How does an EHR need to be adapted to address pediatric behavioral health care?
The implementation of an electronic health record that incorporated information from pediatric behavioral health providers is uniquely complicated due to confidentiality and other legal implications in providing this type of care. Issues arise particularly in the area of the privacy of and access to the behavioral health records, as noted in this article from the National Council for Community Behavioral Healthcare (PDF - 1.5MB). These privacy and security concerns are even more complex for children because of their own unique privacy issues.
Monitoring pediatric behavioral health issues in children early is key to delivering quality preventative pediatric health care. Therefore, it is crucial that children are screened for developmental and behavioral conditions during the well-child visit as noted by the Commonwealth Fund. With the goal of delivering support to children, families, and providers in the area of mental and developmental health, First 5 California's Special Needs Project provides numerous resources to inform the screening process. Screening can help identify behavioral health issues early through the well-child screening, a need that is even more pertinent to the care of children at risk, such as foster children (PDF - 67KB), according to the American Academy of Pediatrics.
An EHR can prompt a physician to screen for behavioral health issues and incorporate questions similar to those used in the Ace Study (PDF - 9KB), a project led by Dr. Vincent Felitti and Dr. Robert Anda that studies adverse childhood experiences. These questions focus on asking about negative experiences in childhood and explore the impact of parental behavior upon children's health. Furthermore, the ACE Study determined that negative experiences in childhood increase the potential for adverse behavioral and health issues in adulthood, according to an article from the ACE study in the American Journal of Preventative Medicine. During childhood, and as the child transitions through adolescence to adulthood, privacy and access to the behavioral health record is an important concern that needs to be addressed.
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