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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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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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]).


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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)

Closest conformance criterion: N/A… DC.1.2 (Manage patient demographics) comes closest (N/A).


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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)).


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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)).


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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).


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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?)).


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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?)).


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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

Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 30

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E-Prescribing & Ordering

Include body weight (or any other data used to decide dose, like gestational age or diagnosis) in the data sent with a prescription

Closest conformance criterion: (These data elements would be dictated by e-prescribing standards).


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Allow drug dose and based on compounded oral solutions, in the case where no oral solution is available in standard formularies

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


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When allow ordering of blood products in units appropriate to pediatric care

Closest conformance criterion: DC.1.9.4 ([Order blood products and other biologics]).


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Communicate with pediatric providers on medication use: Weight/height/BSDA, conditions and any disease management information from pharmacy.

Closest conformance criterion: Makes no sense (These data elements would be dictated by e-prescribing standards).


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Make the patients age, weight, body surface area, and gestational age visible when viewing orders at every stage of the ordering process


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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.]).


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Family Linkage

Allow the recording of a relationship by living situation


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Family Linkage

Facilitate the scheduling of siblings to be seen as a group or in contiguous time slots

Closest conformance criterion: N/A (S.1.6: Scheduling) (N/A).


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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).


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Growth

Plot body mass index against normative curves



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Growth

Provide graphical growth chart and norms for children with varying conditions (e.g., Down syndrome and Turner syndrome)



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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).


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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).


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Guardianship

Support the recording of multiple guardians and residences for given child whose parents are divorced or who have joint custody


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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


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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]).


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Immunizations

Allow recording of parental consent to immunizations, according to applicable state law, as part of the point of care interface


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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)


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Immunizations

Display immunizations by antigen Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 99

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Interface

Include age and DOB on every display, both printed and on the screen


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Medical Home

Allow the recording of a primary care physician for each patient

Closest conformance criterion: N/A (N/A - this has GOT to be an oversight).


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Medical Home

have the capability to identify multiple primary providers as well as multiple sub-specialists


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Medical Home

Indicate multiple primary care providers, in the case were a pediatrician and a family practitioner are assuming that role


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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)


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Norms

Indicate normal range for items (lab values and physical exam data) based on stage of sexual maturity


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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.).


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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


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Parental Data Entry

Permit oversight by parents of the patient entered information

Closest conformance criterion: N/A (May be to ill-defined in this form).


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Patient Identification

Allow entry of temporary ID numbers, which can be replaced with more formal identification number systems


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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


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Pedigree

Allow construction of graphical patient pedigrees


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Prenatal

Allow creation of a record of a patient before the patient’s birth


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Prenatal

Allow the retention of data related to prenatal procedures within the record of the patient postnatally


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Privacy

In cases of care given to patients during adolescence, offer reminders based on diagnoses of the need for special privacy handling


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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

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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).


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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.).


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Terminology

Support terminology systems specifically designed for use in pediatrics

Closest conformance criterion: Nonsensical; no such terminoligy systems exist ().


Documents

Reconciling the pediatric requirements with the EHR model May 2006 Age Representation Allow recording of post conceptional age and distinguish it from