Boston hospital rises to unique challenges of pediatric health IT

If health IT were one-size-fits-all, we might actually have a nationwide system of interoperable EMRs by now. But it's not. And nowhere are the differences more pronounced than in pediatrics, largely because standards of care vary so much from patient to patient. "First of all, everything that you do for patients in a pediatric world is based on their developmental stage, which includes their size and gender, so there's not a standard way you would approach a patient in performing a procedure or giving a medication. It's all age-based," Children's Hospital Boston Chief Nursing Officer Eileen Sporing says in the second part of an interview with Healthcare Informatics. And then there's the fact clinicians have to consult the parents before treating a patient.

Yet, even enterprise health IT systems aren't usually designed with pediatric considerations in mind. Two patients in one room could be getting the same medication, and they would totally different doses, totally different schedules," Sporing says. "Most young patients that have to have an X-ray here need to be sedated, because they can't hold still while an X-ray is being taken, particularly an MRI or CT-scan. So there are just enormous differences, and you can imagine how that translates into the electronic environment that supports that care."

Even with these challenges, Children's Hospital Boston has installed a Cerner EMR that it interfaced with Epic scheduling, administration and billing systems and opened an online patient portal. The hospital also is moving ahead with a bar-coded medication administration pilot and plans on extending a portal-based personal health record to affiliated physician practices. "So you can start to imagine that the patient will basically have a single place where all of their health data can be aggregated. We see enormous value both for the patients and the clinicians," CIO Dr. Daniel Nigrin explains.

For more about the challenges and triumphs of the Children's Hospital Boston IT shop:
- check out part 2 of this Healthcare Informatics Q&A

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