Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA.
Acad Pediatr. 2013 May-Jun;13(3):259-63. doi: 10.1016/j.acap.2013.01.010. Epub 2013 Feb 4.
Hospitals that care for children face unique barriers in electronic medical records (EMR) use that may affect their ability to meaningfully use EMR. The purpose of this study was to investigate hospitals that care for children, both freestanding and adult hospitals with children's services, to determine progress toward advanced stages of EMR use.
The American Hospital Association survey described hospitals across the United States. Healthcare Information and Management Systems Society 2006 and 2010 databases identified hospitals' EMR use. EMR stage was classified according to previous studies. Multivariable analysis was used to determine independent predictors of EMR use.
The analysis included 2794 hospitals. During the study time frame, a significant increase occurred for hospitals moving into any stage of EMR in adult hospitals with children's services (47% to 75%; P < .001), while improvements for freestanding children's hospitals were modest at best (46% to 59%; P = .3). Conversely, freestanding children's hospitals had the largest gain in advance stage 3 adoption (6% to 39%; P < .001) compared to adult hospitals with children's services (6% to 23%; P < .001). Freestanding children's hospitals were less likely to use pharmacy information systems but more likely to use computerized provider order entry.
In 2010, freestanding children's hospitals had the highest percentage use of advanced stage EMR (39%), but the lowest improvements in percentage of hospitals entering into any stage of adoption over the study period. This trend created a digital divide among freestanding children's hospitals that may improve with pediatric-specific electronic medication management products.
儿科医疗机构在使用电子病历（EMR）时面临独特的障碍，这可能影响他们有效使用 EMR 的能力。本研究旨在调查儿科医疗机构，包括独立的儿童医院和设有儿科服务的综合性医院，以确定其在 EMR 使用方面的进展达到了哪个阶段。
美国医院协会的调查描述了全美各地的医院。医疗保健信息和管理系统协会 2006 年和 2010 年的数据库确定了医院的 EMR 使用情况。根据先前的研究对 EMR 阶段进行分类。采用多变量分析确定 EMR 使用的独立预测因素。
该分析包括 2794 家医院。在研究期间，综合性医院中采用 EMR 的任何阶段的医院数量显著增加（47%至 75%；P<0.001），而独立儿童医院的改善则较为有限（46%至 59%；P=0.3）。相反，独立儿童医院在采用高级阶段 3 方面的增长最大（6%至 39%；P<0.001），而综合性医院则增长较小（6%至 23%；P<0.001）。独立儿童医院更有可能使用计算机化医嘱录入系统，但不太可能使用药房信息系统。
2010 年，独立儿童医院采用高级 EMR 的比例最高（39%），但在研究期间，进入任何采用阶段的医院比例的改善最小。这种趋势在独立儿童医院中造成了数字鸿沟，而儿科专用的电子药物管理产品可能会缩小这一差距。
