title: Electronic medical record adoption in hospitals that care for children.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA. teufelr@musc.edu
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Teufel
authors.forename: Abby Swanson
authors.initials: AS
authors.lastname: Kazley
authors.forename: Annie L
authors.initials: AL
authors.lastname: Andrews
authors.forename: Myla D
authors.initials: MD
authors.lastname: Ebeling
authors.forename: William T
authors.initials: WT
authors.lastname: Basco
mesh_terms: D057286:Electronic Health Records / Q000706:statistics & numerical data* / Q000639:trends; D006748:Hospital Departments / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D062527:Meaningful Use; D010372:Pediatrics / Q000379:methods* / Q000706:statistics & numerical data; D014481:United States