Though the number of office-based pediatricians using electronic health records has risen to nearly 80 percent, relatively few of them use a basic or fully functional EHR and even fewer have added pediatric functionality, while EHR cost and reduction in productivity remain serious concerns.

That is the conclusion of an article published online Dec. 29 in Pediatrics, the journal of the American Academy of Pediatrics. To determine the prevalence and functionalities of EHRs, as well as pediatricians’ perceptions of EHRs, a self-administered questionnaire was sent to 1,621 pediatricians from July to December 2012 and the responses were compared with a similar 2009 survey.

Despite the fact that the percentage of pediatricians using EHRs increased significantly 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 with equal or greater than 20 percent public insurance patients (the threshold for meaningful use eligibility) were more likely to have an EHR, while solo and two-physician practices were least likely to have adopted an EHR.

When it comes to health information exchange, the article finds that “EHR products used in pediatric offices lack the meaningful data exchange with other EHRs or public health repositories” and that the “benefit of increased communication because of EHR implementation remains largely limited to within the practice or the enterprise EHR.”

In addition, cost was identified as a barrier by 63.5 percent of those surveyed and productivity loss by 74.9 percent. Other barriers indicated by survey participants included the difficulty finding a system meeting provider needs (72.3 percent), concerns over systems becoming obsolete (60 percent), resistance to adoption (59.5 percent), lack of resources to select, contract, and implement a system (57.2 percent), and concerns over return on investment (53 percent). At the same time, few survey respondents considered legal or regulatory barriers to be major barriers.

“It is critically important to the health maintenance of our children that pediatricians adopt EHRs, which support the basic practices of pediatrics,” conclude the article’s authors. “There is a role for the EHR certification process to mainstream key pediatric functionalities to improve usability for pediatricians.”

The article argues that more research on best practices and the effects of EHRs on pediatric offices is necessary to develop improvements needed to increase pediatricians’ confidence in EHR technology.

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