Children's Electronic Health Record Format

What is the Children’s EHR Format?

The Children’s Electronic Health Record (EHR) Format was developed to bridge the gap between the functionality present in most EHRs currently available and the functionality that would more optimally support the care of children. Specifically, the Format provides information to EHR system developers and others about critical functionality, data elements, and other requirements that need to be present in an EHR system to address health care needs specific to the care of children, especially those enrolled in Medicaid or the Children’s Health Insurance Program (CHIP). To address these needs, the Format includes a minimum set of data elements and applicable data standards that can be used as a starting point or checklist for EHR developers seeking to create a product that can capture the types of health care components most relevant for children. The child-specific data elements and functionality recommendations are sorted into various topic areas, including—

  • Prenatal and newborn screening tests
  • Immunizations
  • Growth data Information for children with special health care needs
  • Well child/preventive care

The Format allows for interoperable exchange of data, including data collected in school-based, primary, and inpatient care settings; is compatible with other EHR standards; and facilitates quality measurement and improvement through collection of clinical quality data. The Format was authorized by the 2009 Children’s Health Insurance Program Reauthorization Act (CHIPRA) and developed by the Agency for Healthcare Research and Quality (AHRQ) in close collaboration with the Centers for Medicare & Medicaid Services (CMS). For more information on other AHRQ-supported work related to the CHIP Reauthorization Act, click here.

Recent Improvements to the Format

Feedback from users of the Format suggested that its impact could be greater if software developers and other stakeholders were provided additional guidance in using it. In 2014, in collaboration with CMS, AHRQ contracted with RTI International to enhance the Format. The main goal of this enhancement project was to offer system developers, practitioners, provider organizations, patients, and other key stakeholders effective ways to improve EHRs used in the care of children.

The Children’s EHR Format 2015 Priority List, and Recommended Uses for the Format (PDF, 1.71 MB) provide the enhanced guidance to the Format. The hope is that this additional guidance will spur dialogue among software users, developers, and other stakeholders that will ultimately result in safer medication use, better tracking and completion of childhood immunizations, improved communication and knowledge about growth and development, and better screening and management of children with special health care needs.

How Can I Use the Format?

The Children’s EHR Format is not just for EHR developers. EHR system purchasers, policymakers, and child health advocates may also find the Format a useful tool for understanding the current requirements necessary to optimally support the care of children. To assist these other groups in using the Format, we have developed specialized instructions that can be accessed in the Documentation and User Guide available on the Format's home page.

In addition, refer to the 2015 Priority List and Recommended Uses of the Format (PDF, 1.71 MB) for a short list—47 items—that have been edited or rewritten for clarity, and are supported by implementation notes that expand upon what is contained in the description of the requirement.

What Should I Know About HL7 and the Format?

The Children’s EHR Format contains portions of the Health Level Seven International (HL7®) Child Health Functional Profile Specification, release 1, and modifications thereof, developed by HL7, the copyright of which is owned by HL7. Portions of the Format that contain excerpts from the HL7 Child Health Functional Profile are identified in the Provenance Field. Use of HL7 copyrighted material is governed by copyright law and HL7’s policies related to the use of HL7 Intellectual Property (IP). For more information on HL7’s IP Policy, go to