Skip to main content

Pediatric Electronic Health Records and Research

  • Chapter
  • First Online:
Pediatric Biomedical Informatics

Abstract

Pediatric providers use electronic health record systems to review patient information, to document care, to order clinical interventions, and to perform related administrative tasks. All of these activities create data that might be useful in research, although research is seldom the objective of EHR-related data entry. Providers may use other information systems (e.g., specialized systems for analyzing electrocardiograms), but the EHR is the central application for clinical and administrative clinical activities. While there are a few EHR systems designed specifically for care of pediatric patients, most pediatric providers adopt general-purpose EHRs that must be customized for specialized pediatric environments. In this chapter we outline the special functional requirements of EHRs (e.g., growth monitoring, medication dosing, and immunization management), the relative difficulty of meeting these requirements with EHRs that are currently available in the marketplace, and current adoption trends. We discuss workflows that present special challenges to EHR implementation. We discuss the typical workflow phenomena that affect the use of data for research and other secondary uses. We also discuss special aspects of terminology systems employed by EHRs that have implications for pediatric usability. Lastly, we address special issues in the use of EHR data for the extraction of care quality measures.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 179.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 229.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • American Academy of Pediatrics Committee on Practice and Ambulatory Medicine and Bright Futures Steering Committee. Recommendations for preventive pediatric health care. Pediatrics. 2007;120(6):1376.

    Google Scholar 

  • Blavin F, Ormond B. HITECH, meaningful use, and public health: funding opportunities for state immunization registries, C.f.M.a.M. Services, editor, Washington, DC; 2011.

    Google Scholar 

  • CCHIT. CCHIT Child Health Workgroup. 2010 [cited 2012 Apr 1]. Available from: http://www.cchit.org/workgroups/child-health

  • CDC. Percentile data files with LMS values. 2012 [cited 2012 Mar 14]. Available from: http://www.cdc.gov/growthcharts/percentile_data_files.htm

  • CMS. Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs. 2012 [cited 2012 Apr 1]. Available from: https://http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRIncentivePrograms/

  • Conroy S, Sweis D, et al. Interventions to reduce dosing errors in children: a systematic review of the literature. Drug Saf. 2007;30(12):1111–25.

    Article  PubMed  Google Scholar 

  • Cooley WC, Sagerman PJ. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2011;128(1):182–200.

    Article  PubMed  Google Scholar 

  • Cortese MM, et al. Leveraging state immunization information systems to measure the effectiveness of rotavirus vaccine. Pediatrics. 2011;128(6):e1474–81.

    Article  PubMed  Google Scholar 

  • Dart RC, Rumack BH. Intravenous acetaminophen in the United States: iatrogenic dosing errors. Pediatrics. 2012;129(2):349–53.

    Article  PubMed  Google Scholar 

  • DesRoches CM, et al. Electronic health records in ambulatory care – a national survey of physicians. N Engl J Med. 2008;359(1):50–60.

    Article  PubMed  CAS  Google Scholar 

  • Fairbrother G, Simpson LA. Measuring and reporting quality of health care for children: CHIPRA and beyond. Acad Pediatr. 2011;11(3 Suppl):S77–84.

    Article  PubMed  Google Scholar 

  • Fenton TR. A new growth chart for preterm babies: Babson and Benda’s chart updated with recent data and a new format. BMC Pediatr. 2003;3:13.

    Article  PubMed  Google Scholar 

  • Finnegan B, et al. Policy Research Brief No. 9: boosting health information technology in medicaid: the potential effect of the American Recovery and Reinvestment Act, in Geiger Gibson/RCHN Comunity Health Foundation Research Collaborative, George Washington University; 2009.

    Google Scholar 

  • Friedlin J, Dexter PR, Overhage JM. Details of a successful clinical decision support system. AMIA Annu Symp Proc. 2007;2007:254–8.

    Google Scholar 

  • Gardner RM, Pryor TA, Warner HR. The HELP hospital information system: update 1998. Int J Med Inform. 1999;54(3):169–82.

    Article  PubMed  CAS  Google Scholar 

  • Grummer-Strawn LM, et al. Use of World Health Organization and CDC growth charts for children aged 0–59 months in the United States. MMWR Recomm Rep. 2010;59(RR-9):1–15.

    PubMed  Google Scholar 

  • Haggerty RJ. Health supervision visits: should the immunization schedule drive the system? Pediatrics. 1987;79(4):581–2.

    PubMed  CAS  Google Scholar 

  • HHS. Health Information Technology for Economic and Clinical Health (HITECH) Act, Title XIII of Division A and Title IV of Division B of the American Recovery and Reinvestment Act of 2009 (ARRA), in Pub. L. No. 111-5 (Feb. 17, 2009), U.S.D.o.H.a.H. Services, Editor, Washington, DC; 2009.

    Google Scholar 

  • Jha AK, et al. A progress report on electronic health records in U.S. hospitals. Health Aff (Millwood). 2010;29(10):1951–7.

    Article  Google Scholar 

  • Kallem C. Transforming clinical quality measures for EHR use. NQF refines emeasures for use in EHRs and meaningful use program. J AHIMA. 2011;82(11):52–3.

    Google Scholar 

  • Kemper AR, Uren RL, Clark SJ. Adoption of electronic health records in primary care pediatric practices. Pediatrics. 2006;118(1):e20–4.

    Article  PubMed  Google Scholar 

  • Kressly S. Testimony from the Hearing on Health IT Adoption and the New Challenges Faced by Solo and Small Group Health Care Practices, June 24, 2009. Small Business Committee Document Number 111–032. Available via the GPO Website: http://www.access.gpo.gov/congress/house. Accessed 1 June 2012.

  • Laron Z, Lilos P, Klinger B. Growth curves for Laron syndrome. Arch Dis Child. 1993;68(6):768–70.

    Article  PubMed  CAS  Google Scholar 

  • Leu MG, O’Connor K, Marshall R, Price D, Klein D. Pediatricians’ use of health information technology: a national survey. Pediatrics. 2012; in press.

    Google Scholar 

  • Mandl KD, Kohane IS. Escaping the EHR trap – the future of health IT. N Engl J Med. 2012;366:2240–2.

    Article  PubMed  CAS  Google Scholar 

  • Martin ND, et al. New height, weight and head circumference charts for British children with Williams syndrome. Arch Dis Child. 2007;92(7):598–601.

    Article  PubMed  CAS  Google Scholar 

  • McColm D, Karcz A. Comparing manual and automated coding of physicians quality reporting initiative measures in an ambulatory EHR. J Med Pract Manage. 2010;26(1):6–12.

    PubMed  Google Scholar 

  • Menachemi N, et al. Charting the use of electronic health records and other information technologies among child health providers. BMC Pediatr. 2006;6:21.

    Article  PubMed  Google Scholar 

  • Miller RA, et al. The anatomy of decision support during inpatient care provider order entry (CPOE): empirical observations from a decade of CPOE experience at Vanderbilt. J Biomed Inform. 2005;38(6):469–85.

    Article  PubMed  Google Scholar 

  • Nakamura MM, et al. Electronic health record adoption by children’s hospitals in the United States. Arch Pediatr Adolesc Med. 2010;164(12):1145–51.

    Article  PubMed  Google Scholar 

  • Nellhaus G. Head circumference from birth to eighteen years. Practical composite international and interracial graphs. Pediatrics. 1968;41(1):106–14.

    PubMed  CAS  Google Scholar 

  • Ranke MB, et al. Noonan syndrome: growth and clinical manifestations in 144 cases. Eur J Pediatr. 1988;148(3):220–7.

    Article  PubMed  CAS  Google Scholar 

  • Rollins JD, Collins JS, Holden KR. United States head circumference growth reference charts: birth to 21 years. J Pediatr. 2010;156(6):907–13, 913.e1-2.

    Article  PubMed  Google Scholar 

  • Rosenbloom ST, et al. Implementing pediatric growth charts into an electronic health record system. J Am Med Inform Assoc. 2006;13(3):302–8.

    Article  PubMed  Google Scholar 

  • Selden TM. Compliance with well-child visit recommendations: evidence from the Medical Expenditure Panel Survey, 2000-2002. Pediatrics. 2006;118(6):e1766–78.

    Article  PubMed  Google Scholar 

  • Shiffman R, et al. Information technology for children’s health and health care: report on the information technology in children’s health care expert meeting, September 21–22. J Am Med Inform Assoc. 2000;8(6):546–51.

    Article  Google Scholar 

  • Spooner SA. Special requirements of electronic health record systems in pediatrics. Pediatrics. 2007;119(3):631–7.

    Article  PubMed  Google Scholar 

  • Spooner SA, Classen DC. Data standards and improvement of quality and safety in child health care. Pediatrics. 2009;123 Suppl 2:S74–9.

    Article  PubMed  Google Scholar 

  • Strom BL, et al. Unintended effects of a computerized physician order entry nearly hard-stop alert to prevent a drug interaction: a randomized controlled trial. Arch Intern Med. 2010;170(17):1578–83.

    Article  PubMed  Google Scholar 

  • Taketomo CK, Hodding JH, Kraus DM. Lexi-Comp’s pediatric & neonatal dosage handbook: a comprehensive resource for all clinicians treating pediatric and neonatal patients (Pediatric dosage handbook). 18th ed. Hudson: Lexi-Comp; 2011.

    Google Scholar 

  • Yasuda K, C.o.P.a.A. Medicine. Immunization information systems. Pediatrics. 2006;118(3):1293–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. Andrew Spooner M.D., M.S., FAAP .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Spooner, S.A., Kirkendall, E.S. (2012). Pediatric Electronic Health Records and Research. In: Hutton, J. (eds) Pediatric Biomedical Informatics. Translational Bioinformatics, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5149-1_1

Download citation

Publish with us

Policies and ethics