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

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260 G.R. Kim and C.U. Lehmann 18.2.3 Interoperability Beyond shareability, “interoperability of healthcare information (in the form of data and records [stored in an EHR])” has three primary aspects: technical (assurance of structure, syntax, and reliable communication), semantic (preservation of full meaning) and process (integration to health care delivery process and work flow). 9 An EHR interoperability model (EHR-IM) also in development by HL7 is complementary to the HL7 EHR-S FM in describing specific profiles. 18.3 Pediatric Aspects 18.3.1 Functionality Needs Critical pediatric “direct care” functionality areas for EHR-S have been described in a policy statement by the American Academy of Pediatrics 10 and include special functionalities (among others) for: Immunization Management (recording data, linking to immunization information systems, decision support) Growth Tracking (graphical representation, percentile calculations, calculation of body parameters such as BMI) Medication Dosing (body weight or surface area based dosing, dose-range checking, dose rounding, age-based dosing decision support, school day dosing) Patient Identification (newborns, prenatal identifiers, name changes, ambiguous gender) Data norms (numeric and nonnumeric data, complex normative data, gestational age data) Privacy (adolescents, foster/custodial care, consent by proxy, adoption, guardianship, emergent care, Chapter 22) Collaborative work by the Health Level 7 Pediatric Data Standards Special Interest Group (HL7 PeDSSIG) 11 and the Health Level 7 Electronic Health Record Technical Committee (HL7 EHR TC) is seeking to ensure that these pediatric functions are included in the HL7 EHR FM through creation of a Child Health Functional Profile. 12 In 2007, the Certification Commission for Healthcare Information Technology (CCHIT, a recognized certification body (RCB) for electronic health records and their networks established a Child Health Expert Panel composed of a variety of healthcare professionals and stakeholders 13 charged with the task of developing and publishing test scripts and certification criteria for ambulatory pediatric EHR systems (based on the Child Health Functional Profile). 12
18 Electronic Health Records and Interoperability for Pediatric Care 261 18.3.2 Interface Needs Pediatric EHRs may require interfaces to other information systems to share information needs. These include: Ambulatory EHRs to: � Practice management and billing systems � Public health agencies (Immunization information systems, newborn screening registries, regional health information networks) 14 � Inpatient hospital discharge records, including newborn discharges � Pharmacy, laboratory and imaging information systems � Patient portals and personal health records � Foster care and guardianship programs � School health record systems Hospital and Emergency Department EHRs to: � Maternal records for prenatal data, including prenatal screening and diagnoses, genomic data, risk factors, and in-utero procedures � State newborn screening registries and programs � Ambulatory (Medical Home) EHRs for follow up care � Long-term care facility EHRs for convalescent care � Specialty care and research programs � Breast milk banking programs � Error reporting systems Pediatric specialty EHRs to: � Biological resource registries (cord blood and tissue registries, organ banks) � Clinical trial databanks � Emergency medical services for children � Injury, poisoning, and other reporting registries A practical articulation of both functionality and interface needs for a primary care practitioner’s office may include a mix of functions and interfaces including telephone systems. 15 18.3.3 Other Interoperability Needs Beyond functional and interface needs, there is a need to develop standards that adequately and accurately represent pediatric entities and events (when communicating in electronic environments) with the appropriate concepts, to the appropriate granularity or level of detail and in the correct context in a form that can be encoded for use in computerized environments. Many current content standards lack this pediatric focus. 10 Considerations for data and terminology standards for pediatrics are covered in Chapters 32 and 33.
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Health Informatics (formerly Comput
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Editors Christoph U. Lehmann George
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vi Series Preface changes to both t
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viii Foreword This text will prove
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x Preface financial investment and
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How to Use This book This book is t
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xvi Contents 9 Pediatric Care, Safe
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xviii Contents Part VII A Vision an
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xx Contributors Donna M. D’Alessa
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xxii Contributors Christoph U. Lehm
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xxiv Contributors Mark M. Simonian,
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4 G.R. Kim pharmacy, medical educat
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6 K.B. Johnson and G.R. Kim Deaths
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8 K.B. Johnson and G.R. Kim 2.4.1 I
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10 K.B. Johnson and G.R. Kim 2.4.3
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12 K.B. Johnson and G.R. Kim Educat
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14 K.B. Johnson and G.R. Kim 2.6 Co
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Chapter 3 Core Pediatric Data Kevin
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3 Core Pediatric Data 21 3.3 Pediat
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3 Core Pediatric Data 23 3.6 Pediat
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Chapter 4 Neonatal Care and Data De
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4 Neonatal Care and Data 27 Essenti
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4 Neonatal Care and Data 29 4.3 The
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4 Neonatal Care and Data 31 some ma
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4 Neonatal Care and Data 33 Measure
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4 Neonatal Care and Data 35 4.5.2.4
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4 Neonatal Care and Data 37 4.6.3 I
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4 Neonatal Care and Data 39 4.7.2.2
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4 Neonatal Care and Data 41 Availab
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44 D.M.N. Paperny Tasks related to
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46 D.M.N. Paperny Behavioral risk d
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48 D.M.N. Paperny for outside ancil
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50 D.M.N. Paperny Video reinforceme
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52 D.M.N. Paperny 3. Litzelman DK,
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Chapter 6 Children with Development
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6 Children with Developmental Disor
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Chapter 7 Pediatric Emergency and P
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7 Pediatric Emergency and Pediatric
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84 W.H. Drummond et al. A recovery
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86 W.H. Drummond et al. 8.2.2 Forma
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88 W.H. Drummond et al. 8.2.2.1 Sys
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90 W.H. Drummond et al. The multidi
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92 W.H. Drummond et al. noise overl
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94 W.H. Drummond et al. needs requi
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96 W.H. Drummond et al. Children’
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98 W.H. Drummond et al. After the P
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100 W.H. Drummond et al. Table 8.2
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104 W.H. Drummond et al. when to su
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106 W.H. Drummond et al. It is crit
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108 W.H. Drummond et al. traditiona
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110 W.H. Drummond et al. and human
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112 W.H. Drummond et al. blood prod
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116 W.H. Drummond et al. 35. Collin
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Chapter 9 Pediatric Care, Safety, a
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9 Pediatric Care, Safety, and Stand
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134 D.M. D’Alessandro The EBM pro
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136 D.M. D’Alessandro 10.4 Pragma
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138 D.M. D’Alessandro 4. Case ser
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140 D.M. D’Alessandro Ontario, BC
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142 D.M. D’Alessandro Table 10.1
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144 D.M. D’Alessandro Children ar
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146 D.M. D’Alessandro 17. Ely JW,
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Chapter 11 Clinical Practice Guidel
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11 Clinical Practice Guidelines: Su
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162 M.J. Feldman in patients withou
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164 M.J. Feldman The art of medicin
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166 M.J. Feldman important design g
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168 M.J. Feldman Incorrect or missi
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170 M.J. Feldman Fig. 12.4 GIDEON D
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172 M.J. Feldman system or etiology
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174 M.J. Feldman ED-12: “Practica
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176 M.J. Feldman Fig. 12.7 DXplain:
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178 M.J. Feldman For GIDEON: Rabies
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180 M.J. Feldman KB on infectious d
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182 M.J. Feldman 4. Johnson KB, Fel
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Chapter 13 Managing Pediatric Knowl
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13 Managing Pediatric Knowledge Res
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Chapter 14 Supporting Continuing Pe
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14 Supporting Continuing Pediatric
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14 Supporting Continuing Pediatric
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Chapter 15 Pediatric Care Coordinat
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15 Pediatric Care Coordination: The
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Chapter 23 Electronic Mail in Pedia
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23 Electronic Mail in Pediatric Pra
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Chapter 24 Information Management b
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24 Information Management by Patien
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Chapter 25 Overview of Pediatric In
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25 Overview of Pediatric Inpatient
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Chapter 26 Prescribing/Ordering: Co
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26 Prescribing/Ordering: Computeriz
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346 S.H. Mitchell et al. 27.2.1 Med
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348 S.H. Mitchell et al. context of
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350 S.H. Mitchell et al. 27.3.3.1 C
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352 S.H. Mitchell et al. challenges
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354 S.H. Mitchell et al. work round
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Chapter 28 Medication Administratio
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28 Medication Administration and In
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Chapter 29 Understanding and Preven
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29 Understanding and Preventing Err
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386 D.C. Stockwell and A.D. Slonim
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400 J.H. Schneider a number of prob
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402 J.H. Schneider on governance, u
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404 J.H. Schneider 31.6.1 Data Rele
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406 J.H. Schneider Understanding op
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408 J.H. Schneider of this componen
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410 J.H. Schneider Table 31.1 (cont
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412 J.H. Schneider References 1. Am
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Chapter 32 Developing Pediatric Dat
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32 Developing Pediatric Data Standa
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430 G.R. Kim and S.T. Rosenbloom Co
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432 G.R. Kim and S.T. Rosenbloom No
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434 G.R. Kim and S.T. Rosenbloom pr
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436 G.R. Kim and S.T. Rosenbloom ab
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Chapter 34 Pediatric Research and I
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34 Pediatric Research and Informati
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Chapter 35 The Moving Picture of Pe
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35 The Moving Picture of Pediatric
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470 G.R. Kim and K.B. Johnson Cente
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472 G.R. Kim and K.B. Johnson 36.4
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Index A 2006 AAP recommendations on
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Index 477 psychological data, 45 se
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Index 479 High frequency flow inter
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Index 481 O Online Mendelian Inheri
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Index 483 Standards development org
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