Modifying electronic health record software can help catch early signs of childhood obesity, problems with oral health, vision, and hearing, and the risk of developing autism, expert says.
Electronic health record software has not met some pressing needs of pediatricians.
After years of federally funded studies of the problem, and few meaningful actions as part of meaningful use, it's time for a change.
One healthcare organization has identified pediatricians' biggest EHR pain points and is working to improve the situation.
"The biggest gaps that we found were largely around developmental screening and follow-up," says Kern Eason, pediatric EHR consultant at Community Care of North Carolina, a group of 14 physician practice networks in the state of North Carolina.
"A lot of what pediatrics is about is not so much dealing with acute episodes of care. Especially in the ambulatory setting, it's [about] preventative [measures]."
Modifying EHR software and its decision-support elements, would help catch early signs of childhood obesity, problems with oral health, vision, and hearing, and the risk of developing autism, Eason says.
"The idea is to catch it early," he says. "Adults come in for one visit a year, whereas very young kids have two or three visits with their primary care physician a year."
And systems designed for adults, aren't entirely suitable for children. EHR-prompted adult screening questions such as smoking status need to be deemphasized before patients reach their teenage years, he says.
Instead, EHR prompts for topics such as nutrition and car seat safety can make a big difference, developmentally, he says.
In addition, pediatricians calculate childhood body mass index very differently than they would calculate adult BMI. "A system that measures body mass index using adult metrics is going to be completely off for a child," Eason says.
"The same [is true] for blood pressure percentiles, [which are] completely measured differently in the pediatric world."
Even a task as simple as calculating the appropriate dose of medication for a child can necessitate a pocket calculator. "It's just not real safe, so we're working on making sure that some of those core things that improve care and make care consistent are built into EHRs," Eason says.
Funded by a Federal Grant
This work predates meaningful use, and CCNC was working on it as early as 2010. Stage 1 of meaningful use contained almost no pediatrician-specific quality measures, and stage 2 and stage 3 added just a few, Eason says.
Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.