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Patient Safety/Quality

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Researchers identify five information technologies that have great potential to improve patient safety for children

Five information technologies have great potential to improve child safety, according to the results of an extensive review of research studies on the topic. The review was supported by the Agency for Healthcare Research and Quality (HS11868). Some of these technologies will be adopted widely in the next 10 years, according to authors Kevin B. Johnson, M.D., M.S., of Vanderbilt University Medical Center, and Coda L. Davison, F.A.C.H.E., M.P.A., of the Johns Hopkins University School of Medicine.

First, use of care provider order entry (CPOE), which has been studied primarily with adult patients, has dramatically decreased the incidence of medication errors. One study showed that use of CPOE reduced by 75 percent the incidence of allergic reactions and excessive drug dosages in intensive care patients. Since children are even more sensitive to medication than adults, they should benefit more from CPOE.

Second, outpatient studies have found that guideline-based documentation was associated with increased guideline compliance in the areas of pediatric oncology, pediatric health maintenance, and emergency medicine. Third, Internet-based disease management resources, ranging from sophisticated online support groups to E-mail and Web pages, can enhance provider decisionmaking, improve disease management communication, and educate adolescents and older youths about their illnesses.

Fourth, teleconsultation can improve access to care and has been found to be useful in pediatric surgery, evaluations of suspected abuse or neglect, psychiatry, pediatric dental screening, pediatric ophthalmology, and neonatology. Fifth and finally, electronic health records (EHR) have the potential to improve the safety of pediatric care. For example, evidence shows that inclusion of preventive services tracking software in the EHR improves rates of preventive services.

See "Information technology: Its importance to child safety," by Dr. Johnson and Mr. Davison, in the January/February 2004 Ambulatory Pediatrics 4(1), pp. 64-72.

Editor's Note: Another AHRQ-supported study on a related topic highlights the role of informatics in promoting patient safety and enabling evidence-based practice. For more details, see Bakken, S., Cimino, J.J., and Hripcsak, G. (2004, February). "Promoting patient safety and enabling evidence-based practice through informatics." (AHRQ grant HS11806). Medical Care 42(2 Suppl.), pp. II49-II56.

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