“The problem with EHRs in treating children is that children are not little adults. They have very specific needs,” says Erin Grace, Senior Manager for Health Information Technology with the Agency for Healthcare Research and Quality (AHRQ).

Unfortunately, EHRs as currently designed may not fully take the needs of children’s healthcare into consideration. As Dr. Carolyn Clancy, the director of AHRQ, testified at a public hearing on health disparities in early June, “Overall, EHRs frequently lack the specification necessary to enable safe, quality care for children.”

We bring this up because $19.2 billion stimulus dollars are going to incentivize health providers to adopt electronic health records, and there are concerns about whether the records will be designed in a way that will help America’s children.

Grace explained that children's specific needs include information such as immunization schedules, dosing tools, and very specific weight measures as well as growth and development charts. Jon White, a family doctor by training who now directs AHRQ’s Health IT Portfolio, adds that children have “a whole host of medical conditions that you'd want to be thinking about in kids that you wouldn't think about in adults.” In order to be most useful, he explains, EHRs in family practices have to dynamically present the physician with the array of information and
decision support that he or she needs at the appropriate time. It won’t do to have a screen for an adult patient cluttered up by child-specific information, or vice versa.

Children’s EHRs must also balance the competing concerns of linking a child’s information to mother, father, and siblings, while not infringing on numerous privacy and security concerns, especially as the child ages into adulthood.

Grace expressed hopes that in the future, these child-specific elements – which are being codified in a model format under construction by AHRQ – would get built into the criteria for Recovery Act funding.