Critical developments in pediatric EHRs: Content design and data viability for research and clinical quality applications

The application of electronic health record (EHR) systems in clinical environments serving vulnerable populations and medically underserved patients has the potential to improve measurably the quality and continuity of their care. While evidence- and standards-based content have been applied in the development of adult hospital and ambulatory care EHRs, development of pediatric content has lagged comparatively. Vulnerable populations have thus far been among the last to benefit from high quality content embedded in health information technology. The Children's Health Fund (CHF) and Center for Community Health Technology (CCHT) have developed rigorous and field proven pediatric EHR content based on current evidence-based and evidence-informed standards. This content is designed to support the highest level of clinical care to pediatric patients and in particular focuses on addressing health care disparities in vulnerable, medically underserved pediatric populations. Structured evidence-based clinical content for EHRs also serves as a unique source of data on these patient populations. Output data can be tailored to meet continuous quality improvement needs and serve as source material for applied research. This presentation will discuss the implementation of pediatric EHR content, reporting and information systems design for this content and opportunities to utilize health technology to shape provider behavior, standardize delivery of care according to evidence-based and evidence-informed models, and to identify health disparities. These data sources can also be used to develop population-based pediatric health indicators, clinical decision support, and clinical pediatric outcome measures to supplement the few that are currently utilized (e.g., infant mortality, low birthweight, immunization coverage).