Electronic health record (EHR) adoption is becoming the standard due to the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program. However, medical records on St. John, as with much of the US Virgin Islands, are still mostly paperbased. Some of the providers are able to share medical records, but this is particularly challenging with the emergency clinic.

EHRs make health information available instantly and securely to authorized users whenever and wherever they need them. EHRs could help streamline the healthcare workplace, improve quality of care, update information easily, and exchange data with other care providers. However, implementing an EHR system on St. John will come with unique challenges, such as the frequent lack of connectivity on the island, finding an EHR suitable to the combination of providers and island setting, a limited HIT workforce to initiate and service the system, and possible difficulty obtaining community buy-in as well as buy-in from health providers. Healthcare staff on St. John are limited and often working very busy schedules and long hours, as well as frequently taking on multiple roles, which will make dedicating time to this effort a challenge. This project will implement an EHR system on St. John that allows a patient to opt-in to having their medical records stored electronically and shared across providers whether they are private, government or nonprofit. This will ideally involve coordination across the territory in order to ensure optimal integration into one health information exchange.

IMPLEMENTATION STEPS: 1. Select a Key Players and recruit a support team for the project. 2. Initiate an informational campaign to increase buyin from local providers and healthcare recipients. 3. Select an EHR provider (assess St. John’s needs, cost factor, resources, technical expertise available) that is cloud-based 4. Establishing a governance process and a project plan, communicating with healthcare staff and patients, redesigning workflows and providing education.the system.

Key Players: Healthcare providers on St. John Alignment: HSS RSFs Cost: < $500,000 Timeline: Three Years