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The Usefulness of Electronic Health Records From Preventive Youth Healthcare in the Recognition of Child Mental Health Problems.

ABSTRACT: Background and Objectives: Early identification of child mental health problems (MHPs) is important to provide adequate, timely treatment. Dutch preventive youth healthcare monitors all aspects of a child's healthy development. We explored the usefulness of their electronic health records (EHRs) in scientific research and aimed to develop prediction models for child MHPs. Methods: Population-based cohort study with anonymously extracted electronic healthcare data from preventive youth healthcare centers in the Leiden area, the Netherlands, from the period 2005-2015. Data was analyzed with respect to its continuity, percentage of cases and completeness. Logistic regression analyses were conducted to develop prediction models for the risk of a first recorded concern for MHPs in the next scheduled visit at age 3/4, 5/6, 10/11, and 13/14 years. Results: We included 26,492 children. The continuity of the data was low and the number of concerns for MHPs varied greatly. A large number of determinants had missing data for over 80% of the children. The discriminatory performance of the prediction models were poor. Conclusions: This is the first study exploring the usefulness of EHRs from Dutch preventive youth healthcare in research, especially in predicting child MHPs. We found the usefulness of the data to be limited and the performance of the developed prediction models was poor. When data quality can be improved, e.g., by facilitating accurate recording, or by data enrichment from other available sources, the analysis of EHRs might be helpful for better identification of child MHPs.

SUBMITTER: Koning NR

PROVIDER: S-EPMC8202822 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND: Previous studies regarding the use of information technologies (IT) specifically among pediatricians and other physicians who treat children are lacking. As such, the objective of this study is to examine the use of electronic health record (EHR) systems and other IT applications among pediatricians and other child health providers (CHPs) in Florida. METHODS: We focus on pediatricians and other CHPs who responded to a state-wide physician survey of IT use. CHPs included general pediatricians, pediatric sub-specialists, and family physicians who self-reported a practice composition of at least 20% children. We compared general pediatricians to other CHPs and all CHPs (including pediatricians) to other physicians with respect to computer and internet availability, and to the use of personal digital assistants and EHRs. Those with an EHR were also compared regarding the availability of key functions available in their system. Statistical analyses included chi-square analysis and logistic regression models which controlled for numerous factors. RESULTS: A total of 4,203 surveys (28.2% response) including 1,021 CHPs, were returned. General pediatricians (13.7%) were significantly less likely to be using an EHR than both CHP family physicians (26.1%) and pediatric sub-specialists (29.6%; p < .001). In multivariate analysis, only general pediatricians were significantly less likely than other physicians to indicate the use of an EHR system (OR = .43; 95% C.I. = .29 - .64). Overall, CHPs were less likely to have key functions available in their EHR system including electronic prescribing (53.3% vs. 61.9%; p = .028), and electronic order entry (47.7% vs. 57.2%; p = .017) among others. General pediatricians and pediatric sub-specialists frequently lagged behind CHP family physicians with respect to key EHR functions. In contrast, CHPs had growth charts (51.3% vs. 24.0%; p < .001) and weight-based dosing functions (35.5% vs.22.7%; p < .001) more frequently than others. CONCLUSION: Physicians caring for children, and especially pediatricians, in Florida, are significantly slower than other doctors to adopt EHRs, and important electronic patient safety functionalities, into their office practices.

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The Usefulness of Electronic Health Records From Preventive Youth Healthcare in the Recognition of Child Mental Health Problems.

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