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

44 D.M.N. Paperny
Tasks related to health care and anticipatory guidance
Screen for and manage health problems (acute and chronic illnesses, acne,
obesity, eating disorders)
Schedule sexual health care (family planning, Depo-Provera, STIs, Pap smears,
pregnancy)
Detect latent and active illnesses (HIV, substance abuse, maltreatment, domestic
violence)
Provide age, race, gender, and literacy-appropriate anticipatory guidance
Monitor patient health in the context of family history (blood pressure, obesity,
cardiac disease)
Tasks related to practice operation
Communicate (telephone, fax, e-mail, secure messaging)
Schedule appointments with practitioners
Prescribe safely, securely and accurately (e-prescribing)
Provide population-appropriate patient educational materials and resources
Assure confidentiality, integrity, and availability of medical records
Tasks related to financial management
Bill appropriately
Preserve confidentiality
Adolescents are not simply large children. In addition to the complex physical
growth and maturational changes they undergo, teens also have four major
developmental tasks to accomplish from age 11–24 years old. They must
establish:
Personal identity
Independence
Adult sexuality
Vocational choice
These involve intellectual, psychological, and emotional growth and maturity as
well as social, cultural, and legal changes, which may have profound impacts on the
relationships between the patient and the physician, the physician and the family,
and the patient and the family. These changes may also expose the growing youth
to risks from self-injurious or harmful behaviors.
For the clinician, obtaining information on these issues may be challenging.
Identification of high-risk behaviors in adolescents may be difficult because
of physical, legal, cultural, and/or economic barriers to seeking care, because of
confidentiality and trust issues in discussing hidden agendas and because of health
literacy and physician cultural competence issues. The sensitive nature of
health and non-health issues, especially in a population that is discussing them for
the first time in a medical setting, may create patient or clinician discomfort and
confidentiality issues. As a result, clinician “forgetfulness” may contribute to low
rates of sensitive issues addressed. In addition, the health system may pit patient