The 2015 Priority List for the Children’s EHR Format suggests a number of ways to improve the design of the EHR, which can help software developers doing EHR product planning and road map development. In some cases, an EHR can be improved by addressing a specific requirement or set of requirements. In other cases, an EHR can be improved by taking a more flexible approach to implementing requirements, such as a service-oriented architecture (SOA) and software-as-a-service (SAAS) approach. For example, designing an EHR to incorporate third-party decision and documentation rules could shift the work of developing custom templates and tools away from individual vendors and toward a collective of pediatric and technical subject matter experts. This shift, which could accelerate adoption and use of content-rich requirements, such as Req-2043 (specialized scales and scoring), which calls for EHR support of many template-driven and scored instruments like the Apgar score, Glasgow coma scale, or Dubowitz score.
One of the significant obstacles to the development of pediatric features is a lack of guidance and clinical content. Having a prioritized list of requirements for a children’s EHR provides a much needed target.
EHR functionality that serves the care of children competes for priority with other EHR functional requirements, slowing the pace of adoption and reducing the overall software maturity level. This makes standards less likely to be adopted, or in some cases, defined. Wide functional variations between currently available products and the lack of a certifying body focused on pediatric-specific EHR requirements continues to be a challenge.
All requirements are relevant.