Pediatrician use of EHRs up, but systems still inadequate

More pediatricians are adopting electronic health records, but many of the systems lack basic functionalities and/or functionalities geared to their specialty, according to a new study in Pediatrics, the official journal of the American Academy of Pediatrics.

The researchers, from Vanderbilt University and elsewhere, sent questionnaires to more than 1,600 pediatricians. They found that the percent of pediatricians using EHRs increased from 58 percent in 2009 to 79 percent in 2012. However, only 31 percent used one with basic functionality, and only 14 percent used one that was fully functional. Many of the systems lacked pediatric functionality, such as weight-based dosing and anthropometric analysis. However, there was an increase in some functionality from 2009 to 2012, mainly in race/ethnicity, electronic prescribing, electronic transmissions, medical history and follow up notes, according to the study.

"Lack of pediatric functionality requires that pediatricians perform tasks outside the EHR or develop workarounds adding to workload and reducing productivity and efficiency," the researchers said. "Not using EHRs that effectively support the care of children results in failure to achieve promised benefits of increased safety, decreased cost, and improved outcomes."

Studies have shown that while EHRs improve the health of children, the lack of pediatric functionality has proven to be a big stumbling block. The Agency for Healthcare Research and Quality recently outlined core functionalities that should be contained in a pediatric EHR, such as growth charts, vaccinations, family dynamics and pediatric conditions, such as asthma.

Using a checklist enhanced by an electronic health record and a unit-wide dashboard decreased the rate of central line-associated bloodstream infections (CLABSIs) in children, according to a study published last spring in Pediatrics.

To learn more:
- read the study (.pdf)