Design and Implementation of Electronic Health Record Tools for Integrated Primary Care in Pediatrics
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Objective: Pediatric Integrated Primary Care (IPC) models include various practice elements, including shared electronic health records (EHRs). Although shared EHR systems provide collaboration opportunities and can be resources for program evaluation and quality improvement initiatives, to be used effectively, EHR tools need to be user-informed and capture the complexities and heterogeneity of behavioral healthcare. The aim of this study was to evaluate the implementation of adapted EHR tools designed to collect relevant, routine data, including presenting concerns, patient history, specific intervention components administered, patient goals and progress, and adherence to protocols. Methods: We describe the design and implementation of three interconnected EHR tools developed to promote the use of practice-based data within an established IPC program. The tools included: (1) a data flowsheet, (2) customizable documentation template, and (3) a real-time data dashboard. The RE-AIM framework guided the identification and evaluation of implementation outcomes including patient reach, provider adoption, and implementation. Behavioral Health Provider (BHP) use of the tools was examined via EHR chart review, and Tableau© tracked access to the data dashboards. Results: Six months after the introduction of the flowsheet and template to BHPs, all utilized the tools in most of their patient encounters. High use rates were sustained three years later (87.56% of encounters). The dashboard tool was never adopted for clinical purposes. Conclusions: While documentation tools were readily adopted, challenges exist in BHP uptake of data visualization tools. Further exploration of factors influencing BHP use of clinical data is essential for advancing practice-based research in pediatric IPC.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it