Children's Electronic Health Record Format

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A number of Pediatric EHR functions are unique, such as support for neonatal medicine, congenital syndromes and defects, the use of growth charts, and tracking developmental progress. Many EHR functions such as weight-based dosing and immunization record keeping are used in adult medicine, but without the frequency and importance that they have in pediatrics. On the whole, EHR software development has not emphasized these functions. This may be due in part to the relatively small market share of pediatric medicine, and a slow uptake of EHR by the specialty before the age of Meaningful Use.

In the 1990s the informatics efforts of the American Academy of Pediatrics gathered steam. Many pediatric implications for the EHR were recognized with reports around patient privacy, adolescent confidentiality, and the patient-centered medical home. Interest in the EHR’s ability to improve patient safety increased with the 2000 publication by the Institute of Medicine titled to To Err Is Human (citation number). In 2001 the ideal qualities of a good pediatric electronic health record were proposed in detail by the American Academy of Pediatrics (cite). Spooner later prioritized this list of qualities in 2007 in the paper Special requirements of electronic health record systems in pediatrics. The 2000’s were marked by studies on the benefits and costs of pediatric clinical information systems such as Computerized Provider Order Entry. In 2005 a study conducted in a pediatric intensive care unit at the Children’s Hospital of Pittsburgh became a flashpoint for attention to the relationship between EHR use and medical errors. Subsequent studies at Seattle Children’s Hospital published in 2006, and in Palo Alto in 2010 put emphasis on implementation itself as a critical factor for the success of EHRs in minimizing medical errors (cite Coiera paper).

CHIPRA and the model Children's EHR Format of 2009 to 2013

The Children’s Health Insurance Program Reauthorization Act (CHIPRA) was passed by US Congress in 2009 and it included a program to enhance pediatric Electronic Health Records. The Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare and Medicaid Services (CMS) started that year, and included representatives from the American Academy of Pediatrics, Vanderbilt University, and RTI International.

Children's EHR Format 2015 Priority List and Recommended Uses


Submitted by Ben Sanders, April 2018