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Enhancing Electronic Health Record Usability in Pediatric Patient Care: A Scenario-Based Approach



Emily S. Patterson, Jiajie Zhang, Patricia Abbott, Michael C. Gibbons, Svetlana Z. Lowry, Matthew T. Quinn, Mala Ramaiah, David Brick


Adoption of electronic health record (EHR) systems in hospitals and physician practices is accelerating. Usability of EHRs has been identified as an important factor impacting patient safety and EHR adoption rate for both adult and pediatric care providers. A panel of interdisciplinary experts was convened to generate consensus recommendations to improve EHR usability when supporting pediatric care. Experts were invited to participate by the National Institute of Standards and Technology in developing and gaining consensus on recommendations that were informed by human factors expertise to enhance the EHR usability of critical user interactions. Members represented expertise in the disciplines of human factors engineering, 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 project outcomes were reviewed by invited experts in pediatric informatics, emergency medicine, neonatology, pediatrics, human factors engineering, nursing, usability engineering, and software development and implementation. Selected recommendations for EHR developers, small-group pediatric medical practices, and pediatric hospitals were identified out of fifty-four original recommendations grouped by critical user interaction categories: patient identification, medications, alerts, growth chart, vaccinations, labs, newborn care, privacy, and radiology. Discussion: Pediatric patient care has unique elements and some aspects of care are more complex and have higher stakes than care for adult populations. These are anticipated to increase the rate of EHR adoption by pediatric care providers and improve patient safety for both pediatric and adult patients. The described methodology might be useful for accelerating adoption in specialty clinical areas where there are lagging adoption rates for EHRs.
Joint Commission Journal on Quality and Patient Safety


Patterson, E. , Zhang, J. , Abbott, P. , Gibbons, M. , Lowry, S. , Quinn, M. , Ramaiah, M. and Brick, D. (2013), Enhancing Electronic Health Record Usability in Pediatric Patient Care: A Scenario-Based Approach, Joint Commission Journal on Quality and Patient Safety, [online], (Accessed July 13, 2024)


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Created March 19, 2013, Updated October 14, 2021