Electronic Health Reporter

By Abhinav Shashank, CEO and co-founder, Innovaccer.

Children have entirely distinctive needs as compared to adults. Care is delivered to them in a manner entirely different than adults by care teams that hardly ever double-up as providers for the elderly.

In fact, we hear numerous stories of organizations that transformed their care delivery by fabricating children-specific strategies and have been really successful in doing so. However, very few experts ever discuss how little thought we put when it comes to developing healthcare technologies tailored to the specific needs of pediatric organizations.

Do pediatric organizations have the technology to succeed?

By 2017, more than 95 percent of hospitals had certified EHR technology. However, these EHRs are heavily adult care centric and may not include measures that are specific to pediatric populations. In fact, in a recent research piece conducted on 9,000 pediatric patient safety reports, it was found that about 36 percent of reports were related to EHR usability issues.

EHR usability has been one of the underrated issues that we need to address if we are to build an efficient pediatric landscape. This can be attributed to the fact that even a slight misjudgment in comprehending the information stored in EHRs can substantially increase the chances of errors and adverse events. The issue is all lot serious for pediatric organizations where patients are extremely sensitive to the care provided to them at any given point of time. Complicated EHRs can do no good to neither children nor pediatricians.

Why is the EHR usability valid ask for pediatricians?

Infants born prematurely have different needs as compared to completely healthy infants. A 5-year old kid faces problems that a 13-year old teenager does not. Vaccination once missed can prove costly in the future. A child with Type 1 diabetes may require care plans entirely dissimilar to other children. Theoretically and practically, each child is unique: from a prematurely-born child weighing less than a kilogram to an obese 105 kg 14-year-old. The EHR should be able to ingest all such details with perfection and should provide as many measures that pediatricians may require.

Consider twin siblings born on the same day, having an identical vaccination cycle, and same last name. However, they may react differently to various treatments and have different weight or gender. If they need some medication, they might be given different mg/dose prescription. Amidst all this, the care teams have the onus of ensuring that each exercise is taken care of with utmost precision. For that, they need powerful EHR systems and alert systems, among other things. In other words, organizations need advanced decision support systems, an ask that is only valid to deliver value-focused care.

Doctors need reliable EHRs to understand the complete picture

More often than not, there are only two sources of information during any given care episode — data stored in the EHR and patient’s own words. However, pediatricians cannot expect much support from their young and very young patients. For infants, it gets all lot difficult since it gets even harder to comprehend their symptoms.

For such patients, EHRs need to tell the complete picture each time lest errors are bound to happen. Goes without saying, children are more vulnerable to such errors as compared to any other patient population. Ideally, pediatric organizations need to have extremely robust, agile, and accurate EHR systems. However, the situation is far from ideal even at this age and time.

Pediatric organizations need custom-made EHRs and IT infrastructure

To begin with, EHRs should have an extremely user-friendly interface, support for adding or converting charts locally for specific syndromes, extremely precise dosage range, and capabilities to identify missed or pending vaccination. They should strictly have a pediatric-specific threshold for each symptom, treatment, or trait, while also having a feature for identifying copied and newly-added records. Alerts, as discussed earlier, for potentially wrong data entry should also be a default feature.

Coupled with a layer of advanced analytics system on top of their EHRs, pediatricians can successfully navigate the challenges as they come their way. If pediatric organizations have a system in place to send regular immunization and wellness visit reminders, they can both increase adherence rates and reduce potential risks.

Role-based access to sensitive patient information and automatic triggers for varying health trends can further play a substantial role in making care more efficient for the young. All such steps combined can help us in realizing the dream of creating the “Internet of Healthcare,” where every stakeholder is connected with each other and there is a seamless exchange of information at all places in real-time.

The road ahead

As we embark upon the journey of creating an “Internet of Healthcare” where everyone would be connected with everyone, we first need to have quality IT infrastructure that can make this possible. EHRs are the building block for such a system. It’s time we add the human touch to such technological solutions, and take the first step in the direction of reinventing EHRS.