Pediatricians cite cost, uncertainty of benefits as barriers to EHR adoption

November 20, 2012 in Medical Technology

Pediatricians in the U.S. continue to adopt electronic health record (EHR) systems at an underwhelming rate, citing costs and hesitancy over potential system benefits, according to a new report published Monday.

The study, published in Pediatrics and conducted by researchers at the Seattle Children’s Hospital, East Carolina University and the American Academy of Pediatrics, sought to shed light on the often opaque and limited data surrounding pediatricians and health IT adoption rates.

After examining survey results on adoption rates and potential barriers, researchers pegged pediatricians to be about 1-2 years behind physicians in other specialties when it comes to EHR adoption.

[See also: Survey names top five states for physician EHR adoption.]

Although self-reported pediatrician EHR use was pegged at 41 percent, findings show only 19 percent of the systems met the definition of a basic EHR, and a paltry 6 percent were considered “fully functional.”

Moreover, data confirms only 3 percent of pediatricians used a system that was both fully functional and “pediatric-supportive.”

“Even if the pediatricians are adopting the systems, the systems that they’re adopting don’t have the features that would really make the practice easier,” said Michael Leu, MD, co-author of the study.

He cites one reason behind this as being several key differences between pediatric system needs and adult system needs. Normal EHR systems, he added, typically don’t have something called “weight-based dosing” because adults usually have one dose amount across the board. “In pediatrics, we support kids that are all different sizes and shapes,” Leu said. “So a small child gets a small amount of medicine, and a large child gets a larger amount of medicine.” Without this capability, pediatricians would need to calculate the dosages on their own.

The most significant factor dissuading physicians from adopting such systems was financial barriers, with more than half (56 percent) of pediatrician respondents citing cost concerns.

Some 40 percent reported that actually finding a system that met the provider’s particular needs was another substantial concern. Because EHR systems don’t typically have weight-based dosing features, in addition to automatic growth chart plotters, immunization tracking and catch-up immunization calculations, Leu said it makes sense that providers are concerned over finding a system that meets pediatric needs.

Other barriers cited included concern over loss of productivity during transition (36 percent), qualms regarding return on investment (34 percent) and apprehension that the system will be outmoded and dated by the time it is implemented (34 percent).

Solo pediatrician practices or those with two physicians were less likely to have a fully functional and pediatric supportive EHR system.

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