Empiric study showing that EHR implementation does slow patient flow through a busy pediatric ED, but this effect resolves within three months.
Spellman Kennebeck 2012 (JAMIA) | PubMed 22052897 | Author SearchAn AHRQ comparative-effectiveness technical brief summarizing current understanding of the special needs of child-health environments that should be reflected in the functionality of electronic health records.
Dufendach 2015 (Link) | PubMed 25950078 | Author SearchJoint statement from the American Academy of Pediatrics Committee on Adolescence and Council on Clinical Information Technology regarding how electronic health records should support the special privacy needs of adolescent patients. Acknowledges the basic conflict between parent as the financially responsible party and the adolescent who may want certain kinds of care to be kept private from the parent. Proposes the creation of standards that could support more sophisticated modes of information transmission and display.
[su_cite_pediatrics url_fragment = ‘130/5/987’ author = ‘Blythe’ year = ‘2012’] | PubMed 23109684 | Author SearchSurvey of U.S. Children’s Hospitals, confirming the observation that the HITECH Meaningful Use program was not felt to have much relevance to pediatric care. Describes rates of success in applying for, and receiving, this stimulus payment in the Eligible Hospital program.
[su_cite_pediatrics url_fragment = ‘135/6/e1409’ author = ‘Teufel’ year = ‘2015’] | PubMed 25963005 | Author SearchOregon Health & Science University study found a statistically-insignificant (p = 0.18) decrease of 11% in patient volume across four ophthalmology providers. RVUs were not evaluated. Despite the finding, the article concludes that there was a decrease in productivity attributable to the EHR implementation. From the Journal of American Association for Pediatric Ophthalmology and Strabismus.
Redd 2014 (Link) | PubMed 25456030 | Author SearchReviews obstacles to participation in the U.S. Meaningful Use EHR incentive program that are more important for pediatricians than for other types of providers, like meeting the 20% Medicaid threshold.
[su_cite_pediatrics url_fragment = ‘135/1/e1’ author = ‘Miller’ year = ‘2014’] | PubMed 25548326 | Author SearchA technical report outlining pediatric-specific needs for software used in the inpatient setting, but it also largely applicable for other clinical settings. From the American Academy of Pediatrics Council on Clinical Information Technology.
[su_cite_pediatrics url_fragment = ‘135/3/e756’ author = ‘Lehmann’ year = ‘2015’] | PubMed 25713282 | Author SearchResults of a survey by the American Academy of Pediatrics, showing the rate of AHR adoption by pediatricians. The percent of pediatricians using EHRs increased significantly from 58% in a 2009 survey to 79% in this 2012 data. Only 31% used an EHR considered to have basic functionality, and only 14% used a “fully functional” EHR (as defined in the paper). Even fewer used a fully “pediatric supportive” EHR, but the requirements for this were very high, and included decision support logic for immunizations that few EHRs can achieve. Providers with equal or greater than 20% public insurance patients (threshold for meaningful use eligibility) were more likely to have an EHR. Solo/2-physician practices were least likely to have adopted an EHR. Younger physicians were more likely to consider an EHR important to quality care and perceived the presence of an EHR as more important in recruiting.
[su_cite_pediatrics url_fragment = ” author = ‘Lehmann’ year = ‘2015’] | PubMed 25548325 | Author SearchPart of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program that attempts to define what an electronic health record used in child health ought to do in order to provide ideal care. The document (“format”) was developed through discussion with a broad range of stakeholders. There was no attempt to make this document a rigorous EHR functionality specification. It’s best described as a collection of good ideas about things an EHR should do in the child-health environment. A response to the use of the “format” indicated that the content had some face validity, but set a high bar for current EHR systems. The document can be downloaded from the AHRQ’s United States Health Information Knowledgebase.
To assess the impact of implementation of an electronic medical record system on families in an academic pediatric rheumatology practice, families were surveyed 1 month pre-EMR implementation and 3 months post-EMR implementation. Overall, the EMR was well received by families. Compared with the paper chart, parents agreed the EMR improved the quality of doctor care (55% or 59/107 vs 26% or 26/99, P < .001). More parents indicated they would prefer their pediatric physicians to use an EMR (68% or 73/107 vs 51% or 50/99, P = .01). [cite journal = 'jmir' url_fragment = '2011/2/e40' author = 'Rosen' year = '2011'] [su_pubmed pmid = '21622292' author = 'Rosen' inits = 'P']