RTI International, Durham, North Carolina;
RTI International, Durham, North Carolina.
Pediatrics. 2018 Apr;141(4). doi: 10.1542/peds.2016-3894. Epub 2018 Mar 8.
Electronic health record (EHR) use throughout the United States has advanced considerably, but functionality to support the optimal care of children has been slower to develop and deploy. A previous team of experts systematically identified gaps in EHR functionality during collaborative work from 2010 to 2013 that produced the Children's EHR Format (Format), funded under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3. After that, a team of practitioners, software developers, health policy leaders, and other stakeholders examined the Format's exhaustive list of 547 EHR functional requirements in 26 topic areas and found them to be valuable but in need of further refinement and prioritization. Work began in 2014 to develop a shortened high priority list of requirements and provide guidance to improve their use. Through a modified Delphi process that included key document review, selection criteria, multiple rounds of voting, and small group discussion, a multistakeholder work group identified and refined 47 items on the basis of earlier requirements to form the 2015 Children's EHR Format Priority List and developed 16 recommended uses of the Format. The full report of the Format enhancement activities is publicly available. In this article, we aim to promote awareness of these high priority EHR functional requirements for the care of children, sharpen industry focus on adopting these changes, and align all stakeholders in prioritizing specific health information technology functionalities including those essential for well-child preventive care, medication management, immunization tracking, and growth data for specific pediatric subgroups.
电子健康记录 (EHR) 在全美得到了广泛应用，但支持儿童最佳护理的功能开发和部署速度较慢。一个由专家组成的团队在 2010 年至 2013 年的协作工作中，系统地确定了 EHR 功能中的差距，该工作由 2009 年《儿童健康保险计划再授权法案》（公法 111-3）资助，产生了儿童电子健康记录格式（Format）。在此之后，一组从业者、软件开发人员、卫生政策领导人以及其他利益相关者检查了 Format 在 26 个主题领域中详细列出的 547 个 EHR 功能要求，发现它们很有价值，但需要进一步细化和优先排序。自 2014 年以来，我们开始制定一个简短的高优先级需求清单，并提供指导以改进其使用。通过一个修改后的 Delphi 流程，包括关键文件审查、选择标准、多轮投票和小组讨论，一个多利益相关者工作组根据早期的要求确定并精炼了 47 项要求，形成了 2015 年儿童电子健康记录格式优先级清单，并制定了 16 项 Format 的推荐用途。Format 增强活动的完整报告可供公众查阅。在本文中，我们旨在提高人们对这些儿童护理高优先级 EHR 功能要求的认识，促使行业关注这些变化的采用，并使所有利益相关者能够优先考虑特定的卫生信息技术功能，包括那些对儿童预防保健、药物管理、免疫接种跟踪以及特定儿科亚组的生长数据等方面至关重要的功能。
