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

272 K.B. Johnson and C.G.M. Weigle
Fig. 19.4 ACPOE value dimensions 15
prescription?), their task needs (How will ACPOE streamline/hinder specific steps
in e-prescribing in a small/medium/large practice and how will it affect the error
rate?) and their information needs (What specific medical and practical knowledge is
needed to assure safe prescribing (pediatric-specific and appropriate drug forms (oral
liquid availability) and test options (micro methods for infants)?). Consideration of
provider culture is essential. As has been shown by Lorenzi and Ash, transformational
impacts of ACPOE and other health information technology may be both recognized
and mitigated using established approaches (Fig. 19.4). 27,33–35
19.4 Recent Advances
Ambulatory order entry systems have become increasingly sophisticated to the
point where the Institute of Medicine and the Leapfrog Group have advocated
for eRx for use by all clinicians by 2010. A framework for measuring the impact
(and value) of ACPOE in terms of financial, clinical, and organizational dimensions
has been developed, 15 with the demonstration of significant benefits to patients as a
result of eRx and medication management data inoperability.
19.5 Pediatric Issues in ACPOE Adoption
19.5.1 Pediatric Practitioners’ Needs
Practitioners’ needs for ACPOE are pragmatic: Does it make prescribing safer than
without it? If it does not and if it is required for practice, how can it be adapted to
meet practitioners’ needs? How is return on investment in a product assured?
Availability of pediatric-specific functions: As shown in Fig. 19.1, basic
pediatric-specific data and functions include patient weight, age, body-mass index,