Appl Clin Inform 2012; 03(04): 437-447
DOI: 10.4338/ACI-2012-06-RA-0023
Research Article
Schattauer GmbH

Clinician Perceptions of Pediatric Growth Chart Use and Electronic Health Records in Kentucky

N. Soares
1   Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles
,
K. Vyas
2   University of Kentucky, College of Medicine
,
B. Perry
3   University of Kentucky, Department of Sociology
› Institutsangaben
Weitere Informationen

Correspondence to:

Neelkamal Soares, MD
300 UCLA Medical Plaza, Suite 3300
Los Angeles, CA 90095
USA

Publikationsverlauf

Received 13. Juni 2012

Accepted 10. November 2012

Publikationsdatum:
19. Dezember 2017 (online)

 

Summary

Background: Growth chart recording is a key component of pediatric care. EHR systems could provide several growth charting functionalities compared to paper methods. To our knowledge, there has been no U.S. study exploring clinicians’ perceptions and practices related to recording of growth parameters as they adapt to electronic methods.

Objectives: To explore clinician practices regarding recording growth parameters as they adapt to electronic health records (EHR) and to investigate clinician perceptions of electronic growth charting using EHR.

Methods: An online survey of pediatricians and family practitioners in Kentucky inquiring about EHR usage, specifically use of growth charting with EHR, was conducted.

Results: Forty-six percent of respondents utilized EHRs, with pediatricians lagging family practitioners, and academic pediatricians lagging non-academicians. There was no consensus on EHR platforms being used. Almost a third of those who used EHR did not utilize electronic growth charting. Clinicians using EHR reported that electronic growth charts would improve clinician satisfaction and clinical efficiency as well as parent satisfaction and parent education. Only 12% of respondents provided copies of growth charts to parents at the end of their visit and discussed growth parameters with parents, with clinicians using EHR more likely to engage in these activities than nonEHR users.

Conclusion: Although Kentucky clinicians continue to slowly adopt EHRs, clinician perceptions and practices reflect enduring barriers to widespread use of electronic growth charting in pediatric and family practice. However, our results suggest that electronic growth charting has important benefits for both clinicians and patients, and greater adoption is expected as EHRs become standard across health care systems.

Citation: Soares N, Vyas K, Perry B. Clinician perceptions of pediatric growth chart use and electronic health records in Kentucky. Appl Clin Inf 2012; 3: 437–447

http://dx.doi.org/10.4338/ACI-2012-06-RA-0023


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Conflict of Interest

The authors have no financial or other conflicts of interest related to the content or findings reported in this manuscript.

  • References

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  • 29 American Academy of Family Physicians (AAFP) Available at http://www.aafp.org Accessed September 12, 2012

Correspondence to:

Neelkamal Soares, MD
300 UCLA Medical Plaza, Suite 3300
Los Angeles, CA 90095
USA

  • References

  • 1 Council on Clinical Information Technology.. Health information technology and the medical home. Pediatrics 2011; 127 (Suppl. 05) 978-982.
  • 2 Holden RJ. Physicians’ beliefs about using EMR and CPOE: in pursuit of a contextualized understanding of health IT use behavior. Int J Med Inform 2010; 79 (Suppl. 02) 71-80.
  • 3 Rosenbloom ST, Qi X, Riddle WR, Russell WE, DonLevy SC, Giuse D, Sedman AB, Spooner SA. Implementing pediatric growth charts into an electronic health record system. J Am Med Inform Assoc 2006; 13 (Suppl. 03) 302-8.
  • 4 Samaan ZM, Klein MD, Mansour ME, DeWitt TG. The impact of the electronic health record on an academic pediatric primary care center. J Ambul Care Manage 2009; 32 (Suppl. 03) 180-187.
  • 5 Task Force on Medical Informatics Special Requirements for Electronic Medical Record Systems in Pediatrics Pediatrics 2001: 108-513.
  • 6 American Academy of Pediatrics: Task Force on Medical Informatics.. Special requirements for electronic medical record systems in pediatrics. Pediatrics 2001; 108 (Suppl. 02) 513-515.
  • 7 Shiffman RN, Spooner SA, Kwiatkowski K, and Brennan PF. Information Technology for Children’s Health and Health Care. Journal of the American Medical Informatics Association 2001; 8 (Suppl. 06) 546-551.
  • 8 Spooner SA, Classen DC. Data standards and improvement of quality and safety in child health care. Pediatrics 2009; 123 (Suppl. 02) S74-S79.
  • 9 Gracy D, Weisman J, Grant R, Pruitt J, Brito A. Content barriers to pediatric uptake of electronic health records. Adv Pediatr 2012; 59 (Suppl. 01) 159-181.
  • 10 Nakagawa S. A farewell to Bonferroni: The problems of low statistical power and publication bias. Behavioral Ecology 2004; 15: 1044-1045.
  • 11 Bender R, Lange S. Adjusting for multiple testing- when and how?. Journal of Clinical Epidemiology 2001; 54 (Suppl. 04) 343-349.
  • 12 Perneger T. What’s wrong with Bonferroni adjustments?. British Medical Journal 1998; 316: 1236-1238.
  • 13 Simon SR, Kaushal R, Cleary P, Jenter C, Volk L, Poon E, Williams D, Orav E, Bates D. Correlates of electronic health record adoption in office practices: a statewide survey. Journal of the American Medical Informatics Association 2007; 14 (Suppl. 01) 110-117.
  • 14 Stream GR. Trends in adoption of electronic health records by family physicians in Washington State. Inform Prim Care 2009; 17 (Suppl. 03) 145-152.
  • 15 Menachemi N, Ettel DL, Brooks RG, Simpson L. Charting the use of electronic health records and other information technologies among child health providers. BMC Pediatr 2006; 6: 21.
  • 16 Kemper AR, Uren RL, Clark SJ. Adoption of Electronic Health Records in Primary Care Pediatric Practices. Pediatrics 2006; 118: e20.
  • 17 Simon SR, McCarthy ML, Kaushal R, Jenter CA, Volk LA, Poon EG, Yee KC, Oray EJ, Williams DH, Bates DW. Electronic health records: which practices have them, and how are clinicians using them?. Journal of Evaluation in Clinical Practice 2008; 14 (Suppl. 01) 43-47.
  • 18 Boonstra A, Broekhuis M. Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions. BMC Health Serv Res 2010; 10: 231.
  • 19 Simpson LA, Peterson L, Lannon CM, Murphy SB, Goodman C, Ren Z, Zajicek A. Special challenges in comparative effectiveness research on children’s and adolescents’ health. Health Aff (Millwood). 2010; 29 (10) 1849-1856.
  • 20 Office of the National Coordinator for Health Information Technology.. Available at http://oncchpl.force.com/ehrcert?q=CHPL. Accessed on May 30, 2012.
  • 21 American Academy of Pediatrics (AAP) Child Health Informatics Center (CHIC).. Available at http://www2.aap.org/informatics/chic.html. Accessed on May 30, 2012.
  • 22 AAP COCIT EMR Product Reviews. Available at http://www.aapcocit.org/emr/readreviews.php?task=Compare_Feature&typefeat=GROWTH&filter=N Accessed on July 21, 2012
  • 23 Centers for Medicare and Medicaid Services EHR Incentive Program.. Available at https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/EP-MU-TOC.pdf Accessed on June 4, 2012.
  • 24 Canadian Paediatric Society & Dieticians of Canada Collaborative Public Policy Statement (2010).. Promoting Optimal Monitoring of Child Growth in Canada: Using the New WHO Growth Charts Available at http://www.cps.ca/english/statements/N/ExecSummary.pdf. Accessed June 5, 2012.
  • 25 Ben-Joseph EP, Dowshe SA and Izenberg N. Do Parents Understand Growth Charts? A National, Internet-Based Survey. Pediatrics 2009; 124: 1100-1109.
  • 26 McMahon SR, Iwamoto M, Massoudi MS, Yusuf HR, Stevenson JM, David F, Chu SY, Pickering LK. Comparison of e-mail, fax, and postal surveys of pediatricians. Pediatrics 2003; 111 4 Pt 1 e299-e303.
  • 27 Edwards PJ, Roberts I, Clarke MJ, Diguiseppi C, Wentz R, Kwan I, Cooper R, Felix LM, Pratap S. Methods to increase response to postal and electronic questionnaires. Cochrane Database Syst Rev 2009 Jul 8 (3).
  • 28 American Academy of Pediatrics (AAP) Department of Community, Chapter and State Affairs Available at http://www.aap.org Accessed September 14, 2012
  • 29 American Academy of Family Physicians (AAFP) Available at http://www.aafp.org Accessed September 12, 2012