The National Institute of Standards and Technology (NIST) has taken another step to help the electronic health record industry improve EHRs, issuing a guide to improve EHR usability when treating pediatric patients.
The guide points out that pediatric patients are more vulnerable to even small mistakes and care delays, and often need more complex care.
"Pediatric patients have unique characteristics that translate into unique EHR usability challenges," the guide says. "It is not surprising, then, that the adoption of EHRs by pediatric care providers has lagged behind adoption for adult care providers."
The guide focuses on a user-centered design and "critical user interactions" between the clinician and the EHR. It makes specific recommendations regarding patient identification, medications, alerts, labs, vaccinations, newborn care, privacy, and radiology that should be incorporated into pediatric EHRs.
NIST identified its most important recommendations as:
- Displaying information in menu items and on charts/graphs without truncating critical information, including doses and measurement units;
- Supporting one-click access to the growth chart in the standard display format;
- Eliminating automated changes to adult doses for medication orders; and
- Protecting against ordering medications in the wrong units, which could result in tenfold or higher dosing errors.
The guide also suggests several opportunities for innovation for pediatric EHRs, such as adding charts for specific conditions like Down syndrome, smart vaccine support, and role-based access control for sensitive portions of the note.
NIST has for years expressed concern about how difficult EHRs are to use, launching an initiative to voluntarily test existing EHR systems and issuing technical guidance for evaluating the usability of EHRs earlier this year.