P e D S SIG Reconciling the pediatric requirements with the EHR model May 2006 Age Representation Allow recording of post conceptional age and distinguish it from post-natal age Closest conformance criterion: N/A… DC.1.2 (Manage patient demographics) comes closest ([no CC contains this specific concept]). NOT INCLUDED, noncontroversial Reference number: 2
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Reconciling the pediatric requirements with the EHR model May 2006 Age Representation Allow recording of post conceptional age and distinguish it from.
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Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Age Representation
Allow recording of post conceptional age and distinguish it from post-natal age
Closest conformance criterion: N/A… DC.1.2 (Manage patient demographics) comes closest ([no CC contains this specific concept]).
NOT INCLUDED, noncontroversial Reference number: 2
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Age Representation
Allow recording of the exact time of birth down to the minute
Closest conformance criterion: N/A… DC.1.2 (Manage patient demographics) comes closest ([no CC contains this specific concept]).
NOT INCLUDED, noncontroversial Reference number: 3
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Age Representation
Display age with the appropriate units, based on the child's age (for example, infants who are four days old should have their age displayed in days, as opposed two weeks or months)
NOT INCLUDED, noncontroversial Reference number: 4
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Custody
Provide patient identification mechanisms that can withstand changes in family structure, such as loss of a child from the family in a custody decision
Closest conformance criterion: N/A ((I am pretty sure this needs some significant clarification)).
NOT INCLUDED, noncontroversial Reference number: 19
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Custody
Provide patient identification mechanisms that can withstand changes in family structure, such as removal of the child from the home
Closest conformance criterion: N/A ((I am pretty sure this needs some significant clarification)).
NOT INCLUDED, noncontroversial Reference number: 20
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Custody
Provide authentication procedures for adults who claim to be parents or guardians of a child, in cases where the child is under investigation for abuse and neglect
Closest conformance criterion: Needs more detail… hard to put this one into a conformance criterion (Perhaps this one could be achieved merely by supporting some kind of alerting mechanism for kids whose custody is not straightforward).
NOT INCLUDED, noncontroversial Reference number: 18
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Decision Support
Allow the deferral of alerts and reminders to a subsequent episode of care
Closest conformance criterion: N/A ((If a system decided that service X was needed today, and the user decided not to do it, then the system generally would decide that is needed tomorrow, too, right?)).
NOT INCLUDED, noncontroversial Reference number: 24
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Decision Support
Display deferred actions Closest conformance criterion: N/A ((If a
system decided that service X was needed today, and the user decided not to do it, then the system generally would decide that is needed tomorrow, too, right?)).
NOT INCLUDED, noncontroversial Reference number: 27
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Decision Support
In cases where gender is unknown, and in the case where certain decision support is gender specific, provide both male and female versions in cases where the gender is unknown
Reconciling the pediatric requirements with the EHR model May 2006
E-Prescribing & Ordering
Transmit relevant body measurements (usually weight) with prescriptions
Closest conformance criterion: N/A ([EHRs are going to do what the eRx messaging standards say to do… if weight is a field, then they'll send it. If not, they won't.]).
NOT INCLUDED, noncontroversial Reference number: 66
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Family Linkage
Allow the recording of a relationship by living situation
NOT INCLUDED, noncontroversial Reference number: 78
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Growth
Allow graphic display of growth data against a user-selectable set of normative curves
Closest conformance criterion: DC.1.4? (Growth charting is briefly mentioned in the text of DC.1.4 "Manage Assessments," but there are no specifics).
NOT INCLUDED, noncontroversial Reference number: 82
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Growth
Plot body mass index against normative curves
Closest conformance criterion: DC.1.4? (Growth charting is briefly mentioned in the text of DC.1.4 "Manage Assessments," but there are no specifics).
NOT INCLUDED, noncontroversial Reference number: 85
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Growth
Provide graphical growth chart and norms for children with varying conditions (e.g., Down syndrome and Turner syndrome)
Closest conformance criterion: DC.1.4? (Growth charting is briefly mentioned in the text of DC.1.4 "Manage Assessments," but there are no specifics).
NOT INCLUDED, noncontroversial Reference number: 87
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Growth
Provide alerts about variances in the growth chart
Closest conformance criterion: Needs more detail… hard to put this one into a conformance criterion (Growth charting is briefly mentioned in the text of DC.1.4 "Manage Assessments," but there are no specifics).
NOT INCLUDED, noncontroversial Reference number: 86
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Growth
Provide mechanism for monitoring of growth over time
Closest conformance criterion: Needs more detail… hard to put this one into a conformance criterion (Growth charting is briefly mentioned in the text of DC.1.4 "Manage Assessments," but there are no specifics).
NOT INCLUDED, noncontroversial Reference number: 88
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Guardianship
Support the recording of multiple guardians and residences for given child whose parents are divorced or who have joint custody
Reconciling the pediatric requirements with the EHR model May 2006
Guardianship
Allow reference to subsets of the demographic data of the patient’s guardian to serve for parts of the patient’s demographic data, to avoid re-entry of data and avoid data anomalies
Reconciling the pediatric requirements with the EHR model May 2006
Immunizations
Allow reporting of immunization status of populations of children within the practice
Closest conformance criterion: DC.1.3.3 #3 ([This is not directly mentioned in the conformance criteria, but it would be a derivative of the process used to compute immunizations for individuals]).
NOT INCLUDED, noncontroversial Reference number: 95
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Immunizations
Allow recording of parental consent to immunizations, according to applicable state law, as part of the point of care interface
Reconciling the pediatric requirements with the EHR model May 2006
Immunizations
Compute immunization recommendations for a time other than the time of the current encounter (for example if a parent wants to know what immunizations are due at the next visit, the system would facilitate this analysis)
Reconciling the pediatric requirements with the EHR model May 2006
Norms
Calculate and immeditely display, along with the original data, percentile values for any piece of data entered into the system for which a percentile distribution is known (height, weight, head circumference, body mass index, blood pressure)
Reconciling the pediatric requirements with the EHR model May 2006
Parental Data Entry
provide a Web-based interface for entering data by parents, patients, school nurses, pharmacy labs/medical devices technicians.
Closest conformance criterion: DC.1.1.4 #3 (specifying "web-based" is beyond the scope of this document; this CC should handle the EHR end of this requirement) (The system SHALL capture, explicitly label the source of clinical data provided on behalf of the patient.).
NOT INCLUDED, noncontroversial Reference number: 121
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Parental Data Entry
Allow designation of a given patient as competent to enter his or her own information at a point selected by the clinician
Reconciling the pediatric requirements with the EHR model May 2006
Patient Identification
To the extent afforded by existing national patient identifier systems, allow replacement of an identifier assigned in the pediatric period to a new, “adult” identifier at the age of majority
Reconciling the pediatric requirements with the EHR model May 2006
Privacy
Include donor management support: Functions in an EMR related to organ and tissue donation may need to accommodate information about the gamete or zygote donated that resulted in pregnancy that gave rise to the patient, within applicable privacy laws.
Closest conformance criterion: S.1.2: Donor Management Support… but does not include ART ().
NOT INCLUDED, noncontroversial
Reference number: 143
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Telehealth
Provide access to the electronic medical record to sites where telehealth is being implemented
Closest conformance criterion: N/A (Whether an application is available through a network is an implementation issue).
NOT INCLUDED, noncontroversial Reference number: 167
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Terminology
include special terminology used in pediatric care: Example: EMR systems include common pediatric terms (pediatric lexicon) used to describe pediatric preventive health care (e.g., developmental milestones, educational progress, and anticipatory guidance) and physical findings (e.g., weak cry, bulging anterior fontanels, and umbilical granuloma).
Closest conformance criterion: Nonsensical; making terminology systems adequate for pediatric care is beyond the present scope (We need an entirely separate document detailing what we mean by pediatric terminology.).
NOT INCLUDED, noncontroversial Reference number: 168
Pe
D S SIG
Reconciling the pediatric requirements with the EHR model May 2006
Terminology
Support terminology systems specifically designed for use in pediatrics
Closest conformance criterion: Nonsensical; no such terminoligy systems exist ().
NOT INCLUDED, noncontroversial Reference number: 169