Pediatricians slower to adopt EHRs than most docs

Pediatricians' adoption of electronic health records lags behind general adoption of the technology, according to a study published online this week in the journal Pediatrics.

Six hundred forty-six U.S. members of the American Academy of Pediatrics were polled in 2009, before federal incentives to move to electronic records went into effect. Though 41 percent reported using electronic records, only 25 percent used technology that met the definition of a basic system; 6 percent used systems defined as fully functional EHRs.

Only 3 percent reported using a system that supported pediatric features, such as immunization tracking and weight-based dosing for prescriptions, according to MedPage Today.

Basic functionality included features such as patient demographics, problem lists, prescription orders, clinical notes and the ability to view laboratory results. Full functionality included such features as out-of-range laboratory result display, drug interaction warnings and e-prescribing.

Respondents said the biggest barriers to adoption were cost (56 percent), finding an EHR that met their needs (40 percent) and concern about loss of productivity during transition (36 percent). Those in one- or two-physician practices were five times less likely to use a basic EHR system than those in a multispecialty practice, and almost six times less likely that those in a hospital or clinic practice.

The authors estimated that pediatricians are one to two years behind the general rate of adoption of fully functional EHR systems.

Though the adoption rate no doubt has grown with the federal incentives, S. Andrew Spooner, M.D., of the Cincinnati Children's Hospital, in an accompanying commentary, called the results "alarming." He says the Meaningful Use criteria will not drive development of systems that pediatricians need, such as immunization tracking.

The study authors suggested that policy initiatives may be required to remove barriers, such as difficulty in data sharing, with state immunization registries.  

Various physician groups have complained that off-the-shelf EHR systems don't meet their specific needs. Indeed researchers at the University of California at Davis have argued that "one-size-fits-all" EHR design simply does not work, saying technology design "should vary by physicians' requirements and work-flow demands."

Earlier this month, the American Academy of Pediatrics released a policy statement saying that EHR technology should be retooled to protect the medical privacy of adolescent patients. Its recommendations included developing criteria for EHRs that meet federal and state standards for adolescent privacy and determining who has access to or the ability to control access to the medical record.

In a recent study of teens at a detention center who engage in high-risk behaviors, a vast majority expressed interest in accessing their health records online, but only half said they were willing to share that information with their parents.

To learn more:
- read the abstract
- here's the MedPage Today article