- electronic health records
- Meaningful Use
- Patient Protection and Affordable Care Act
- quality of care
Although the intent of the federal Meaningful Use (MU) program is to improve the health of children and adults through adoption and use of electronic health records (EHRs), pediatricians face unique obstacles to participation in this program.1 In addition to known problems with EHR functionality to support pediatric care and the alignment of MU incentives with child health priorities, evidence suggests that the current structure of the MU program puts pediatricians at a disadvantage compared with clinicians caring for adults, leading to wide variability in pediatrician participation in the program across states.2 Specifically, despite a national mean participation rate of <20% in 2012, pediatrician registration in the MU program varied considerably across states, from <10% in New Jersey, Georgia, and Hawaii to nearly 70% in North Dakota (Fig 1). By synthesizing participation data with a detailed policy analysis, the present commentary addresses potential causes of this variability and suggests specific solutions to support effective pediatric EHR implementation across all states.
Address correspondence to Alexander Fiks, MD, MSCE, The Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, CHOP North, 15th Floor, Room 1546, Philadelphia, PA 19104-4399. E-mail: