To ensure quality pediatric medical care, electronic health records for use with children need to be able to reflect and track patients’ changing physiology and maturity as well as the relationship between pediatric patients and their parents.

That’s according to a report from the federal Agency for Healthcare Research and Quality (AHRQ).

As part of the report, researchers from AHRQ’s Evidence-Based Practice Center at Vanderbilt University , Nashville, Tenn., assembled a panel of experts representing clinical, policy, research, and vendor perspectives. The panel noted that many functionalities overlap with adult care, but agreed that “given the nuances associated with longitudinal and coordinated care for the pediatric population, some functionalities will be more critical than in adults.”

The panel also emphasized “the importance of a flexible, longitudinal record that integrates critical information about the child, the family, and family history as it affects health, capabilities tailored to the needs of the clinician treating the child, and agile information display that shows the right information at the right time, despite the high volume nature of pediatrics.”

The report put vaccine management at the top of its list of core functions. Experts viewed it as “a necessity, and felt that it was well established as a need for pediatric EHRs due to its prominence both in public and personal health.”

Vaccine functionality has its challenges, they noted, because of factors such as noncentralized, proprietary databases that can fragment vaccination records, hindering clinical decision support tools and leading to improper immunizations.

Routine health care maintenance, another core function, requires that EHRs reflect standards and guidelines, including those by the American Academy of Pediatrics.

“A translation process has to occur to move general clinical guidelines, intended to provide evidence-based recommendations for provisions of care across a variety of practices, into specific algorithms that can be implemented into the available technology,” the panel recommended.

The panel called for more research into needed pediatric-specific functions in EHRs to help with their development and implementation, noting that there is a limited number of studies that provide an evidence base for what works best.

“We hope this report encourages all stakeholders to collaborate on this effort to improve electronic health records, ensuring we provide the best possible care for children,” the report concluded.


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