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Enhancing Electronic Health Record Usability in Pediatric Patient Care: A Scenario-Based Approach

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Abstract:

Background: Usability of electronic health records (EHRs) is an important factor affecting patient safety and the EHR adoption rate for both adult and pediatric care providers. A panel of interdisciplinary experts (the authors) was convened by the National Institute of Standards and Technology to generate consensus recommendations to improve EHR usefulness, usability, and patient safety when supporting pediatric care, with a focus on critical user interactions.

Methods: The panel members represented expertise in the disciplines of human factors engineering (HFE), usability, informatics, and pediatrics in ambulatory care and pediatric intensive care. An iterative, scenario-based approach was used to identify unique considerations in pediatric care and relevant human factors concepts. A draft of the recommendations were reviewed by invited experts in pediatric informatics, emergency medicine, neonatology, pediatrics, HFE, nursing, usability engineering, and software development and implementation.

Recommendations: Recommendations for EHR developers, small-group pediatric medical practices, and children's hospitals were identified out of the original 54 recommendations, in terms of nine critical user interaction categories: patient identification, medications, alerts, growth chart, vaccinations, labs, newborn care, privacy, and radiology.

Conclusion: Pediatric patient care has unique dimensions, with great complexity and high stakes for adverse events. The recommendations are anticipated to increase the rate of EHR adoption by pediatric care providers and improve patient safety for pediatric patients. The described methodology might be useful for accelerating adoption and increasing safety in a variety of clinical areas where the adoption of EHRs is lagging or usability issues are believed to reduce potential patient safety, efficiency, and quality benefits.

Document Type: Research Article

Publication date: 2013-03-01

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  • The Joint Commission Journal on Quality and Patient Safety will be published by Elsevier beginning in 2017! For readers who receive access to the journal through their institutions, the journal can now be found on ScienceDirect (http://www.sciencedirect.com/science/journal/15537250). For librarians looking to subscribe to the journal for their institutions please contact your Elsevier Account Manager or visit www.myelsevier.com for more information. All other readers, please visit http://www.jointcommissionjournal.com/ to subscribe to the journal or to claim your access for an existing subscription.
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