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