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Barriers for Implementation of Clinical Information Technology In Pediatric Practice

Sunday, October 21, 2012: 9:15 AM
Room 270 (Morial Convention Center)
Klara Galperina, DO and Anna Petrova MD, PhD, MPh, Pediatrics, UMDNJ/RWJMS, New Brunswick, NJ

Purpose

Personal Health Records (PHR) are a part of clinical information technology that were developed to target safety, effectiveness and timeliness of quality health care delivery and to decrease the risk of medical errors. The Executive Committee of the Council on Clinical Information Technology of the American Academy of Pediatrics (AAP) published a Policy Statement in 2009 that explains the importance of PHRs in delivery of quality health care including the improvement of patient-provider relationship and their role in health care decision-making as well as a reduction of the healthcare expenditure. Despite the obvious advantages PHRs are not widely accepted and used in pediatric practice. Therefore, obtaining realistic view regarding barriers to the implementation of PHR is essential for developing a model that will assist in successful diffusion of PHRs in management of pediatric patients.

Methods

A survey study was designed to identify parental barriers in utilization of PHRs for their children. Specifically, we evaluated parental knowledge, attitude and beliefs regarding the use of PHR in pediatric medical care. The questionnaires were collected anonymously prior to or after their visit to a pediatric clinic.

Results

A total number of 98 parents (73.5% mothers, 73.5% with college or master diploma, 66.0% with private insurance, 69.1% with 2 or more children in the house) were surveyed. Approximately 50% of parents showed awareness about the PHR and 26.3% reported use of paper PHR. More than 70% of parents would like to use PHR for their children and expressed the importance of being educated on this matter, although majority have no knowledge how to start using a PHR for their children. Almost all surveyed parents believed at moderate or very high degree that PHRs play a role in safety and quality of child care, understanding and improving child's medical care and doctor-patient communication. Moreover, parents articulated the leading role of primary care pediatricians in maintaining of their children's PHRs and would like to include the health educational material in PHR files. Approximately 80% of respondents are concerned about privacy and independence of PHR from health insurance and necessity for reassessing the access to the PHR when the child reaches the age of 18 years. More than one-third recognized the difficulty of implementing PHR for non-English-speaking families.

Conclusion

Survey of mostly educated and insured parents showed willingness for employment of PHR in medical care of their children. Limited parental knowledge and privacy concerns are the key barriers for PHR implementation. Wide publicity of new health information technologies, development of an appropriate model and precise explanation of mechanisms for implementation will be required for successful utilization of PHR in pediatric clinical practice.