Use of Health Information Technology by Children's Hospitals in the United States

Abstract

OBJECTIVE. The purpose of this study was to examine the adoption of health information technology by children's hospitals and to document barriers and priorities as they relate to health information technology adoption.METHODS. Primary data of interest were obtained through the use of a survey instrument distributed to the chief information officers of 199 children's hospitals in the United States. Data were collected on current and future use of a variety of clinical health information technology and telemedicine applications, organizational priorities, barriers to use of health information technology, and hospital and chief information officer characteristics.RESULTS. Among the 109 responding hospitals (55%), common clinical applications included clinical scheduling (86.2%), transcription (85.3%), and pharmacy (81.9%) and laboratory (80.7%) information. Electronic health records (48.6%), computerized order entry (40.4%), and clinical decision support systems (35.8%) were less common. The most common barriers to health information technology adoption were vendors' inability to deliver products or services to satisfaction (85.4%), lack of staffing resources (82.3%), and difficulty in achieving end-user acceptance (80.2%). The most frequent priority for hospitals was to implement technology to reduce medical errors or to promote safety (72.5%).CONCLUSION. This first national look at health information technology use by children's hospitals demonstrates the progress in health information technology adoption, current barriers, and priorities for these institutions. In addition, the findings can serve as important benchmarks for future study in this area. Pediatrics 2009;123: S80-S84 T HE USE OF health information technology (HIT) by hospitals has increased significantly over the past decade. 1 The increase in use has corresponded to mounting evidence 2-4 suggesting the diverse benefits that can be realized when hospitals implement information systems. These benefits include improved clinical, 5,6 operational, 7 and financial 8,9 performance. Studies have highlighted the specific benefits, 10-12 as well as the risks, 13 of HIT for pediatric patients, who are more susceptible to potential harm from medical errors. 14 For example, the use of electronic order entry by physicians in a pediatric critical care unit was associated with almost-complete elimination of medication prescribing errors. 15 The use of electronic tools was associated with error reduction in pediatric chemotherapy. 16 Given the frequency with which patient safety events, 17 including adverse drug events 12 and medication errors, 18,19 affect pediatric care, many experts have advocated the increased use of HIT by pediatric providers. 18-21 However, some researchers have identified adverse outcomes related to the implementation of HIT. 13 Most children who require hospital care are seen at either acute-care community facilities or specially designated children's hospitals (CHs). CHs, which are devoted exclusively to the care of children, inclu...

Factors Associated With Meaningful Use Incentives in Children's Hospitals

“…2 As early as 2005, children's hospitals reported barriers to EHR use similar to hospitals that care for adults, such as cost and provider resistance, as well as barriers unique to pediatric care, such as products not designed for care of children. 3,4 Examples of important EHR features needed to support pediatric workflows include weight-based dosing of medications, pediatric-specific drug-drug interactions, growth charts, and age-adjusted normal values for vital signs, and diagnostic test results. [5][6][7] Despite these challenges, studies have revealed that US children's hospitals are relatively early adopters of information technology (IT), with adoption rates that are higher than those of community hospitals focused on care of adults and similar to those of other academic teaching hospitals.…”

“…[5][6][7] Despite these challenges, studies have revealed that US children's hospitals are relatively early adopters of information technology (IT), with adoption rates that are higher than those of community hospitals focused on care of adults and similar to those of other academic teaching hospitals. 3,8,9 However, to truly use EHRs in a meaningful way for children's health care, children's hospitals will need to invest resources to increasingly incorporate EHRs into provider, hospital, and interfacility workflow while also working with vendors to ensure products fit pediatric needs.…”

“…The membership of this not-for-profit organization has been used to study IT within children's health care and includes children's hospitals, large pediatric units in medical centers, and related institutions, including those that specialize in rehabilitation. 3 The survey examined various issues related to EHR adoption by children's hospitals, including challenges of both MU of EHRs and specific MU criteria. The survey data were linked with data from the Office of the National Coordinator on MU incentives paid to hospitals from the start of incentive payments (2011) through March 2014.…”

Pediatrics in the Year 2020 and Beyond: Preparing for Plausible Futures

“…26 Increased use is correlated with increasing pressure from government agencies and payers to require electronic health records (EHRs) to drive quality measurement and payment. 27 Concurrently, initiatives have been developed to advance patientcentered pediatric care through the increased exchange of information from multiple sources and personalized patient records.…”

“…28 Consumer demands are increasingly focused on personalized medicine, telehealth, and communication technologies. Despite these pressures, adoption and implementation of EHRs in pediatrics lag behind other medical fields, 26 and technologybased tools for shared decisionmaking and management are most often limited to local demonstration projects. The profession and the public also struggle with ethical questions surrounding health data and the implications of providing information security.…”