ONC asked to improve pediatric EHR usability, safety

The Office of the National Coordinator for Health Information Technology (ONC) is being called on to develop a voluntary certification program to help improve the usability and safety of pediatric electronic health records (EHRs).

In a viewpoint recently published in JAMA Pediatrics, authors Raj Tatwani, PhD, Ben Moscovitch and Josh Rising, MD, said EHR technology has yet to recognize the different needs between adults and pediatric patients and their “inadequate usability” can negatively impact pediatric care. With the passage of the 21st Century Cures Act, the authors believe it's a perfect time to address the issue. 

“Given the centrality of EHRs to modern medicine, inadequate usability (the design, customization, and use of systems) can have serious ramifications on pediatric care, including patient harm, when technology is not optimized for the treatment of children,” the authors said. “For example, children often receive drug dosages based on weight, yet the poor usability of some EHRs has contributed to pediatric patients overdosing on medications.”

In the article, the authors made five recommendations to the ONC on how to improve pediatric EHR usability and safety. Recommendations included emphasizing the importance of EHR implementation and encouraging transparency between vendors and healthcare organizations.

The authors suggested the ONC require a user-centered design process which identifies and prioritizes the needs of the end user (clinician) in EHR products. They also suggested requiring usability test participants and “rigorous” test cases to assess EHR usability and safety.

“As the use of EHRs continues to accelerate with more clinical decision support tools and automation, clinicians will increasingly rely on this technology to help them provide safe, high-quality care. However, just like in other aspects of medicine, the use of this technology differs in the care of children than adults,” the authors concluded. “The ONC, in implementing the 21st Century Cures Act, can rectify that gap to decrease the likelihood of patient harm associated with EHRs.”