Electronic Health Records

Adoption & Implementation News

Nearly 80% of Pediatricians Use Electronic Health Records

By Jennifer Bresnick

The adoption of electronic health records among pediatricians could be improved by specialty-specific functionalities, a new survey finds.

Electronic health records reached nearly 80% of pediatricians as early as 2012, according to a newly published study from the American Academy of Pediatrics, although few providers use EHRs that qualify as “basic” or “advanced,” and pediatric-specific functionalities are scarce.  While EHR adopters tended to skew younger and work in larger care settings, the generally high rate of usage, and the intent of many more pediatricians to adopt EHRs in the future, is encouraging for health IT advocates.

“The American Academy of Pediatrics (AAP) considers the use of electronic health records a mark of professionalism and a means to improve quality, efficiency, and safety of pediatric care,” the study says.  “It is critically important to the health maintenance of our children that pediatricians adopt EHRs, which support the basic practices of pediatrics.”

The survey follows up on a similar 2009 questionnaire, in which just 58% of pediatricians were using electronic health records of any kind.  In 2012, the typical pediatric EHR adopter was likely to be younger than 49 years old and have more than 40% of his or her patient population reliant on public insurance.  Pediatricians are only eligible for the EHR Incentive Programs if 20% or more of their patients are eligible for Medicaid, which may explain why providers with larger numbers of public insurance patients are approximately 15% more likely to be EHR users than those with fewer public insurance beneficiaries.

Larger organizations were much more likely than solo or small practice physicians to use EHRs.  Medical schools, hospitals, and clinics boasted the highest adoption rate at 90 percent, while only 56% of individual practitioners and two-physician providers could say the same.  Rural practices were significantly more likely to be EHR adopters than suburban ones.

Forty-five percent of users had electronic health records that meet the standards of a basic or fully functional EHR, the study found, but only 8% of fully-functional EHR adopters had the ability to access the five main pediatric-specific functionalities: weight-based dosing aids, well-child visit and immunization tracking, the ability to calculate catch-up immunizations, and the ability to plot child growth charts and analyze body mass index (BMI).

The most common features available to pediatricians were patient demographics, laboratory results, problem lists, prescription orders, clinical notes, and growth charts.  Users were unlikely to have access to dosing alerts, chronic disease intervention guidelines, and age-specific normal values.  Sixty percent of physicians thought that the greater availability of pediatric-specific features might encourage greater adoption.

Despite the room for progress, most pediatricians took a positive view of EHRs.  Fifty percent believe that EHs are necessary to provide high quality patient care, while just 32.4% disagreed.  Providers who had already adopted EHRs were more likely to agree with the statement than those without one.  Adopters cited communication with other providers, better access to medical records, easier prescription management, and better practice management as some of the benefits they had seen from EHR use.

“Improving the quality of care by using an EHR has been widely touted as an important reason and incentive for adoption,” the study concludes. “The survey data indicate that the current state of pediatric EHRs may be falling short. The most frequently mentioned negative EHR impact was decreased efficiency and added documentation burden.”

“More research on best practices and the effects of EHRs on pediatric offices is necessary to develop improvements needed to increase pediatricians’ confidence in EHR technology.”

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