Evaluation of dynamic templates used in pediatric well child checkups at an Indian health service clinic

Providing adequate preventive care for children continues to be a major area of concern in today's healthcare environment. Despite proven positive outcomes and an immense volume of pediatric Well-Child Care (WCC) visits, effective use of medical informatics and Electronic Health Record (EHR) tools for supporting WCC visits are lacking. A computerized pediatric WCC encounter form was created to incorporate the benefits of using an encounter form based system but minimize the disadvantage of age-based, pre-printed encounter forms. The WCC encounter form was created to function within the Indian Health Service's ambulatory computerized health record, Patient Care Component + (PPC+), and replaced existing WCC encounter forms. The WCC encounter form was implemented and used exclusively in an Alaskan Indian Health Service pediatric clinic by 10 clinicians for a trial period of 3 months. Clinicians were asked to complete a questionnaire after completion of the trial period. The questionnaire was directed to assess the impact of the WCC encounter forms on staff perceptions of productivity, functionality, and usability. The WCC encounter form was used 5,876 times during the 3-month study period. Clinicians responded positively to all areas measured, most positively to facilitation of documentation and inclusion of age-specific information content. Several areas of improvement were also delineated. The positive questionnaire results were encouraging and demonstrated medical informatics utilities can be successfully developed and implemented to facilitate the delivery of pediatric preventive care. Pediatric clinicians are ready to embrace new modalities of information presentation better suited to the practice of preventive pediatrics. Future research needs to be done to link health outcomes data to quality of information presented to the pediatric clinician during a preventive encounter.