Pediatric Informatics: Computer Applications in Child Health (Health ...

218 D.E. Lighter
The automated system process is presented in Fig. 15.2. Several steps have been
eliminated by the automated approach, with consequent savings in personnel time
making telephone referrals and managing paper reports. Elimination of the three
step process of referral is evident at node 1 in Fig. 15.2. The provider picks a subspecialist
from a dropdown list during the patient visit and immediately dispatches
an email request for an appointment. In most cases, a reply with a time and date
for an appointment returns within a couple of minutes, but if the process requires
more time, the provider can “hand off” the process to one of the support staff
(node 2). As the appointment is accepted, the provider can also click on a dropdown
box to select the sections of the chart that are to be made available to the subspecialist
for the consultation, and the consultant can connect at a convenient time to
review those chart sections. After the patient has been evaluated by the consultant,
(s)he can either enter the results of the consultation directly into the patient’s EHR,
or create a document file that can be uploaded to the patient’s record as indicated
at node 3. These improvements to the process not only expedite delivery of the
information to practitioners, but they also reduce costs by eliminating much of the
paper handling that requires expensive human resources. Cost avoidance benefits
provide additional support for the business case made earlier to justify automation,
as well as increase the quality of care by more timely access to information by all
of the child’s health care providers.
15.7 Summary
The information required to care for CYSHCN has increased exponentially in the last
few years, and manual systems of recordkeeping are inadequate to the task. As EHR
systems become ubiquitous, the needs of these children must be addressed if automation
is to be considered successful. By eliminating the costly and time- consuming
human interventions in managing information transfer, the quality and cost of care
can be enhanced, resulting in favorable financial and clinical outcomes.
References
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unraveling? Pediatrics. 2004;114(3):878–888.
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