Trends in Use of Electronic Health Records in Pediatric Office Settings

Objectives: To determine the prevalence and functionalities of electronic health records (EHRs) and pediatricians’ perceptions of EHRs. Study design: An 8-page self-administered questionnaire sent to 1619 randomly selected nonretired US American Academy of Pediatrics members in 2016 was completed by 709 (43.8%). Responses were compared with surveys in 2009 and 2012. Results: The percent of pediatricians who were using EHRs increased from 58% in 2009 and 79% in 2012 to 94% in 2016. Those with fully functional EHRs, including pediatric functionality, more than doubled from 8.2% in 2012 to 16.9% in 2016 (P =.01). Fully functional EHRs lacking pediatric functionality increased slightly from 7.8% to 11.1% (P =.3), and the percentage of pediatricians with basic EHRs remained stable (30.4% to 31.0%; P <.3). The percentage of pediatricians who lacked basic EHR functionality or who reported no EHR decreased (from 53.6% to 41.0%; P <.001). On average, pediatricians spent 3.4 hours per day documenting care. Conclusions: Although the adoption of EHRs has increased, >80% of pediatricians are working with EHRs that lack optimal functionality and 41% of pediatricians are not using EHRs with even basic functionality. EHRs lacking pediatric functionality impact the health of children through increased medical errors, missed diagnoses, lack of adherence to guidelines, and reduced availability of child-specific information. The pediatric certification outlined in the 21st Century Cures Act may result in improved EHR products for pediatricians.