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Electronic Health Record Adoption by Children's Hospitals in the United States

2010; American Medical Association; Volume: 164; Issue: 12 Linguagem: Inglês

10.1001/archpediatrics.2010.234

1538-3628

Mari Nakamura, Timothy G. Ferris, Catherine M. DesRoches, Ashish K. Jha,

Pharmaceutical Practices and Patient Outcomes

Objective: To assess adoption of electronic health records (EHRs) and clinical functionalities, involvement in health information exchange, and barriers to and facilitators of adoption among children's hospitals in the United States.Design: Survey presented as an information technology supplement to the American Hospital Association's annual member survey.Setting: General acute care children's hospitals in 2008, identified using the membership directory of the National Association of Children's Hospitals and Related Institutions.Participants: Chief information officers or equivalent hospital leaders.Main Exposures: Potential barriers to or facilitators of EHR adoption.Main Outcome Measures: Rates of EHR adoption, determined using expert-formulated definitions based on presence of essential functionalities, and rates of imple-mentation for individual functionalities and participation in health information exchange.Results: Of 155 children's hospitals, 108 (69.7%) responded to the survey.Only 2.8% had a comprehensive EHR, whereas an additional 17.9% had a basic system.Adoption of individual functionalities varied widely; comprehensive implementations of computerized provider order entry for medications and many forms of decision support were reported by fewer than half.In all, 15.7% of hospitals exchanged health information electronically.Hospital characteristics were not associated with EHR adoption or participation in health information exchange.Hospitals identified financing as the most important target for policy strategies.Conclusions: Most children's hospitals lack the minimum functionalities needed for a basic EHR.Ensuring access to adequate financial resources will be critical for inclusion of children's hospitals in efforts to expand EHR use.