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

2 Informatics and Pediatric Health Care 9
guide pediatricians in focusing their clinical knowledge and representing them
explicitly as data, in the perspectives, interpretations, and granularity required to
assure correct execution by applications. Thus, pediatricians also serve as child
advocates at the developers’ table.
As with many fields, the bulk of published evidence supporting the value of
clinical informatics has been derived from data involving (nonpregnant, nongeriatric)
adults. This limits generalization of findings to other populations,
neglecting important distinctions between general adult medicine and pediatrics
(for example) that may affect the design, implementation, and outcomes of
interventions that use clinical informatics applications. Examples of distinctions
between pediatric and adult medicine data needs are listed in Table 2.2.
Health IT advocacy may go beyond the institutions in which pediatricians
practice. Much of pediatric informatics data and research has been derived from
academic pediatric centers, and often in inpatient settings. However, much of
pediatric care occurs in ambulatory settings and in community hospitals, in
which children and infants receive care but where there may be no certified
pediatricians. 22
Table 2.1 Sample questions for pediatric informatics
Pediatric area of concern Special clinical informatics issues
Premature infants and their
associated medical problems
How can clinical systems automatically adjust to
expected developmental ages and needs of premature
infants?
Injury prevention How can injuries be prevented in inpatient settings?
How can parent knowledge about injury risks be assessed
and improved by primary care practitioners?
How can physician/parent adherence to injury prevention
guidelines be improved?
Well child care What are the advantages of well-child care
documentation by computer?
Congenital issues
How should pediatricians be trained in the age of
(anomalies AND disease)
genomic medicine?
Drug prescribing How can errors and miscommunications in weight-based
prescriptions for children be reduced or eliminated?
Office of the future How might pediatric office visits better utilize
telemedicine/teleconferencing to better inform
caregivers?
How might aggregate public health data improve home
management and triage? How should the privacy
considerations for adolescents be managed in the
electronic age?
Parent engagement
(systems approach to care)
How can personal health records improve parent
activation?
What is the impact of improved school information
systems on medication adherence?