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Explore the specific information requirements of pediatric clinics, from growth data to reporting needs, including unique system issues and the importance of tailored EHR systems for efficient operations.
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Information Needs of Pediatric Clinics: An Example Farrokh Alemi, Ph.D. June 2007
Unique Data Needs • Growth data. • Record, graph, display growth patterns benchmarked against normal growth • Small scales • Patient identifier. • Identifier assigned before or at time of birth • Accommodate changing data (e.g, "Infant Boy Smith" or "Boy June Jones") • Multiple names used by a patient. • Special terminology and information • Pediatric lexicon (e.g, developmental milestones, education progress, anticipatory guidance) • Physical findings (e.g, weak cry, bulging anterior fontanelle, and umbilical granuloma) • Age-based normal ranges • Normal ranges for vital signs change with a child's age • Accept normative values provided by the reference laboratory • Normal ranges to represent specific ethnic or geographic populations • Time of birth
Unique Reporting Needs • Prescribing of medications • Based on the age, weight or body surface area of the child • Prescription tools needed • Immunizations • Efficient recording of immunizations • Effective display of immunization data • Exchange with registry • Reminders for missed immunizations to providers • Reminders to patients • Alerts of contraindications • Parents' special documentation requirements • Parents may ask to review or append chart information • Support summary reports to parents and others • Reporting • Match mandated formats (e.g., school or camp physicals
Unique System Issues • Special privacy issues • Adolescent privacy may preclude reporting to parents • Genetic information may be restricted to parents (donor embryo process) • Guardianship data may be different from biological parents • Represent relationships in families involving adopted children • Reporting requirements of social service agencies for foster care • Protect data in ways consistent with abuse and neglect laws • Parent or guardian may not be the financially responsible person • Pediatric work settings • Data entry must work in busy pediatric settings • Speech interfaces may be impractical in noisy environments • Curious children may also present special challenges. • Family member links • Links to records of other family members • Easy movement among records of siblings • Registry linkages • Timely notification and follow-up
Take Home Lesson EHR systems need to be tailored to each practice’s operations