Most Pediatric Hospitals Still Not EHR-ready

The vast majority of pediatric hospitals in the US lack the minimum functionalities required for a “basic” EHR system, according to research published in the Archives of Pediatric & Adolescent Medicine.

In the study, Mari M. Nakamura, MD, MPH, of Children's Hospital Boston, and colleagues assessed adoption of EHRs and clinical functionalities, involvement in health information exchange, and barriers to and facilitators of adoption among children's hospitals in the US.

Of the 108 hospitals that responded to the survey, only 2.8% had a comprehensive EHR, and 17.9% had a basic system, according to the authors. Adoption of individual functionalities varied widely, as fewer than half of the facilities reported “comprehensive implementations of computerized provider order entry for medications and many forms of decision support.”

In all, 15.7% of hospitals reported that they exchange health information electronically, while 34.3% have "comprehensive implementations" of computerized prescriber order entry for medications, with the majority lacking "many forms" of clinical decision support.

Not surprisingly, cost was the most common reason provided by organizations that haven’t adopted electronic records. "The two most common barriers to EHR adoption identified by children's hospitals were inadequate capital for purchase and maintenance cost," the authors wrote. The most frequently cited facilitators were reimbursement for EHR use and financial incentives for implementation.

“Most children's hospitals lack the minimum functionalities needed for a basic EHR,” Nakamura and colleagues concluded. “Ensuring access to adequate financial resources will be critical for inclusion of children's hospitals in efforts to expand EHR use.”

Children’s Hospital Boston (CHB), however, fits into the small percentage of children’s health organizations that has achieved significant success in implementing IT systems. In fact, CHB—which is a teaching facility—recently achieved Stage 7 status, the highest level of the EMR Adoption Model established by HIMSS Analytics. CHB is one of just 52 hospitals (1% of the 5,000 hospitals in the HIMSS Analytics Database) to earn this recognition.

HIMSS Analytics developed the EMR Adoption Model in 2005 as a methodology for evaluating the progress and impact of electronic medical record systems for hospitals in the HIMSS Analytics Database, it said in a press release. Tracking their progress in completing eight stages (0-7), hospitals can review the implementation and utilization of IT applications with the intent of reaching Stage 7, which represents an advanced patient record environment. The validation process that confirms a hospital has reached Stage 7 includes a site visit conducted by an executive from HIMSS Analytics and former or current CIOs to ensure an unbiased evaluation of the Stage 7 environments.

For more:

• Electronic Health Record Adoption by Children's Hospitals in the United States
• Less than 3 percent of children's hospitals have 'comprehensive' EHRs
• Study: Most Pediatric Hospitals Lack 'Basic,' 'Comprehensive' EHRs