Change in Adoption of Electronic Health Records by US Children’s Hospitals

Reports survey results that suggest that children’s hospitals (especially academic ones) are adopting electronic health records at a fast pace from 2008 to 2011, and faster than adult hospitals. Describes survey analysis of selected meaningful use criteria in 2011. Speculates that meaningful use criteria have taken precedence over other functionalities that are more pediatric-specific.

Nakamura 2013 (Pediatrics) | PubMed 23589808 | Author Search

Clinical Tracking of Severely Obese Children: A New Growth Chart

Proposes a new type of growth chart that plots BMI againt the usual isobars plus an additional set that represent multiples of the 95th percentile for age/gender (x 1.1, x 1.2, x 1.3, etc.). Offers a way to indicate changes in body weight for the very obese that are perhaps more intuitive than the usual z-score method, and definitely more meaningful than percentiles. The screen shot in the article has been modified to label the isobars in a way that the software does not support.

Gulati 2012 (Pediatrics) | PubMed 23129082 | Author Search

Growth of Breast-Fed Infants Deviates From Current Reference Data: A Pooled Analysis of US, Canadian, and European Data Sets

Early recognition of the difference in growth patterns due to differences in diet among normal infants. This is the foundation of our understanding of the lower growth rates seen in health, breast-fed infants. These patterns are now incorporated into the recommended World Health Organization growth charts recommended for those under two years old in the United States. Dewey 1995 (Pediatrics)

Physician Specialty and Variations in Adoption of Electronic Health Records

Do pediatricians lag behind other specialties in electronic heath record adoption? In this study of National Ambulatory Medical Care Survey data from 2005-2009, full EHR adoption was highest for internal medicine, family medicine, and pediatrics (9.9 – 11%), but any EHR adoption was lower in pediatrics than the mean adoption rate. In other words, when pediatricians adopt, they tend to implement fully, but they may adopt at a lower rate than other specialties. Grinspan 2013 (Applied Clinical Informatics)

The Natural History of Weight Percentile Changes in the First Year of Life

Another demonstration that growth in the first year of life is not as smooth as we’d like to think, and that “crossing percentile lines” does not mean what we have long been taught. Before you do a “failure to thrive workup” (whatever you think that is), check out this data to be sure you are interpreting “failed” growth appropriately. In this study from EMR data, 38% of infants fell by 2 “percentile lines” and would have been considered to be failing to thrive by that definition. But they were not.

Bennett 2014 (JAMA Pediatrics) | PubMed 24797161 | Author Search