reconciling the pediatric requirements with the ehr model may 2006 consent in cases where consent...

PeDS SIG

Reconciling the pediatric requirements with the EHR model May 2006

Consent

In cases where consent forms are managed by the system, allow adolescent patients to participate as if they were adults under appropriate conditions

Closest conformance criterion: DC.1.11.3: Manage consents and authorizations ((Does not explicitly mention this function)).

NEEDS NEW CC IN THIS FUNCTION Reference number: 13

PeDS SIG


Decision Support

Indicate in the case of decision support function whether the function applies to the pediatric population

Closest conformance criterion: DC.1.6.1 #1, 3, 4, 5 (assuming decision support = guidelines) ((Comes close)).


PeDS SIG


Decision Support

Apply patient age to all decision support functions

Closest conformance criterion: DC.1.6.1 #5 (The system SHALL support context-sensitive care plans, guidelines and protocols (function DC.2.2.1.2) ).

INCLUDED if we make minor mods in a CC Reference number: 25

PeDS SIG


Decision Support

Facilitate selection of guidelines based on patient age

Closest conformance criterion: DC.1.6.1 #5 (The system SHALL support context-sensitive care plans, guidelines and protocols (function DC.2.2.1.2) (provided "context" = "age")).


PeDS SIG


Decision Support

Based on the record of encounters, the patient's current age, and existing guidelines, calculate whether the patient is current on the health maintenance schedule

Closest conformance criterion: DC.2.6.3 (as long as failure to participate in well-care is considered a health risk, which pediatricians generally do) AND DC.2.5.1 (The system SHALL provide a means to identify those patients who have not received appropriate action in response to a health risk alert. (Care Plan Function Links) --> How to modify this to deal with health maintenance? AND The system SHOULD present alerts for all patient specific preventive services to the provider. ).


PeDS SIG


E-Prescribing & Ordering

Allow drug dosing based on ideal body weight for a given medication

Closest conformance criterion: DC.1.8.1 ([Order Medication]).


PeDS SIG



In weight-based dosage functions, reflect maximum dose per day in the resulting prescription



PeDS SIG



Link to FDA drug alerts Closest conformance criterion: DC.1.8.1

([Order Medication]). NEEDS NEW CC IN THIS FUNCTION Reference number: 61

PeDS SIG



Offer drug dosing decision support for those drugs with a recommended starting dose range (e.g., methylphenidate) and graduated dosage increments



PeDS SIG



Allow recording of dose per meter squared of body surface area, so that the prescription can be replicated later at the same dose per meter-square

Closest conformance criterion: DC.1.8.1 #14 (The system MAY support medication re-prescribing by allowing a prior prescription to be reordered without re-entering previous data (e.g. administration schedule, quantity). --> Probably should be promoted to SHOULD and the dosage per kg should be available so one can replicate the prescription at the same dosage (i.e., at the new body surface area)).


PeDS SIG



Allow recording of the dose per kilogram in the record of a prescribed medication, so that the prescription can be replicated later at the same dose per kilogram

Closest conformance criterion: DC.1.8.1 #14 (The system MAY support medication re-prescribing by allowing a prior prescription to be reordered without re-entering previous data (e.g. administration schedule, quantity). --> Probably should be promoted to SHOULD and the dosage per kg should be available so one can replicate the prescription at the same dosage (i.e., at the new body weight)).


PeDS SIG



Allow recording of exceptions to medication administration, such as refusal of medication, vomiting of the dose, or intravenous access not available

Closest conformance criterion: DC.1.8.2 ([Manage medication administration]).


PeDS SIG


Epidemiology

identify patients by parent's employer in cases of epidemiologic surveillance involving an occupational exposure

Closest conformance criterion: D.3.5.4 #1 (The system MAY support the identification of patients related by employer and work location for purposes of epidemiological exposure and public health analysis and reporting --> Needs to include PARENT'S employer as well).


PeDS SIG


Epidemiology

Allow recording of the location of day care center, institutional food source, camps, schools, and so forth for the purposes of environmental monitoring

Closest conformance criterion: DC.2.6.2 #1 (The system SHALL provide identification of the individual care providers or care managers within a cared for population --> Only if schools, camps, and day care centers are classified as "providers or care managers").


PeDS SIG


Epidemiology

Facilitate notification of schools, camps, day care settings, and so forth of health risks that apply to populations of children within those institutions

Closest conformance criterion: DC.2.6.2 #4 (The system MAY have the ability to disseminate a notification of a health risk to the identified individual care providers or care-managers through one or more alternative means --> Only if schools, camps, and day care centers are classified as "providers or care managers").

INCLUDED if we make minor mods in a CC

Reference number: 72

PeDS SIG


Growth

Allow the recording of head circumference Closest conformance criterion: DC.1.10.2 #2

comes close (The system MAY capture other clinical measures as discrete elements such as peak expiratory flow rate, size of lesions, oxygen saturation, body mass index and severity of pain.).


PeDS SIG


Immunizations

Allow user level updating of immunization guidelines

Closest conformance criterion: DC.1.3.3 #5 (The system SHALL allow for the updating of the immunization schedule --> Does not include "user level… is this important?).


PeDS SIG


Medical Home

Allow the designation of Advocate for the patient, who can append information to the chart

Closest conformance criterion: DC.1.1.4 ((Mentions surrogate for patient in the description, but lists no conformance criteria)).


PeDS SIG


Medical Home

If the system provides a directory of providers, indicate which of those providers see pediatric patients, or who are pediatric specialists

Closest conformance criterion: S.1.3.1 #5 (The system MAY provide a directory of clinical personnel external to the organization that are not users of the system to facilitate documentation communication and information exchange --> Needs addition of data on peds specificity).


PeDS SIG


Norms

Provide age based norms for data when such norms exist

Closest conformance criterion: DC.1.10.1 (). NEEDS NEW CC IN THIS FUNCTION Reference number: 114

PeDS SIG


Norms

The system should accept normal ranges supplied by the external reference laboratory. Ideally, lab values are linked to ""disease-specific state"" values.

Closest conformance criterion: DC.1.10.1 (Receiving normal ranges and critical ranges from external sources is the default behavior for systems that accept lab values from external sources; this is not explicitly mentioned in the functional model).


PeDS SIG


Norms

Indicate normal ranges for values for which there are mutliple normal ranges within each age range (example: blood pressure, for whuch there are different normal values for each height range within each age range)


PeDS SIG


Norms

Provide an indicator of abnormal vital signs in cases where the vital signs fall outside the range of normal for age


PeDS SIG


Parental Data Entry

Provide patients with a web-based tool to access their medical record information.

Closest conformance criterion: DC.3.2.3 #5 (The system SHALL enable a secure web connection to support communications between providers and patients or their representatives ).


PeDS SIG


Parental Data Entry

Support entry of information by parents, patients, school nurses via the Web

Closest conformance criterion: DC.3.2.3 #5 (The system SHALL enable a secure web connection to support communications between providers and patients or their representatives ).


PeDS SIG


Patient Identification

Allow changes in identifying data at the time of family changes due to adoption

Closest conformance criterion: DC.1.1.1 #6 almost works (The system SHALL provide the ability to query and retrieve appropriate parts of a patient record using a primary identifier, secondary identifiers, or other information which are not identifiers, but could be used to help identify the patient. ).


PeDS SIG



Allow entry of mother’s identifying data as part of the patient’s identifying data

Closest conformance criterion: DC.1.1.1 #6 almost works (Closest CC doesn't quite do it: The system SHALL provide the ability to query and retrieve appropriate parts of a patient record using a primary identifier, secondary identifiers, or other information which are not identifiers, but could be used to help identify the patient. ).


PeDS SIG



Allow name changes, and retain old names for the purpose of searching for patient records

Closest conformance criterion: DC.1.1.1 #6 almost works (The system SHALL provide the ability to query and retrieve appropriate parts of a patient record using a primary identifier, secondary identifiers, or other information which are not identifiers, but could be used to help identify the patient. ).


PeDS SIG



Allow the retention (and use as search criteria) the multiple names applied to a patient

Closest conformance criterion: S.1.4.1 ((Mentions changing names in the description, but there are no conf criteria mentioning how name changes would affect subsequent system operation)).


PeDS SIG



Allow users to be able to find a patient in the system based on multiple search criteria

Closest conformance criterion: S.1.4.1 ((Mentions changing names in the description, but there are no conformance criteria mentioning how name changes would affect subsequent system operation)).


PeDS SIG


Privacy

Label clinical information as requiring special privacy consideration, based on patient's age and applicable laws (this applies to so-called adolescent privacy)

Closest conformance criterion: DC.1.1.6 #2 (The system SHALL restrict access to summarized information based on applicable rules for confidentiality of patient health information --> assuming the rules can respond to age and sensitive diagnoses).


PeDS SIG


Privacy

Allow user to mark sections or patients as confidential. This allows the practice to not print demographics, certain confidential sections, or other items

Closest conformance criterion: I.1.1.9 #8 (if "age" is added to it) (System MAY allow varying levels of confidentiality based on patient class and/or diagnosis. --> System SHOULD allow varying levels of confidentiality based on patient class, age, and/or diagnosis.).

INCLUDED if we make minor mods in a CC

Reference number: 140

reconciling the pediatric requirements with the ehr model may 2006 consent in cases where consent...

Documents

pediatric requirements

ehr model

function reference number

cc reference number

protocols function dc

new cc

order medication

medication administration