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Researchers recommend EHR certification for pediatric care

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Just as women and men are different, physically, so are adults and children. Many researchers have found that those differences also require differences in the electronic health record (EHR) capabilities for each patient age group.

The 21st Century Cures Act for States includes a section for “Assisting doctors and hospitals in improving quality of care for patients.” In regard to EHRs and pediatric care, section 4001(b) specifically states that the Office of the National Coordinator for Health Information Technology (ONC) “must encourage, keep, or recognize the certification of health IT for use in medical specialties” and that Health and Human Services (HHS) “must adopt certification criteria to support health IT for pediatrics, and begin certification soon after.”

Pew researchers have urged the ONC to institute a voluntary certification program for EHRs related to pediatric care, stating that is “a golden opportunity to make digital records more effective for the youngest and often most vulnerable patients.” Pew emphasizes the positive effects of using EHRs for patient care but also cautions that mistakes are often made when caring for children.

One potentially devastating case occurred in 2013, when “a 16-year-old patient in California was inadvertently given 38 times the appropriate amount of an antibiotic; the physician didn’t realize that the EHR’s default setting multiplied the amount entered by the patient’s weight. As a result, the patient suffered a near-fatal grand mal seizure.”

Researchers at Pew emphasize that “ONC should focus on rules to better monitor and test EHRs—including safety evaluations of high-risk functions such as weight-based drug dosing in pediatric care—that go beyond current requirements for EHRs and focus on the issues that emerge in the care of children.”

While requirements are currently in place for certified EHR usage, including certification for electronic prescriptions, researchers are strongly recommending that EHRs also undergo a certification process specifically for use in pediatric care given the many physical differences between adult patients and children.