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Describe the challenges and opportunities associated with the implementation of an EMR, EHR/Patient Portal, or Decision Support/Dashboard?


An environment which is selected for this assignment is a health care set up. This assignment is going to inform challenges and opportunities related to the implementation of an EMR, patient portal and decision support systems within the health care sectors. Three areas will be identified and a detailed discussion will be performed regarding electronic medical record. The challenges and future trends will also be discussed. The discussion will be based on the current working environment that means the current health care set up I am currently working.

Information technologies in health care sector are designed to develop medical decision making and are typically striking for their capacity to deal with the growing data overload doctors face and to offer stage for integrating evidence dependant knowledge into care facility. An electronic health record is said to be a digital version of client’s paper chart. These are patient oriented records, real time records, which make data available directly and safety to the approved users. In this electronic age, the health care professionals have started recognizing the significance of electronic medical records and implementing the same within the health care sector. The Healthcare Information and Management Systems Society or HIMSS illustrated that EMR and EHR, these two terms are frequently applied synonymously but a difference is present between these two terms. The EMR is maintained by the care facility of a client or the doctor’s office and comprises entire details of medication and blood records (Beard & Hamid, 2014). Electronic health record is broader and generally does not include each and every detailed data in the EMR. Instead, the EHR has data summary that means the information a client and care provider should know after care is ended (Estrada & Dunn, 2012).

Decision support system or clinical decision support (CDS) is considered as a system that offers health care personnel, clinicians and others with person centered information and knowledge with wisely filtered or stated at proper times, to develop public health and health care set up (HARRISON & LYERLA, 2012). Decision support system includes various tools to improve decision making within the medical workflow. These mechanisms include clinical guidelines, reminders to health care staff and clients, computerized alerts, situation specific order sets, summaries, patient data statements, diagnostic support, documentation templates and contextually applicable reference information. Decision support system has number of significant benefits, comprising increased care quality and improved health consequences, error avoidance and adverse situations, cost-benefit, developed effectiveness, care providers’ and patient satisfaction. It is considered as a sophisticated health information technology component. It involves person focused information quantifiable biomedical knowledge and a reasoning mechanism, which combines data and knowledge to present and generate supportive data to the doctors. These data need to be organized, filtered and presented in such a way which supports current workflow, permitting the service users to quickly develop an informed decision and take action. Different types of decision support systems are available for different care processes in different care settings. Most of the applications, which are associated with the decision support systems work as elements of comprehensive electronic health record systems, though stand alone decision support systems are also applied.

Opportunities associated with an EMR implementation

An EMR implementation is considered as an enormous opportunity to get staff and physicians more intensely engaged with the organization and more focused to the larger mission. It is also said to be a good possibility to strengthen the way to remind them that the electronic medical record assists every person provide enhanced care services. It is a true fact that implementation of a new technology can bring disruption, but organizations which attempt to prepare staff and physicians for the changeover can observe great outcomes. Benefits of the electronic medical records include: identification of clients who are appropriate for screenings and preventive visits, track information over time, improve overall care quality in healthcare practice and monitor how clients appraise up to definite parameters, for example: reading related to blood pressure and vaccinations.


Challenges associated with an EMR implementation

Challenges may include costs, startup costs, maintenance costs, training costs, software usability deficiencies and software quality and lack of well-formed interoperability. 

Lack of well-formed interoperability: It is said that in the United States, no standards for well-formed interoperability are present regarding health care facts and no syntactic standards are also present. This means while information may be packed in standard format, it lacks explanation or connection to universal shared dictionary (Shedenhelm, Hernke, Gusa & Twedell, 2008). The layer addition of complicated information models does not unravel this basic issue.

Training costs: employees’ training to work with electronic health record system is expensive. New joiners, temporary or permanent employees also require training during initial stage after they are appointed. 

Maintenance costs: maintenance costs are high. Additionally, software technology advancements take place at a fast pace. Most of software involves frequent updates, frequently at a considerable ongoing cost. Various types of operating systems and software need unlimited reimplementation periodically that interrupts not only the financial plan but also productivity. Cost up-gradation and related regression analysis can be especially high where applications are administrated by the FDS guidelines, such as: clinical laboratory systems. Doctors want modular upgrades and capability to repeatedly customize, without comprehensive reimplementation.

Cost savings can take place in large incorporated institutions and not in undersized doctors’ offices. Especially office depended doctors may observe no advantage if they buy such product and can suffer economical harm. Though the application of health information technology could produce cost savings for health system at large, which might offset the cost associated with electronic medical records, many doctors might get failed to diminish their office expenditures or augment their income sufficiently to finance it. For instance, the application associated with health information technology could diminish the amount of duplicated diagnostic analyses. Nevertheless, the development in effectiveness would be doubtful to raise the revenue of many doctors. Provided the easiness at which instruction can be swapped between health information technology systems, clients whose doctors apply them may experience that their confidentiality is at risk if paper documentations were utilized.

Future tends include error prevention in the context of healthcare information process and medications, less but efficient recruitments of selective professionals which can increase quality of health care and care delivery.



Beard, H., & Hamid, K. (2014). Worth a thousand words: Integrating clinical photographs into an electronic medical record. Healthcare, 2(1), 22-25. doi:10.1016/j.hjdsi.2013.09.009

Estrada, N., & Dunn, C. (2012). Standardized Nursing Diagnoses in an Electronic Health Record: Nursing Survey Results. International Journal Of Nursing Knowledge, 23(2), 86-95. doi:10.1111/j.2047-3095.2011.01201.x

HARRISON, R., & LYERLA, F. (2012). Using Nursing Clinical Decision Support Systems to Achieve Meaningful Use. CIN: Computers, Informatics, Nursing, 30(7), 380-385. doi:10.1097/ncn.0b013e31823eb813

Shedenhelm, H., Hernke, D., Gusa, D., & Twedell, D. (2008). EMR implementation and ongoing education. Nursing Management (Springhouse), 39(7), 51-53. doi:10.1097/01.numa.0000326567.84908.44


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