AHRQ report addresses EHR needs for pediatrics

Pediatric EHRs need special features not found in systems used for adults, according to a report from the Agency for Healthcare Research and Quality (AHRQ).

The report is based on research conducted by the Vanderbilt University Evidence-based Practice Center under contract with AHRQ, and searched scientific literature and gathered expert opinions on EHRs used for pediatrics.

“We hope this report encourages all stakeholders to collaborate on this effort to improve electronic health records, ensuring we provide the best possible care for children,” states the report, which lays out the special features related to a child’s evolving physiology, maturity and associated conditions not found in EHRs used for adult patients. Specific pediatric EHR functionalities include: the ability to build and maintain vaccination records, record growth and development data, calculate weight and age-based medication dosing, manage pediatric diseases, identify pediatric norms such as developmental milestones, and document the relationship between pediatric patients and their parents and caregivers.

The report recommends the following six core functionalities to optimize EHRs for pediatric care:

• Vaccine forecasting and management to reflect regional requirements, support documentation, including combination vaccinations, and communicate with registries.
• Routine healthcare maintenance to facilitate longitudinal assessment of growth and development; calculate body mass index, growth velocity, percentiles, and standard deviations; allow customized growth charts as approved by clinicians; and provide tailored longitudinal health and safety recommendations.
• Family structure to link families together for easy navigation and data sharing between family members, and support dynamic privacy controls that support differential access to health data.
• Documentation and billing to integrate into a clinician’s workflow to reduce documentation overload, support use and creation of customized forms, interface with schools and community health organizations.
• Medications to facilitate medication prescribing by weight, body surface area and age, and incorporate dose rounding tailored to a medication’s safety and efficacy profile.
• Management of vulnerable populations to generate patient lists based on key clinical diagnoses or risk factors, identify patients in a clinical subpopulation who are due for preventative services, and incorporate clinical practice guidelines into a standard clinical workflow and to identify areas for improvement.

“While many of these functionalities are not purely pediatric, their key role in the care of children in contrast to their minimal role for adults could mean they can get overlooked if an EHR is designed primarily for adult care,” concludes the report. “Yet, if these functionalities are implemented well, the EHR will also undoubtedly better support the care of all patients.”

Read the complete report.