Development of a Model Electronic Health Record Format for Children - 2011

Summary: Existing electronic health record (EHR) systems typically are designed, implemented, and used with an adult patient population in mind and therefore do not always support the provision of health care to children. Special medical and other considerations that arise in pediatric patient care are often missing or poorly supported.

Westat is collaborating with several organizations to develop and disseminate a model EHR format for children enrolled in Medicaid or Children's Health Insurance Programs. The "format" refers to the various requirements for data elements and standards, usability, functionality, and interoperability. The project team is working to understand how the model format, its structure, and content might be used to develop new or enhance existing EHR products to help providers optimize health care for children. The goals of this project are supported by a technical expert panel to ensure broad stakeholder input at every stage of the project. Two Children's Health Insurance Program Reauthorization Act grantees also are testing and evaluating the format's impact on quality and cost of care.

The outcome of this project will identify core elements of an EHR for children that can be incorporated into vendor systems, and will provide guidance to users of EHRs about the ideal functionality of EHRs for children.

Project Objectives:

• Conduct an environmental scan and gap analysis. (Achieved)
• Develop a model EHR format for children that can be used readily. (Achieved)
• Package the EHR format in a way that facilitates broad incorporation into EHR systems. (Upcoming)

2011 Activities: The focus of activities in 2011 was on finalizing the EHR format and initiating the development of two prototypes based on selected format requirements, growth charting and medication management. The contract was extended by 8 months to enable a number of activities to be undertaken in 2012. These include developing and incorporating additional enhancements of the format; conducting a conformance assessment of the format requirements relative to several selected vendor products; finalizing the two prototypes; and developing a process for a key stakeholder feedback process and validation approach.

Preliminary Impact and Findings: The environmental scan and gap analysis suggest that existing EHR systems and products lack a number of functionalities related to more than 30 topic areas (growth data, newborn screening, medication management, etc.) related to the treatment of children and for which the project is currently developing requirements.

Target Population: Medicaid, Pediatric*

Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to improve health care decisionmaking through the use of integrated data and knowledge management.

Business Goal: Knowledge Creation

*This target population is one of AHRQ's priority populations.