News Feature | January 9, 2015

Study: EHR Use By Office-Based Pediatricians Still Problematic

Christine Kern

By Christine Kern, contributing writer

Doctor Purge UnitedHealth

Only 14 percent of those surveyed used a fully functional EHR.

A recent study concluded that, despite an increase in the number of office-based pediatricians using electronic health records, only 14 percent reported using a fully functional EHR and even fewer have added specific pediatric functionality. And while overall EHR use among pediatricians has risen to nearly 80 percent, costs associated with EHRs and subsequent reductions in productivity remain serious concerns.

The article, Use of Electronic Health Record Systems by Office-Based Pediatricians” was authored by Christoph U. Lehmann, Karen G. O’Connor, Vanessa A. Shorte, and Timothy D. Johnson and appeared in the December 29 online issue of Pediatrics, the journal of the American Academy of Pediatricians.

The study authors set out to determine the prevalence and functionalities of EHRs, as well as pediatricians’ perceptions of EHRs, through the use of a self-administered survey of 1,621 pediatricians from July to December 2012. The responses were then compared with a similar 2009 survey.

The study found that, although there was a significant increase in the percentage of pediatricians who reported using EHRs – from 58 percent in 2009 to 79 percent in 2012 – only 31 percent used an EHR considered to have basic functionality and just 14 percent used a fully functional EHR. Providers at or above the threshold for meaningful use eligibility (20 percent public insurance patients) were more likely to have an EHR, while solo and two-physician practices were least likely to have adopted an EHR.

These figures should not be shocking, given the realities of EHRs and the medical specialties. NueMD reported EHR software is not tailored to the needs of pediatricians. Even the U.S. Department of Health and Human Services (HHS) has realized this gap in availability and has been working to identify the key functionalities necessary to optimize EHR software use for use by pediatricians and other medical specialists.

As early as December 2002, a group of physicians engaged in a study of basic EHR functions needed for pediatrics. The results were published in the journal Pediatrics, and noted that the lack of appropriate functionality was negatively affecting workflow.

Among the ideal features for pediatric EHRs, according to lead author Michael Leu, M.D., a pediatrician at Seattle Children’s hospital, would be the capability to track well-child visits, support growth of chart analysis, track immunizations and forecast vaccines, and enable weight-based dosing of prescriptions.

But almost three years later, the basic functions requested by the pediatric sector are still missing in action. The HHs has attempted to address this gap, and recently the Agency for Healthcare research and Quality (AHRQ) released a technical brief detailing for EHR vendors the fundamental functionalities most desired by medical specialties. The brief was compiled using literature reviews and discussions with key stakeholders to identify these functionalities.

The report concludes, “There is a role for the EHR certification process to advance functionalities used by pediatricians and to increase efficiency, data exchange capability, and general EHR functionality. It is critically important to the health maintenance of our children that pediatricians adopt EHRs, which support the basic practices of pediatrics. There is a role for the EHR certification process to mainstream key pediatric functionalities to improve usability for pediatricians.”