Download Immunization Management

HL7 Child Health Profile
Desired Conformance Criteria
Immunization Management
#
Desired Conformance Criteria
1
The system SHALL provide the ability to recommend required
immunizations, and when they are due, based on widely accepted
immunization schedules; Provide immunization decision support.
The system SHOULD provide the ability to recommend required
immunizations based on patient risk factors; Provide immunization
decision support.
2
3
6
The system SHALL provide the ability to update the immunization
schedule on demand for reasons including but not limited to updates to
external guidelines; Allow immediate updating of immunization guidelines.
The system SHALL provide the ability to capture and display the date on
which the allergy information was entered.
The system SHOULD provide the ability to capture and display the
approximate date of allergy occurrence if exact date is not known.
Ability to record multiple immunizations
8
Automated electronic reporting capability for immunizations received.
9
Record adverse events associated with vaccines.
10
Automate electronic reporting capability for adverse events (for example to
registries and VAERS)
Allow recording of discrete vaccine refusal reasons.
4
5
11
13
14
Record signed immunization consent.
Need to review with AAP Legal Affairs
Need to clarify need to cull out immunizations for special handling
Allow ability to download, upload and synchronize immunization history
with state and/or local immunization information systems or registries.
Status in Draft
Child Health-FP
Shall
DC.1.8.2
DC.2.3.2
Shall
Modified:
DC.1.8.2
DC.2.3.2
Shall
Modified:
DC.1.8.2
Shall
DC.1.4.1
Shall
DC.1.4.1
Shall
DC.1.4.4
Shall
DC.1.4.4
Shall
DC.1.4.1
Should
New: DC.1.4.1
Shall
DC.2.3.2
Shall
DC.1.3.3
Shall
New: DC.1.8.2
Growth Tracking (Manage Patient Clinical Measurement)
#
Desired Conformance Criteria
1
Provide ability to reuse routinely gathered growth measurements (so that
users don’t have to reenter it in a growth chart application)
Automatically generate growth charts (automatically plot growth data on
the chart so the user doesn’t need to plot the points)
Provide ability to reuse growth data and calculations for other tasks (e.g.
decision support, documentation)
2
3
4
Capture weight, height or length, head circumference
5
Calculate body mass index and growth velocity
6
Calculate percentiles and standard deviations based on population norms
Pediatric Data Standards Special Interest Group
Status in Draft
Child Health-FP
Shall
DC.1.8.4.6
Shall
DC.1.8.4.6
Shall
Not needed as
criteria…general
principle of
design
Shall
DC.1.8.4.1
Shall
DC.1.8.4.7
Shall
DC.1.8.4.4
1
HL7 Child Health Profile
Desired Conformance Criteria
7
Capture data using different units of measurement (e.g. grams, kilograms,
pounds)
Display growth data on standardized charts as the default view
Shall
DC.1.8.4.8
Shall
DC.1.8.4.6
10
Display against standard population-based normal curves (e.g.
cdc.gov/growthcharts)
Display normal curves based on age ranges and gender
Shall
DC.1.8.4.6
Shall
DC.1.8.4.9
11
Display time and date of birth for infants
Shall
DC.1.1.2.10
12
Plot the body mass index against age-based normative curves
13
Allow adding, deleting and editing of growth points
Shall
DC.1.8.4.6
Shall
DC.1.8.4.10
14
Support printing and faxing
Shall
S.2.2.1
15
Make growth charts accessible from standard EHR system components
16
Capture context of measurement (e.g. laying or standing, ventilated,
receiving growth hormone)
Display normal curves based on other demographic characteristics
Should – OK;
Part of EHR
description
Should
DC.1.8.4.11
Should
DC.1.8.4.9
Should
Display topic
Should
DC.1.8.4.4
May
DC.3.2.5
May
Not needed
May
DC.1.8.4.13
May
DC.1.8.4.12
May
DC.1.8.4.14
May
DC.1.8.4.11
May
Tool for
discussion but
not data standard
May
DC.1.8.4.15
May
DC.2.1.3.4
8
9
17
18
20
Support user preferences (i.e., connected points, superimposed values,
table or graphical chart)
Allow capability for age-related percentiles provided for all vital signs,
including blood pressure, heart rate and respiratory rate
Support automated data capture from measurement devices (e.g. digital
scales)
Display using graphical and tabular formats
21
Display predictive growth curves or growth targets
22
Calculate mid parental height by gender-specific parent height percentiles
23
Display bone age measurements with actual age measurements
24
Display developmental stages (e.g. Tanner stages) with actual age
measurements
Derive and display the median age at which a given growth point is
achieved
19
19
25
26
Enable varying the scale’s level of detail (i.e. zoom in or out)
27
Provide alerts about variances in the growth chart
Pediatric Data Standards Special Interest Group
2
HL7 Child Health Profile
Desired Conformance Criteria
Medication Administration and Dosing
#
Desired Conformance Criteria
1
9
The system SHALL provide the ability to capture all pertinent details of the
medication administration including medication name, strength, dose, route
time of administration, administrator of the medication and exceptions to
administration.
The system’s drug dosage functions SHOULD work using any component
of a combination drug (e.g. acetaminophen-hydrocodone).
The system SHOULD compute drug doses, based on appropriate dosage
ranges, using the patient’s body weight/BSA/IBW; Compute doses based
on body weight.
The system SHOULD allow the user to specify an alternative “dosing
weight” for the purposes of dose calculation.(combine with #3)
IF the maximum daily doses are known, THEN they system SHALL apply
the maximum dose per day in dosing decision support.
The system SHOULD allow the recording of the dosage (as outlined in #3
above) used to calculate the dose for a given medication order
/prescription)
The system SHOULD provide the ability to re-prescribe a medication from
a prior prescription using the same dosage but updating the body weight.
Suggest doses based on current body weight/bsa/IBW.
10
Request body weight (actual or estimated) input when not available.
11
Request height input when not available.
May
DC.2.3.1.2.12
12
Allow for decision support to determine whether a body weight or height
obtained in the past is outdated for medication ordering.
Check drug doses post hoc using accepted pediatric references and
advise the user when no pediatric references exist.
Support prescriptions expressed in the volume of drug to be administered
and avoid expressing the prescription solely in terms of the mass of the
drug.
In the case where dosing guidelines or formulary benefits vary with age or
gestational age, the system should incorporate those data into its decision
support.
Provide the capability to generate instructions to the pharmacy to dispense
medication in two labeled packages – one for home administration and one
for administration during the day at school, child care or other care setting.
Include body weight and height (or any other data used to decide dose,
like gestational age or diagnosis) in the data sent with a prescription. .
Allow drug dosing based on custom compounded medications; for
example, in the case where no oral solution is available in standard
formularies.
Support calculations of complex intravenous infusions (e.g. total parenteral
nutrition, specific IV preparations or drips).
Shall
DC.2.3.1.2.12
May
DC.2.3.1.2.13
May
DC.2.3.1.2.14
2
3
4
5
6
7
13
14
15
16
17
18
19
20
Support BSA calculations, CR CLR, multiple math models and make it
obvious to user which calculation method was used.
Pediatric Data Standards Special Interest Group
Status in Draft
Child Health-FP
Shall
DC.2.3.2.4
Shall
DC.2.3.1.2.10
Shall
DC.2.3.1.2.8
Shall
DC.2.3.1.2.9
Shall
DC.2.3.1.2.7
Shall
DC.2.3.1.2.11
Shall
DC.1.7.1.15
Shall
DC.2.3.1.2.7
Shall
DC.2.3.1.2.12
Should
DC.2.3.1.2.1
May
DC.1.7.1.8
May
DC.1.7.1.8
May
DC.2.3.1.2.15
Not included
because of
scope…Neonatal
or pediatric
ICU…
Should
DC2.3.1.2.16
3
HL7 Child Health Profile
Desired Conformance Criteria
21
Allow ordering of blood products in units appropriate to pediatric care (such
as mL/kg, “pedipacks” and other aliquots).
May
DC.1.7.2.3.1
22
Allow age-based documentation templates.
23
Allow age-based guideline selection.
Shall
DC.1.5.3
Shall
24
Facilitate the scheduling of siblings to be seen as a group or in contiguous
time slots.
May
S.1.6.4
Patient Identification
#
Desired Conformance Criteria
1
If related patients register with identical data, THEN the system SHOULD
provide the ability to propogate the administrative data to all their records.
2
Allow registration of patients without government-issued identification.
3
Allow retrieval of information based on temporary identifiers.
4
Allow the assignment of an unknown gender.
5
Enable the transfer of clinical record to new patient identification record
such as at the time of family changes due to adoption.
6
7
A system that stores prenatal data (e.g. from a fetal imaging procedure)
should allow the logical connection of these data to the postnatal record
once the child’s record is established in the system.
Support retrieval of data via search on previous names.
8
Capture source of information besides patient.
9
Allow creation of a record of a patient before the patient’s birth.
10
Allow the retention of data related to prenatal procedures within the record
of the patient postnatally.
Status in Draft
Child Health-FP
Should
DC.1.1.1.11
Shall
DC.1.1.1.2
Shall
DC.1.1.1.3
Shall
DC.1.1.2.11
Shall
DC.1.1.1.13
May
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Shall
DC.1.1.1.14
Should
DC.1.1.3.2.3
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Norms
#
Desired Conformance Criteria
1
3
The system MAY compute normal ranges for data based on age and other
parameters such as height, weight, ethnic background, gestational age.
IF required by scope practice THEN the system SHALL capture patient
vital signs such as blood pressure, temperature, heart rate, respiratory rate
and severity of pain as discrete elements of structured or unstructured
data.
Include “time of birth” in description of electronic health record.
4
Include “date of birth” in description of electronic health record.
5
Age-based norms for numeric data where available.
2
Pediatric Data Standards Special Interest Group
Status in Draft
Child Health-FP
Shall
DC.1.8.4.5
Shall
DC.1.8.4.1
Shall
DC.1.1.2
Shall
DC.1.1.2
Shall
4
HL7 Child Health Profile
Desired Conformance Criteria
6
Age-based norms for non-numeric data (Eg. developmental data).
7
Distinguish post-conception (corrected age) from post-natal age. AAP:
Distinguish gestational age, chronologic age and corrected age.;
Gestational age as modifier in decision support.
Allow decision support for Percentile values and z-scores for those few
data for which the distributions are known, such as height, weight, head
circumference and body mass index.
Indicate normal range for items (lab values and physical exam data) based
on stage of sexual maturity.
8
9
DC.1.8.4.5
Shall
DC.1.8.4.5
May
DC.1.1.2.12
Shall
DC.1.8.4.4
May
DC.1.8.4.17
Privacy
#
Desired Conformance Criteria
1
The system SHALL provide the ability to document, for each patient,
patient’s personal representative (e.g. guardian or surrogate) varying
levels of consent or authorization.
2
Adolescent flagging for sensitive content; Support privacy policies that
vary by age, presenting problem and diagnosis.
Assent for treatment; Provide for recording of assent for treatment
combined with parental informed permission. .
Provide for recording of consent for treatment combined with a record of
parental involvement.
Provide for recording of consents authority related to foster and custodial
care circumstances.
Consent by proxy; Provide for recording of custodial parents’ wishes as to
which adult can consent to which child’s care and under what limitations.
Adoption privacy; Allow flagging of data for special adoption-related
privacy protection.
Adoption record separation; In some states, the preadoption record may
need to be separated entirely from any postadoption record, using two
distinct patient identities. .
Allow for distinction between patient’s guardian and the financial
guarantor.
Provide flexibility in allowing for emergency treatment of minors in which
the parent or legal guardian may be absent.
Protect the genetic identity of the child, when desired, when assisted
reproductive technology is used.
3
4
5
6
7
8
9
10
11
Status in Draft
Child Health-FP
Shall
DC.1.3.3.9
DC.1.3.3.10
Shall
IN.1.9.9
Shall
DC.1.3.3.8
May
DC.1.3.3
Shall
DC.1.3.3.10
Shall
DC.1.3.3.8
Shall
IN.1.9.9
Shall
DC.1.1.1.13
Shall
DC.1.3.3.9
Shall
DC.1.3.3.11
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Other
#
Desired Conformance Criteria
1
Support reading level appropriate educational materials at varying levels.
2
Allow recording of the exact time of birth down to the minute.
3
Include donor management support: Functions in an EMR related to organ
and tissue donation may need to accommodate information about the
gamete or zygote donated that resulted in pregnancy that gave rise to the
patient, within applicable privacy laws.
Pediatric Data Standards Special Interest Group
Status in Draft
Child Health-FP
Should
DC.3.2.4.9
Shall DC.1.1.2
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5