Connecting the whole family: the unique demands of an EMR in paediatric care

From infancy to old age, we all require physician care — but the kinds of care we need will change throughout our lifetimes. And the treatments that physicians offer will differ, too, depending on their specialty and the unique needs of their patients.

The tools physicians use should reflect and support those differences with features that suit their specialty. More physicians than ever are adopting EMRs in their practices, and their use among specialists is also increasing; a survey of 2,300 Canadian physicians found that EMR use among specialists has grown from 25% in 2004 to 79% in 2017.

Dr. Neil Cooper, a paediatrician and sports medicine physician based in Calgary, is one such specialist who benefits from using an EMR. In his practice, Dr. Cooper uses PS Suite to gather relevant data and communicate with patients’ families and other physicians.

Pediatricians — like other specialists — have high expectations of the technologies they use in order to meet their patients’ needs. For Dr. Cooper to provide complex care to young patients who often are not managing their own schedules or health, he needs technology that helps him effectively track his patients’ data and communicate successfully with families.

Gathering the right data for their patients’ needs.

An important part of caring for young patients is the need for customizable charts. New health technologies provide ways for specialists like Dr. Cooper to do just that. For instance, EMRs have growth charts and vital sign information that make it easier to track the patient’s development.

“Where other [physicians] might track heart rates and blood pressures — and we do track those things, too — pediatricians really need height, weight, and head circumference. We plot those points against their age and follow along the growth curve,” says Dr. Cooper.

These chart functions also make it easier to track trends such as childhood obesity rates and can be customized to monitor the characteristics of certain conditions.

“All EMRs have growth charts, and those growth charts are all very automatic and customized. For example, we have different kinds of growth charts for conditions like Turner Syndrome or for premature babies,” says Dr. Cooper.

Beyond charts and reporting, there are also innovative approaches and tools that can be used alongside EMRs to help manage complex care for kids. In Dr. Cooper’s practice, he uses online tools to dictate his notes and store brochures, handouts, and other literature for patient families.

But when it comes to pediatrics, caring for patients also means communicating effectively with families.

Keeping parents involved and informed.

Online tools like patient portals help specialists ensure support networks and caregivers can stay involved in the care process without creating additional burden on physicians with phone calls or unnecessary office visits.

Patient portals are a great way for both physicians and patients to access test results, book appointments, and communicate quickly and efficiently. For example, MyHealth Records is a portal that enables patients and families to view and access immunization information, lab results, and medications online. Using MyHealth Records, Alberta developed a province-wide program where, in addition to their own medical records, citizens can access up-to-date healthcare data including information about disease outbreaks — like measles — and their vaccines. This saves valuable time for physicians by reducing the burden of communicating information to patients.

Studies show that EMRs not only save time for physicians, they’re also convenient for parents. For instance, a study that looked at parents using an EMR at a Children’s Rehabilitation Hospital found that, “Participants expressed an appreciation for having more detailed information and knowing the technical language, as they felt they could then communicate on a more level playing field with providers.”

Online screening tools are another way to keep families involved and informed. Dr. Cooper uses one called the “Ages and Stages Questionnaire,” which gathers information from patient families prior to their visit, which enables more streamlined care. The answers from the questionnaire can be easily uploaded straight into the EMR.

“I used to sit down and go through a series of questions with the families and ask the kids to demonstrate some developmental screening tasks, but they don’t usually demonstrate as well in my office as they would at home,” says Dr. Cooper. “Now, we send out the questionnaire every three months or so asking them to go through a lot of the tasks and it gives them a little report card every time they come in.”

Tools like these save time, while gathering and tracking data that augments notes. According to Dr. Cooper, photographs are another great way to track patient information in a more efficient, intuitive way.

Augmenting notes with visuals.

It is often said that a picture is worth a thousand words and, when it comes to tracking symptoms and communicating with patients, a visual reference really can say a lot. To augment written notes and keep track of symptoms and behaviours, more and more physicians are using EMR Mobile to conveniently upload images directly into an EMR.

“Pictures are really useful, especially for things like birthmarks and rashes or gait problems or alignment issues. We used to have to write it down and try to describe things that way. Now it’s so easy to just take pictures,” explains Dr. Cooper. Parents can also share photos or videos of their children’s symptoms and behaviour with specialists, who can then securely store these files in the EMR for future reference.

“I had one case last week where the newborn baby was making funny noises when breathing,” Dr. Cooper recalls. “The dad recorded it on his phone, so I could actually hear what he’s hearing and what he was worried about.”

Augmenting notes; communicating with parents; gathering customized data: the expectations paediatricians have regarding the technology they use are robust and, often, unique to their specialty. Still, they have many of the same needs that other physicians do — and their tools should help with those things, too.

Running an effective, efficient practice.

For physicians of all specializations, coordinating with patients is an important — and time-consuming — component of running a practice. Dr. Cooper employs his EMR to help, accessing features like online appointment reminders and scheduling.

“With a couple of clicks, the front office staff can send out appointment reminders for the coming few days. That’s a really useful tool,” says Dr. Cooper. Plus, with EMRs, all patient information is housed in one place. That means that important data are less likely to get lost, it’s easier to spot drug interactions, and specialists can easily communicate with other healthcare professionals, including pharmacists and primary care physicians — an integral part of specialists’ everyday practice.

“PS Suite allows me to digitally send letters to other physicians with just one or two clicks, directly from the EMR. The referring physician gets a copy of every one of my notes instantly after I’ve finished it,” says Dr. Cooper.

Whether it’s to help make their practice more efficient or to manage the unique needs of their patients, paediatricians like Dr. Cooper are using the many features of EMRs and adjacent technologies to benefit their practice. Every patient is different, every physician is different, and health technologies should reflect the unique needs of both groups. Growing an effective practice, like caring for patients, means having the right tools that are customizable and tailored to physicians’ needs.