As my interest in electronic medical records, especially in the pediatric realm, has grown alongside the weight and height of my young children, I did a little digging to see just how large the pediatric-specific EMR market has become. A simple Google search of “pediatrics, EMR” brought up, suffice it say, results too numerous to dive into (550,000, to be exact).
 
With the subject making recent headlines via the American Academy of Pediatrics recent declaration of support for healthcare IT, and specifically the necessity of EMRs as crucial to the pediatric patient-centered medical home, I’m curious as to what impact this type of technology will have on the delivery of children’s healthcare.
 
It seems pediatricians themselves are just as hungry for information. In response to this need, the American Academy of Pediatrics Child Health Informatics Center earlier this year set up a website devoted to pediatricians interested in adopting EMRs. (Pediatricians have through 2016 to begin participating in Meaningful Use incentive programs through Medicaid.)
 
To get a better understanding of the matter, I recently spoke with Lisa Reichard, RN, who in addition to working in adult medical/surgical nursing roles, has more than 12 years of experience working as a pediatrics nurse at facilities in Hawaii, Florida and Georgia.
 
What benefits will EMRs bring to pediatric practices?
“Faster, more frequent charting may be a benefit of an EMR for pediatrics. Depending on the level of illness, pediatric patients generally require more frequent and unique documentation in the areas of, for example, patient safety and P.O. feeding schedules and growth tracking. Hopefully, the EMRs can be adjusted and updated with pediatric-specific criteria over traditional charting methods that would normally take longer to adjust.
 
“EMRs can be customized over traditional charting methods in the area of pain assessment scales, where doctors/nurses may need to assess and document a FACES Pain scale, such as Wong-Baker, over the traditional numeric 1-10 adult pain scale. Doctors and nurses could bring their iPad or iPhone into the room have the patient point to the associated FACES pain scale, and then document right then and there, versus having a patient look at a paper chart and then going back to the nurses station to document … four patients later.
 
“It would be beneficial if the EMR system could incorporate patient weight into the prescribing process, and take medical dosing recommendations based on approved references into the prescribing process, since the typical method for calculating pediatric drug dosages is based on body weight. I’d say that increased customization is the key to successful pediatric EMR systems. The one-size-fits-all approach will not work, as most EMRs are generally designed with adult patients in mind.”
 
In today's hyper-connected, Web-enabled mobile society, do you think parents will welcome the switch from paper to digital records, especially with regard to increased communication opportunities via secure email?
“Absolutely. Trying to obtain past immunizations records for the life cycle of the patient can be a real challenge with the current system. As long as parents can give consent, I believe most will give consent to the sharing of medical records within the healthcare system.”
 
Do you see any barriers to adoption from nurses, doctors or other pediatric medical staff when it comes to implementing EMRs?
“Being at eye level when talking with pediatric patients is important, as with any patient. With the widespread use of iPhones and iPads, I believe that typing into EMRs will be welcomed by pediatric and young adult populations more so than in geriatric populations, and may even allow for increased patient time if charting can more easily be completed at the bedside.”
 
Do you have a story to tell – good or bad - regarding a pediatric EMR implementation? How have you seen the switch from paper to digital impact a pediatric patient’s care? Please share your comments below.

Jennifer Dennard is Social Marketing Director for Atlanta-based Billian's HealthDATA and Porter Research.