AHRQ outlines redesign for pediatric EHR

New functionality features at core

The Agency for Healthcare Research and Quality (AHRQ) has officially outlined a redesign for pediatric electronic health record (EHR) systems, calling on vendors to improve functionality and customization features, officials announced Thursday.  

In the new EHR format, AHRQ set forth a minimum set of data elements and data standards that can be used as a blueprint for EHR developers seeking to create a system that can capture the types of healthcare components most relevant for children.
 
"Healthcare for children is a calling that carries special challenges," said AHRQ Director Carolyn Clancy, MD, in a news release. "This new children's EHR format will help software developers meet the needs of healthcare providers for children by combining best practices in clinical care, information technology and the contributions of health care providers who treat children every day."
 
[See also: Pediatricians lag with EHR adoption.]
 
Officials say the new format is necessary, as existing EHR systems have not been appropriately tailored to capture or process pediatric health data, which has resulted in a significantly lower EHR adoption rate among pediatricians. A recent study published in Pediatrics found that self-reported EHR use among pediatricians stood at 41 percent – family physician EHR adoption rates were pegged at 54 percent  with only 19 percent of systems meeting the definition of a basic EHR. Moreover, findings also reveal a paltry 3 percent of pediatricians used a system that was both fully functional and "pediatric-supportive."
 
"Even if the pediatricians are adopting the systems, the systems they're adopting don't have the features that would really make the practice easier," said Michael Leu, MD, co-author of the study, in an earlier interview with Healthcare IT News. "Pediatric systems have to be designed so they're a little bit more complicated." 
 
Leu said many EHR features needed for pediatrics, such as weight-based dosing, immunization tracking and automatic growth chart plotters, aren't typically part of most EHR systems. 
 
Thomas McInerny, MD, president of the American Academy of Pediatrics, echoed similar sentiments. "Children are special; they are not little adults where one size can be made to fit all, including one-size EHRs," he said in a statement. 
 
AHRQ requirements include adding all of these features Leu cited – an immunization decision support system, prenatal and newborn screening tests, growth data plotting, information for children with special care needs, child abuse reporting and age/weight-based dosing. 
 
[See also: EHR adoption could exceed 80 percent by end of 2013, new study finds.]
 
The children's EHR format was authorized by the 2009 Children's Health Insurance Program Reauthorization Act (CHIPRA) and developed by AHRQ and the Centers for Medicare and Medicaid Services. AHRQ officials say the next steps include testing by two CHIPRA quality demonstration grantees, the Commonwealth of Pennsylvania and the State of North Carolina. 
 
Looking long term, Leu said, "If there is some way to certify the EHRs for child health appropriateness, then that might be helpful because then at least the pediatricians would know what they should be purchasing."
 
This may not be far off, as CMS officials say they will work toward integration of the format into future editions of the Office of the National Coordinator for Health Information Technology's EHR Standards and Certification Criteria. This would be required for achieving meaningful use of certified EHR technology in future stages of the Medicare and Medicaid EHR incentive programs.