TY - JOUR
T1 - Enhancing electronic health record usability in pediatric patient care
T2 - A scenario-based approach
AU - Patterson, Emily S.
AU - Zhang, Jiajie
AU - Abbott, Patricia
AU - Gibbons, Michael C.
AU - Lowry, Svetlana Z.
AU - Quinn, Matthew T.
AU - Ramaiah, Mala
AU - Brick, David
N1 - Funding Information:
This research was funded by the National Institute of Standards and Technology ( NISTIR 7865 ). The views expressed in this article do not necessarily represent the views of NIST or the US Department of Commerce. The authors gratefully acknowledge the intellectual contributions from the following reviewers of an earlier draft of the report from which part of this article was adapted: Anne Bobb, RPh, Children’s Memorial Hospital, Chicago; Joseph Cafazzo, PhD, PEng, Healthcare Human Factors, University Health Network, Toronto; Willa Drummond, MD, University of Florida College of Medicine, Gainesville; Daniel Essin, MA, MD, University of Southern California Keck School of Medicine, Los Angeles; Scott Finley, MD, MPH, Westat, Rockville, Maryland, and Office of Health Information, Veterans Health Administration, US Department of Veterans Affairs, Washington D.C.; Anne B. Francis, MD, Elmwood Pediatric Group, Rochester, New York; Ayse Gurses, PhD, Johns Hopkins University, Baltimore; Marta Hernanz-Schulman, MD, Vanderbilt Children’s Hospital, Vanderbilt, Tennessee; Kevin Jones, MS, Ohio State University, Columbus; Dean Karavite, MS, Children’s Hospital of Philadelphia; Ben-Tzion Karsh, PhD (deceased), University of Wisconsin, Madison; Yiannis L. Katsogridakis, MD, MPH, Children’s Memorial Hospital, Chicago; Rainu Kaushal, MD, MPH, Weill Cornell Medical College, New York City; George Kim, MD, Johns Hopkins University Children’s Center, Baltimore; Nancy F. Krebs, MD, MS, University of Colorado School of Medicine, Denver; David Kreda, Social Research Corporation, Wyncote, Pennsylvania; Andrew Kroger, MD, MPH, National Center for Immunization and Respiratory Diseases, Atlanta; Herschel R. Lessin MD, The Children’s Medical Group, Poughkeepsie, New York; Eugenia Marcus, MD, Pediatric Health Care at Newton Wellesley, Newton, Massachusetts; Colleen McLaughlin, MPH, PhD, Patient Safety Center, New York State Department of Health, New York City; Deepa Menon, MD, Johns Hopkins University; Mary Patterson, MD, MEd, Akron Children’s Hospital, Ohio; Sean Petty, RN, Jacobi Medical Center, Bronx, New York; Debora Simmons, PhD, RN, CCNS, St. Luke’s Episcopal Health System, Houston; Dean Sittig, PhD, University of Texas Houston; Arthur Smerling, MD, Columbia University College of Physicians and Surgeons, New York City; S. Andrew Spooner, MD, MS, Cincinnati Children’s Hospital Medical Center; Jennifer Stinson, RN, PhD, Hospital for Sick Children, Toronto; Susan Torrey, MD, NYU Langone Medical Center, New York City; Michael S. Victoroff, MD, University of Colorado School of Medicine; Robert Wears, MD, PhD, University of Florida Health Center, Jacksonville.
PY - 2013/3
Y1 - 2013/3
N2 - 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. Copyright 2013
AB - 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. Copyright 2013
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U2 - 10.1016/s1553-7250(13)39019-9
DO - 10.1016/s1553-7250(13)39019-9
M3 - Article
C2 - 23516763
AN - SCOPUS:84875444949
SN - 1553-7250
VL - 39
SP - 129
EP - 135
JO - Joint Commission Journal on Quality and Patient Safety
JF - Joint Commission Journal on Quality and Patient Safety
IS - 3
ER -