NIST Panel Expands Recommendations for Use of EHRs in Pediatrics
NIST Convenes Panel To Accelerate Development of EHRs for Pediatrics
The National Institute of Standards and Technology (NIST) is a non-regulatory federal agency that operates as part of the U.S. Department of Commerce. Established in 1902 NIST’s core mission is to advance science, standards, and technology to enhance economic security. NIST carries out this mission in part by conducting research to help U.S. companies improve products and services.
Last July NIST released an EHR usability guide to help make pediatric EHR systems more innovative.In an effort to accelerate development and adoption EHRs for pediatrics, and using its EHR usability guide as a starting point, NIST convened a panel of experts from the health IT industry, academia and the government. NIST had the panel focus its attention on three key audiences: records-system vendors and developers, small-group pediatric medical practices and children’s hospitals.Last week NIST published the results and recommendations from this panel in a new article, The Joint Commission Journal on Quality and Patient Safety. The article gives details on the methods used to develop the original EHR usability guide and on how to translate its methodologies to similar efforts in other areas where EHRs are being designed and implemented, specifically pediatrics. Here is an abstract from this article:
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.
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