Send to

Choose Destination
Pediatrics. 2015 Jun;135(6):e1409-16. doi: 10.1542/peds.2014-2720. Epub 2015 May 11.

Factors associated with meaningful use incentives in children's hospitals.

Author information

Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina;
Department of Pediatrics, St Louis Children's Hospital, Washington University, St Louis, Missouri;
Divisions of Infectious Diseases, General Pediatrics, and.
Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts; and.
Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, Alabama.



Among children's hospitals, little is known about how barriers to electronic health record (EHR) adoption are related to meaningful use (MU) incentives. We investigated hospital success with MU incentive payments and determined associations with hospital-reported challenges and characteristics.


A survey administered to 224 Children's Hospital Association hospitals assessed a variety of potential challenges to achieving meaningful EHR use (eg, lack of access to capital) and specific MU criteria that would be challenging to fulfill (eg, implement clinical decision support rules). These results were combined with data on hospitals that received MU payments up to March 2014 and information on hospital characteristics. Associations between anticipated challenges, children's hospital type, and receipt of MU incentives were evaluated in bivariate and multivariate analyses.


One hundred thirty-three children hospitals completed the survey (response rate 59.4%). Thirty-five percent of responding children's hospitals received MU incentive payments. The most frequently anticipated hospital challenges included the following: exchange clinical information with other providers outside your hospital system (49%), and generate numerator and denominator data for quality reporting directly from EHR (41%). Freestanding children's hospitals were more likely to indicate lack of relevance of MU criteria to pediatric care (odds ratio: 37.6 [95% confidence interval: 4.6-309.3]) and more likely to receive MU incentive payments (odds ratio: 26 [95% confidence interval: 5.2-130.6]).


As of 2014, a minority of children's hospitals have successfully received MU incentive payments. Freestanding children's hospitals are more likely to report MU is not relevant to pediatric care and to succeed with MU incentive payments.

[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center