Selecting an EHR

Health IT Certification can be a useful indicator even if your practice is not applying for Meaningful Use incentives. Federal certification assures the tools meet technical, functional and security requirements established by the Department of Health and Human Services. 

Questions to consider: 

1. Is the functionality critical, essential, or optional to my practice? For example: vaccine administration, patient portal access and portable access to the EMR. 
2. Is there any functionality missing? If there are things (or features) that are missing, where is this functionality on their development roadmap? When is it expected to be available? 
3. Does the EHR have pediatric specific content for documentation, charting and orders? Will we need to customize? If so, how much? 
4. How well does the EHR perform this functionality? What is the number of clicks and scrolls to accomplish a task? 
5. How usable is the EHR in my practice? What basic IT support is needed, and what does the vendor provide? 
6. How integrated are appointments and billings? Does the vendor have experience with the insurance companies my practice needs? 
7. How does this EHR exchange information with immunization information systems (IIS), newborn (NB) screening registry, hospital systems, labs, radiology offices, regional health information exchanges and other health information exchanges? 
8. What is the pricing for technical support/upgrades? 
9. If you are switching to a new system: What functionalities support transfer of data from your current system? 

Pediatricians and other clinicians who care for children have specific needs for health information technology (HIT) tools to help them provide the highest quality care for their patients. With guidance from AAP, the Office of the National Coordinator for Health IT established voluntary certification criteria for health IT used in pediatric care. The following 10 pediatric health IT functionalities are recommended in the 21st Century Cures Act Interoperability Final Rule.  

1. Use biometric-specific norms for growth curves and support growth charts for children.  
2. Compute weight-based drug dosage.  
3. Ability to document all guardians and caregivers.  
4. Segmented access to information.  
5. Synchronize immunization histories with registries.  
6. Age and weight-specific single dose-range checking.  
7. Transferrable access authority.  
8. Associate mother’s demographics with newborn.  
9. Identify incomplete preventive care opportunities.  
10. Flag special health care needs 

Note: The AAP recognizes this is not an exhaustive list of important functionalities for EHRs used in pediatric care. 

AAP Policy: 

• Electronic Communication of the Health Record and Information With Pediatric Patients and Their Guardians 
• Special Requirements of Electronic Health Record Systems in Pediatrics 
• Electronic Prescribing in Pediatrics: Toward Safer and More Effective Medication Management 
• Health Information Technology and the Medical Home 

 AAP News Health IT Trends Articles (AAP Login required): 

• Pediatricians’ need for specific EHR functionality finally recognized 
• Technology improves pediatric patient engagement, outcomes
• Connect with user group to get most out of your EHR 
• Health IT Trends archive 

Other Resources to Support Clinicians in Selecting and Using EHRs and Health IT 

• ONC Health IT for Pediatric Care and Practice Settings 
• Office of the National Coordinator for Health Information Technology (ONC) Health IT Playbook 
• ONC Health IT Certification Program 
• Search/Compare Certified Health IT Products  
• Agency for Healthcare Research and Quality Pediatric Health Information Technology Resources 
• Children’s Electronic Health Record Format