HHS tailors EHRs for children

Electronic health record (EHR) systems should be enhanced to deal with the needs of people such as children and victims of domestic violence, officials said today at a meeting of a Health and Human Services Department advisory workgroup.

For pediatrics patients, HHS is developing a model EHR with features tailored for their health needs, speakers said. For example, a pediatric record system is likely to have growth charts and vaccination charts.

The Agency for Healthcare Research and Quality (AHRQ) along with the Centers for Medicare and Medicaid Services are creating the pediatric record template for children enrolled in Medicaid or in the Children’s Health Insurance Program (CHIP), Dr. Carolyn Clancy, AHRQ's director, said at a meeting of the HHS Health IT Policy Committee’s meaningful use workgroup.

The workgroup is advising the HHS National Coordinator for Health IT on distributing $17 billion in economic stimulus funds to providers who buy and "meaningfully use" EHR systems.

Although studies have shown that about 21 percent of pediatricians use digital health record systems, only six percent of those doctors said the systems included all the core functionalities that doctors believe necessary, Clancy said.

The AHRQ-Medicaid model children’s digital record project will involve conducting an environmental scan and gap analysis to identify up to three core functions needed for the pediatric EHRs that are currently not available in most digital health record systems, Clancy said.

The goal is to produce a model and format usable by multiple audiences, and to widely disseminate the model to vendors, developers, purchasers and others.

“This work will help bridge the technology gap that exists due to the lack of appropriate electronic tools for health professionals treating children,” Clancy said. “This project is focused on children in Medicaid and CHIP, where the greatest disparities exist but will be applicable to most pediatric providers.”

Also at the meeting, Dr. Howard Hays, acting program manager of the EHR system at the Indian Health Service (IHS), said current EHRs don't deal with nontraditional factors that influence health in disadvantaged communities, such as literacy, language and cultural barriers, domestic violence and crime.

“If meaningful use continues to be defined by traditional health measures, while other nonaddressed factors are critical contributors to inequity, unanticipated negative outcomes may result,” Hays said.

For its own record system, the IHS has developed software and standards for nontraditional data fields such as domestic violence that allows those factors to be tracked and aggregated, he said.