RT Journal
A1 Nakamura MM, Ferris TG, DesRoches CM, Jha AK
T1 ELectronic health record adoption by children's hospitals in the united states
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2010
FD December 1
VO 164
IS 12
SP 1145
OP 1151
DO 10.1001/archpediatrics.2010.234
UL http://dx.doi.org/10.1001/archpediatrics.2010.234
AB 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 implementation 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.