Children’s EHR Format Enhancement

Enhancing health IT functionality for children

The use of electronic health records (EHRs) has advanced considerably throughout the United States, but the functionality to support the care of children has been slower to develop and deploy.

Most EHRs used in the care of children were designed with adult patients in mind, leading to gaps in functionality to support the optimal care of children. A team of experts systematically identified nearly 600 functional gaps during 2010-2013, but the list they produced needed further refinement and prioritization.

With input from a national multi-stakeholder workgroup and a federal workgroup, using a modified Delphi process, RTI identified and refined 47 items to form the 2015 Children’s EHR Format Priority List. To encourage stakeholder use, the RTI team also developed 16 recommended uses of the Format.

The full report of the Format enhancement activities is publicly available. The impact of this work is to identify high-priority EHR functional requirements for the care of children to sharpen industry focus on adopting these changes. Software developers can use the 2015 Priority List to enhance their products; pediatricians can use the functional requirements as selection criteria when they are choosing and configuring systems; and policymakers can align supportive policies with the functionality that has been identified.

Forging broad agreement among a national group of industry stakeholders to prioritize specific health information technology functionalities led to agreement on a small set of essential capabilities for well-child preventive care, medication management, immunization tracking, and growth data for specific pediatric subgroups.

As a result, RTI developed a shortened high-priority list of EHR requirements and provided guidance to improve their use.