title: Enhancing electronic health record usability in pediatric patient care: a scenario-based approach.
abstract: BACKGROUND
  Usability of electronic health records (EHRs) is an important factor affecting patient safety and the EHR adoption rate for both adult and pediatric care providers. A panel of interdisciplinary experts (the authors) was convened by the National Institute of Standards and Technology to generate consensus recommendations to improve EHR usefulness, usability, and patient safety when supporting pediatric care, with a focus on critical user interactions.
  
  
  METHODS
  The panel members represented expertise in the disciplines of human factors engineering (HFE), 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 recommendations were reviewed by invited experts in pediatric informatics, emergency medicine, neonatology, pediatrics, HFE, nursing, usability engineering, and software development and implementation.
  
  
  CONCLUSIONS
  Recommendations for EHR developers, small-group pediatric medical practices, and children's hospitals were identified out of the original 54 recommendations, in terms of nine critical user interaction categories: patient identification, medications, alerts, growth chart, vaccinations, labs, newborn care, privacy, and radiology.
  
  
  CONCLUSIONS
  Pediatric patient care has unique dimensions, with great complexity and high stakes for adverse events. The recommendations are anticipated to increase the rate of EHR adoption by pediatric care providers and improve patient safety for pediatric patients. The described methodology might be useful for accelerating adoption and increasing safety in a variety of clinical areas where the adoption of EHRs is lagging or usability issues are believed to reduce potential patient safety, efficiency, and quality benefits.
authors.affiliation: Division of Health Information Management and Systems, School of Health and Rehabilitation Sciences, College of Medicine, Ohio State University, Columbus, USA. Emily.Patterson2@osumc.edu
authors.forename: Emily S
authors.initials: ES
authors.lastname: Patterson
authors.forename: Jiajie
authors.initials: J
authors.lastname: Zhang
authors.forename: Patricia
authors.initials: P
authors.lastname: Abbott
authors.forename: Michael C
authors.initials: MC
authors.lastname: Gibbons
authors.forename: Svetlana Z
authors.initials: SZ
authors.lastname: Lowry
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Quinn
authors.forename: Mala
authors.initials: M
authors.lastname: Ramaiah
authors.forename: David
authors.initials: D
authors.lastname: Brick
mesh_terms: D003245:Consensus Statements as Topic; D057286:Electronic Health Records / Q000458:organization & administration / Q000592:standards*; D006123:Group Practice; D006776:Hospitals, Pediatric; D006801:Humans; D061214:Patient Safety / Q000592:standards*; D010372:Pediatrics / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D014584:User-Computer Interface