Trends in Use of Electronic Health Records in Pediatric Office Settings

Temple, Michael W.; Sisk, Blake; Krams, Lisa; Schneider, Joseph H.; Kirkendall, Eric S.; Lehmann, Christoph U.

doi:10.1016/j.jpeds.2018.10.039

Cited by 36 publications

(31 citation statements)

References 28 publications

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“…These limitations have left many physicians and clinical team members with a "first, do no harm" approach to providing access to EHRs using the provided portal and access tools, leading to either extensive customization of the EHRs when being used for pediatric populations or exclusion of pediatric and adolescent patients from electronic access to their records. 17 Many EHRs have an all-ornothing privacy and confidentiality approach that is typically used by EHRs for communicating health data such as demographics, problems, medications, and other data (eg, laboratory results, radiology results, and progress notes) and do not support the granular filtering needed to provide the types of protection needed by patients; this is especially true in the special case of pediatric records. 18…”

Section: Limited Ability Of Ehrs and Other Hit To Segment Informationmentioning

confidence: 99%

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Electronic Communication of the Health Record and Information With Pediatric Patients and Their Guardians

et al. 2019

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Communication of health data has evolved rapidly with the widespread adoption of electronic health records (EHRs) and communication technology. What used to be sent to patients via paper mail, fax, or e-mail may now be accessed by patients via their EHRs, and patients may also communicate securely with their medical team via certified technology. Although EHR technologies have great potential, their most effective applications and uses for communication between pediatric and adolescent patients, guardians, and medical teams has not been realized. There are wide variations in available technologies, guiding policies, and practices; some physicians and patients are successful in using certified tools but others are forced to limit their patients' access to e-health data and associated communication altogether. In general, pediatric and adolescent patients are less likely than adult patients to have electronic access and the ability to exchange health data. There are several reasons for these limitations, including inconsistent standards and recommendations regarding the recommended age for independent access, lack of routine EHR support for the ability to filter or proxy such access, and conflicting laws about patients' and physicians' rights to access EHRs and ability to communicate electronically. Effective, safe electronic exchange of health data requires active collaboration between physicians, patients, policy makers, and health information technology vendors. This policy statement addresses current best practices for these stakeholders and delineates the continued gaps and how to address them. DEFINITIONS In this document, the terms below are used with these definitions: • Guardian: legal guardians, including parents, who have access to all or part of the child's medical record and/or patient portal.

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Section: Limited Ability Of Ehrs and Other Hit To Segment Informationmentioning

confidence: 99%

“…This challenge results in fewer pediatric patients enrolling in portals, thereby depriving of them of the access recommended by multiple medical societies. 17…”

Section: Privacy and Confidentiality Needs Of Adolescent Patientsmentioning

confidence: 99%

Electronic Communication of the Health Record and Information With Pediatric Patients and Their Guardians

et al. 2019

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“…The adoption of EHRs over the last decade has allowed for tremendous improvements in pediatric care delivery, including electronic prescribing, automated plotting of growth charts, and support for the appropriate delivery of immunizations and well-child care. 1 Our hope is that this study serves as a catalyst for a focus in the next decade on pediatric EHR usability and safety, not only demonstrating the gains in health care quality seen in adult settings but, also, helping mitigate patient harm and the provider burnout crisis.…”

mentioning

confidence: 92%

“…Nearly every office-based pediatrician now uses an electronic health record (EHR). 1 There is now evidence that using EHRs can improve guideline adherence, reduce medication errors, and improve other measures of health care quality, 2 but the rapid adoption of EHRs has also precipitated unintended and undesired consequences, including the poor usability of EHRs. 3 Usability is the extent to which a technology can be used efficiently, effectively, and satisfactorily.…”

mentioning

confidence: 99%

“…This is generally consistent with survey-based estimates of office-based pediatrician EHR use. 1 Historically, research and policy has been focused on EHR usability primarily in adult settings. Although, in seminal studies in pediatrics, researchers identified harms from poorly designed and implemented EHRs and recommendations exist to improve the pediatric functionality of EHRs, the optimization of EHRs for pediatric settings is lagging.…”

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