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ONC releases updated recommendations for pediatric health IT

Children have specific and unique medical needs – and software supporting their care should be tailored to help address those needs. 

So the Office of the National Coordinator for Health IT has published a new informational resource aimed at shaping the specifications of technology products intended for pediatric use.

“There are critical functionalities, data elements, and other requirements that should be present in health IT products to address healthcare needs specific to the care of children,” according to ONC.

The agency focuses on 10 recommendations that align to “clinical priorities that were identified by the American Academy of Pediatrics in partnership with relevant stakeholders across the country,” wrote Senior Policy Advisor Samantha Meklir and Medical Informatics Fellow Al Taylor in a blog post Wednesday. 

They noted that “significant contributions were also made by healthcare organizations and federal partners to provide detailed review and feedback” on the resource – which describes ONC-developed certification criteria specific to certain pediatric clinical priorities and offers additional technical specs to help developers working with childcare providers.


The recommendations outlined in the informational resource included the use of biometric-specific norms for growth curves and support for growth charts for children; the computation of weight-based drug dosage; the synchronization of immunization histories with registries; and age- and weight-specific single-dose range checking.

Other recommendations acknowledged the potential complications and privacy concerns around providing children care, such as having the ability to document all guardians and caregivers; transferrable access authority (such as in the case of foster care, adoption, divorce or patient emancipation); and segmenting access to information.

“Adolescents may be allowed by law or practice to sequester access to information, such as sexual and behavioral health history in their health record,” according to ONC’s recommendations. “Some jurisdictions require sequestering a child’s record of sexual history or abuse.”

“Sequestering patient-selected information from parental, billing, or insurance communications may be required to protect an adolescent or pediatric patient’s privacy,” the resource continued.

As for the care of newborn patients, the ONC recommends associating maternal health information and demographics – such as infections, immunizations, blood type and heritable genetic conditions – with the infant, given the data’s potential importance in follow-up care.

It also recommended the ability to track incomplete preventative care opportunities, since doing so is “key to maintaining a pediatric patient’s health,” and flagging special healthcare needs.

“All pediatric practices provide care for individuals or groups of patients whose needs cannot always be accurately captured by using standard code systems,” according to ONC.


In January 2019, Pew Charitable Trusts told ONC (and not for the first time) that it should do better prioritizing safety in its pediatric EHR usability efforts.

Poor usability, said Ben Moscovitch, Pew’s project director of health information technology, can lead to dangerous medical errors, such as a patient receiving the wrong dose of a drug.


“Forthcoming regulations from ONC on EHRs used in the care of children and the development of a new reporting program offer opportunities to enhance usability – which would simultaneously reduce burden and improve safety,” said Moscovitch. 


“This [resource] may continue to evolve in the future as gaps are filled and more work is done to expand the tools, functionalities, and standards available for use by healthcare providers who care for children,” said Meklir and Taylor about the new recommendations. 

“We look forward to collaborating with clinicians, hospitals, standards developers, health IT developers and others to continue this work.”


Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.

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  • Posted on July 30, 2020