When a child presents for emergency care, having rapid access to critical information about medical history, health status and required supports is crucial to provide high-quality care.
Since 1999, the AAP and the American College of Emergency Physicians (ACEP) have promoted use of an emergency information form (EIF) for children and youth with special health care needs (CYSHCN) so optimal care can be provided.
An updated approach to EIFs and the information they contain are described in a new policy statement from the AAP Committee on Pediatric Emergency Medicine, Council on Clinical Information Technology, Council on Children and Disasters and the ACEP Pediatric Emergency Medicine Committee.
The policy reviews essential common data elements, discusses integration with electronic health records (EHRs) and proposes broadening the rapid availability and use of collated, organized critical health data for all children and youth, including during disasters.
The policy, Access to Critical Health Information for Children During Emergencies: Emergency Information Forms and Beyond, is available at https://doi.org/10.1542/peds.2022-060970 and will be published in the March issue of Pediatrics.
Barriers to use
Reports from families, physicians and prehospital professionals, along with research findings, have shown the EIF is useful for CYSHCN. Its utility, however, has been limited by a lack of adoption and workflows and incentives to provide and maintain the information reliably.
Widespread adoption of EHRs should improve access to such information. However, when a child presents emergently, finding the correct information in a large volume of poorly organized data can be difficult. In addition, the EHR where the child is receiving care may not be able to communicate with the EHR at the medical home.
Recommended data elements
The EIF is a transition of care document. A Common Clinical Data Set for such documents, defined by the Centers for Medicare & Medicaid Services, was updated in the 21st Century Cures Act. This helped define recommended data elements to include in the EIF.
A table in the policy outlines these data elements as well as additional elements and fields that may assist in caring for children, including those with special needs. For example, the table highlights procedures or treatments to avoid or specific management that should be initiated immediately.
Suggested elements should be accessed automatically from the EHR in a concise and organized format that is standardized across platforms.
Recognizing that EHR access is not always possible, a printed EIF also should be accessible in several locations. The statement encourages patients (when appropriate), families, medical homes and specialists who provide care for children to work together to ensure the data in the EHR and any printed forms are up to date.
Other recommendations
- EHR and mobile health care app vendors should partner with regulatory groups and professional organizations to implement needed pediatric-specific data elements.
- Plans for accessing health information during disasters should fully consider the needs of children with special health care needs.
- If patients have an acute care plan that differs from standard care, families should be educated about the importance of sharing this information.
- Medical teams, emergency medical services professionals and physicians should ask families and caregivers if their child has an EIF or special care plan.
- Innovative ways to promote completion and use of the EIF should be explored and promoted.
- Health care professionals should be compensated appropriately for the completion and maintenance of clinical information that permits production of the EIF.
- EIF completion and accessibility should be encouraged for patients and families regardless of background or health care payment source. Disadvantaged populations may be particularly likely to benefit from making critical health information available. Widespread EIF use may help to address inequities in health outcomes.
Dr. Callahan is a lead author of the policy statement. He is a former member of the AAP Committee on Pediatric Emergency Medicine.
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