How to Solve the ‘new normal’ EHR Implementation Challenges

By Liza Dzhezhora, Healthcare IT Analyst, Itransition
Twitter: @itransition

Electronic health records (EHR) have become ubiquitous in the US healthcare industry. However, the work on improving those solutions is in full swing. According to Fact.MD, the EHR market value is expected to reach $41.8bn in 2022 – 2032.

What are the key EHR implementation challenges, and how to solve them? We will look into the matter.

EHR implementation challenges

The challenges providers face today have broadened. On the one hand, well-known issues like interoperability and usability are still there. On the other hand, the pandemic put an extra load on the US healthcare system, which generated additional hindrances. So what are they? Let’s consider them in full.


EHR interoperability and usability have long been the top EHR implementation challenges. However, in the new normal, the officials and industry leaders have fully acknowledged the critical need for interoperability.

Thus, in May 2020, the HHS Office of the National Coordinator for Health Information Technology (ONC) introduced the final rule for patient access and data sharing. The act set first policies for advancing interoperability and patient access to healthcare information, stressing the need for health data exchange.

According to ONC: “We believe this is an important step in advancing interoperability, putting patients at the center of their health care, and ensuring they have access to their health information”.

Fast Healthcare Interoperability Resources (FHIR), a standard fostering interoperability across providers, allows secure exchange of healthcare information, including clinical and administrative data. However, setting it up requires programming effort from a qualified vendor and additional investments.

While the interoperability challenge is not solved yet at the national level, private health information exchanges, or EHR systems enable interoperability among healthcare organizations in particular regions.


Key factors that worsen EHR usability include data overload, insufficient information (either hidden or missing), and the need for manual calculations, according to a 2022 EHR usability study. Completing tasks, the study participants had to search for the needed data in 12 EHR pages per patient.

Difficulties with adding clinical workflows to EHR are another usability pain point. A 2021 research by Cardiovascular Digital Health Journal looked into the usability of EHR solutions for cardiologists. Unfortunately, the solutions scored only 48 points on the System Usability Scale (SUS). As for workflow support, participants noted that their EHRs impede it.


The pandemic has significantly changed healthcare delivery. Remote care has become a reality, and patients’ behavior also changed. They have become consumers of healthcare services who aim to participate in the decision-making about their health. Accordingly, patient engagement across diverse channels has become even more important.

Statista reports over 50% of the US healthcare leaders have already set off the journey for patient engagement across many channels. However, they should seamlessly integrate new engagement solutions with EHR systems. And this is where we may find the rub.

The problem is that patient engagement apps may come from different vendors and integrating them may take more time and effort. While integrating well with the EHR system, their interaction with one another may be inefficient or faulty.

Human factor

However efficient the tools, for the clinical staff, they become an extra stress factor. A new solution can increase the workload on clinicians, as they have to spend more time on relevant training.

Consequently, the increased workload can foster resistance to change in clinical staff. Employees could disagree that a new electronic records system will improve the situation. It results in missing training sessions, which impedes the training efficiency.

Viable solutions

Though challenges seem overwhelming, a well-designed EHR implementation strategy can help. How to make it work?

Informed preparation

Quite often, a new EHR system is announced shortly before the deployment, which only increases the detrimental effect of the above challenges. It is reasonable to act the other way around.

Your medical facility leader needs to discuss the problems of the existing EHR system and voice the need to replace it with a better solution.

It is also vital to highlight the new system benefits for the key actors – patients, staff, and the provider per se. This approach helps mitigate the resistance to change, as the change comes as the solution to the main pain points.

Adding doctors to the team

Traditionally, doctors’ participation in the projects limits to on-the-go training. However, they could play a more significant role in successful EHR implementation.

It is not necessary to onboard every doctor in your facility. You can select clinicians with a middle to high level of computer literacy and competence with digital tools. To identify them, the project team can run simple computer literacy tests available online. Those who score high then form part of the project team.

Participating in the project activities, doctors can help:

  • Streamline introducing clinical workflows into the system. Doctors can review and update the selected workflows to have them reflect clinical processes fully. Doctors’ participation can leverage introducing user-centered workflows, which helps improve EHR usability and user satisfaction.
  • Facilitate patient engagement or other tools integration. Clinical staff can map potential integrations beforehand and present them to developers. It allows developers to plan the needed activities carefully.
  • Participate in usability testing and detect issues that affect patient safety, such as incorrect dosage or units of measurement.
  • Assist in the training process. Skilled clinicians can supervise training and help digital tool beginners learn the top system use cases, workflows, and features.

Involving clinicians in EHR implementation can help resolve EHR implementation challenges with no extra time and monetary expenses.

Summing up

Though EHRs have already become integral for most US healthcare facilities, the system implementation challenges are not solved yet. Moreover, a whole new set of challenges appeared in the new normal. It is not only EHR interoperability and usability that torment providers and development teams. They should also consider multiple integrations and deal with the human factor.

Resolving the mentioned challenges requires a unified strategy. The steps to take include:

  1. Smart preparations. Your facility leader needs to discuss the issues with the team and communicate how the new EHR system can solve them. This helps reduce negative human factor impact.
  2. Add doctors to the team. Tech-savvy doctors can help adding workflows to the EHR, mapping the needed integrations, and improving the solution’s usability.

The above steps help put the key EHR users – clinicians and patients – at the center of the project and carefully monitor their needs and pains throughout the project implementation.

Choosing an EHR implementation consultant may also help. EHR implementation experts can facilitate the process and help you build an effective EHR system within your organization.