Integrating web services/Applications to improve pediatric functionalities in electronic health records

The past decade has seen a substantial increase in the use of electronic health records (EHRs) by health care providers caring for children. However, gaps in pediatric-specific functionalities continue to exist in some EHR systems, including population-specific growth curves, immunization clinical decision support, weight-based medication dosing with rounding, calculation of pediatric hypertension percentiles, age-specific developmental assessment, newborn bilirubin nomograms, anticipatory guidance reminders, and other functionalities described elsewhere. Implementing pediatric functionalities into EHRs is critical to the provision of safe pediatric care. As an alternative to direct implementation in EHRs, EHR vendor agnostic Web applications, Web services, and application programming interfaces offer an opportunity to provide pediatric functionalities and eliminate the need for each vendor to develop these functionalities. Successful implementation of Web services and related technologies requires responsible attention from both EHR vendors and developers of Web services, Web applications, and application programming interfaces to the use of data terminology standards, adherence to privacy and security requirements, rigorous testing, change management processes, and robust system support and maintenance. Education of health care providers about opportunities to improve pediatric functionalities in EHRs by using these services can facilitate discussions in EHR user groups in which vendors can be lobbied to implement them. This policy statement emphasizes the need to address pediatric-specific functionalities in EHRs by providing insight and recommendations into the development, maintenance, integration, and support of these novel solutions.