Pediatric EHR contact information errors affected 90% of more than 1.1 million young patients at three pediatric organizations, according to a research letter published Nov. 9 in JAMA Pediatrics.
Researchers analyzed deidentified EHR data for 1.15 million active patients ages 0 to 21 at Palo Alto, Calif.-based Stanford Medicine Children’s Health; Wellesley, Mass.-based Pediatric Physicians’ Organization at Boston Children’s; and Washington, D.C.-based Children’s National Hospital. The first two run Epic, while Children’s National uses Oracle Health.
About 1.04 million patients had an inappropriate entry in the patient-level phone field, usually caregiver contact details stored where the patient’s own should be. Rates hit 98% for children, 88% for adolescents and 60% for young adults ages 18 to 21. Email errors affected 44% of patients overall, including 52% of adolescents.
The researchers traced the problem partly to EHR design. Systems often require a patient phone number even for young children, pushing staff to enter a caregiver’s number instead, and both EHRs place caregiver contact fields on a separate screen.
The errors misdirect communications and can expose protected adolescent records to caregivers through patient portals. In foster care or custody disputes, sensitive information could reach someone without legal authority.
The authors urged EHR vendors to restrict contact entries in child patient fields based on local consent laws, block duplicate entries across patient and caregiver fields and require independent contact details for young adults. They also called on the American Academy of Pediatrics to expand its EHR guidance to cover contact information and on HL7 to update its pediatric health IT standard.
The study was led by Naveed Rabbani, MD, of Harvard Medical School, and Natalie Pageler, MD, now CIO of Seattle Children’s.
