As providers engage with EHR developers and suppliers, whether third-party vendors or internal IT staff, they need resources that help them understand and communicate their needs more effectively. The 2015 Priority List, as well as the accompanying implementation notes, can be used by informed clinicians as a reference when interacting or working with those developers or designers to assure that the product is designed and configured to achieve the desired functionality.
The 2015 Priority List helps to educate providers about what to expect from a vendor, and helps software suppliers set expectations for users of their product, such as when a capability that is present, requires specialized data to function properly. One example, Req-2042, describes specialized growth charts where supporting data is available (as of June 2015, data for Downs Syndrome is not generally available to support specialized growth charts). The 2015 Priority List also can be used as a basis for training new providers on specific EHR capabilities.
Organizations that describe and compare EHR capabilities may use the 2015 Priority List to indicate which EHR products support, or do not support, individual requirements. Over time, as more requirements are satisfied by leading EHR products and they become more universally available, they will more likely form the “base” of functionality, rather than “extras”.
The 2015 Priority List provides value to providers and to software suppliers who are trying to improve the functionality of electronic records, such as promoting information exchange, in support of child health. Using the 2015 Priority List as a reference for discussion between an EHR vendor and local IT staff improves communication between the end user customer and EHR developer. The 2015 Priority List may also serve as a blueprint for implementation during the build of the EHR, or as a reference during the optimization phase of an implementation project.
Encouraging staff input on EHR use often provides important insights into an EHR’s functionality that supports improved use by the provider. Staff use the 2015 Priority List to understand what might be expected from a vendor and/or an EHR is critical for driving a system’s use and development.
Use of the 2015 Priority List makes it more likely that end users will have use of a system that meets their needs when caring for children.
The 2015 Priority List items are intended to convey specific information to software developers, EHR users, and other stakeholders. Checklists and written requirements, by their nature, are subject to different interpretation by one reader even when a different reader believes there is high clarity and clear context. One way to improve the use of the items on this list is to make sure that the provider or system developer with less domain expertise understands the intention and context of each item on the list, and why that item might have been included. Non-experts not familiar with the details of a specific functionality may wish to partner with an informaticist or domain expert who can help to translate an EHR requirement into technical language that will be helpful to the system developer, or vice versa.
Not all EHR systems will be immediately ready for configuration as desired due to gaps in the product design or dependencies on other data or systems that cannot be satisfied; some proposed functionality will need to be addressed in later versions of the product. Also, some requirements are not yet easily addressed for reasons external to the EHR product. For example, immunization forecasting is a critical component of knowing that a child is receiving all of the care that they require, but it was not included in the 2015 Priority List because of concerns about feasibility in the current environment. Additional functionalities and coordination between relevant entities must occur before this can become a standard practice. Encouraging the EHR vendor to coordinate with user groups, and users to engage other stakeholders as needed, can help highlight that a particular functionality is vital to a broad set of clients or customers.
Some functionality may not be feasible because data in a suitable electronic format are not available, or materials are subject to copyright and licensure, limiting their implementation without additional cost and agreements. The 2015 Priority List requirements create a framework for improving these discussions, setting more realistic expectations, and highlighting the need for further development of electronically sharable materials that would support the effort to achieve common goals.
The implementation notes that accompany the 2015 Priority List are intended to offer additional details to the EHR vendor or systems developer, but in many cases will not substitute for work with the specific end users to interpret the scope and meaning of a requirement and implement it in a useful way.
All requirements are relevant.