
record challenges that providers face
relate to security, interoperability and
physician burnout.
MTS Transcription Services
United States

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According to a SK&A survey, in March 2017, 67% of all providers reported using an
electronic health record (EHR), a 1% increase over September 2016. As EHR adoption rates
increase across the nation, medical transcription companies continue to provide clinicians
with dedicated clinical documentation solutions to ease data entry hassles. However, recent
reports indicate that hospitals and health systems continue to face many problems related
to implementing, maintaining, and upgrading their EHRs. In 2018, the key EHR challenges
that providers face relate to security, interoperability and physician burnout. Let’s take a
look at these challenges and the solutions recommended by experts.
Cybersecurity: Cybersecurity is critical for health care data and information systems. The
shift from paper records to EHRs was meant to improve efficiency, safety, and patient care.
However, EHR security breaches continue to plague the healthcare industry and are reducing
the overall benefits of the EHR program.
In December 2017, Henry Ford Health System reported that the data of 18,470 patients
were compromised. A ransomware attack on Fayetteville-based Arkansas Oral Facial
Surgery Center in October potentially breached the data of 128,000 of its patients. In
addition to harming the healthcare organization reputation and compromising protected
health information (PHI), breaches are very expensive. Beckers Hospital Review reported
that breaches in the U.S. healthcare field cost $6.2 billion each year.
A 2015 white paper from Accusoft identified the top four EHR security and data challenges
as hacking, adoption, outdated technology, and lack of training. The paper suggests several
measures to address medical record data security concerns:
- Improving administrative controls: This includes password protection and encryption
while sharing EHR data. Administrative controls are necessary to strictly restrict
access to EHRs.
- Monitoring system access: EHR system administrators need to monitor and track
access so that unauthorized access can be quickly detected and addressed.
- Use of advanced document viewers: Integrating a secure and efficient document
viewer will make it possible to read and share documents such as medical and
financial records, insurance forms, physician’s’ orders, prescriptions, X-rays and lab
results, in any format.

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Other measures that security experts recommend to prevent data breaches in healthcare
include:
- Increasing investment in cyber security and setting up an advanced network security
system that can detect signs of compromise and quickly respond before the attack
starts.
- Conducting a HIPAA and HITECH annual security evaluation can reveal potential
threats
- Implementing up-to-date security measures and vet partners and third parties such
as medical transcription service providers to ensure that they also have proper
security systems in place
- Having one secure network exclusively for patient information.
- Providing on-going employee training on data security best practices in the
workplace.
- Securely destroying confidential electronic data
Interoperability: Healthcare IT News notes that the continued focus on interoperability is
another major challenge facing EHRs in 2018. Improved healthcare interoperability is a top
priority to coordinate care across various health settings nationwide. Efforts are being made
by the public and private sectors to allow seamless health data exchange between health IT
systems. Such interoperability is necessary to get the complete picture of a patient.
However, achieving true interoperability continues to be a major challenge.
In a 2017 HIT Intelligence report, Nebraska Medicine Vice President of IT Brian Lancaster
noted that lack of standardization and control over file sharing are major barriers to EHR
interoperability. Other challenges to interoperability include
- the growing volume of data from different sources and remote patient monitoring,
acquisitions
- huge costs involved in getting all of the IT systems to work together
- lack of proper payer participation in interoperable systems, and
- difficulties in creating automated work flows with partner organizations
In the Health IT News report, one expert recommends it should be mandated that all vendor
products meet interoperability standards and also making some standards simpler.
According to another expert, interoperability can succeed only if EHRs are open to accept

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data from outside resources such as daily living settings and nursing homes and also data
collected in daily living settings such as home, work, and restaurants.
The shift to value-based care in the healthcare industry is another problem. EHRs need to
be designed to incorporate value-based aspects in place of fee for service paradigms.
Clinician burnout: Burnout a major problem hounding physicians in recent years, caused
mainly by the increased workload that EHRs pose. Clinicians are finding it very difficult to
maintain and update patient records while providing care. Many studies have shown that
patient care and safety are at stake when providers get overwhelmed by the workflows to
manage EHRs.
Experts recommend that one way to overcome this challenge is have a team exclusively
focused on working with the staff and explain the workflow requirements, find shortcuts,
and inform EHR analysts about the issues they face. Medical transcription outsourcing is
also helping to address clinician burnout due to EHR data entry issues. Experienced
companies now provide HIPAA-compliant EHR-integrated documentation solutions for all
medical specialties.
EHRs are not going away and industry stakeholders need to step up their efforts to make
them work smoothly. Stringent cyber health laws and robust encrypted data storage and
exchange in EHR systems can prevent security issues and data breaches. Consumers as well
as physicians need to be educated on EHR usage and security. Improving EHR design to
meet evolving industry standards and new requirements is necessary to support clinician
workflow. Increased interoperability should be developed between EHR systems and
patient’s mobile devices and telehealth systems.