Electronic health record with computerized decision support tools for the purposes of a pediatric cardiovascular heart disease screening program in Crete

Comput Methods Programs Biomed. 2018 Jun;159:159-166. doi: 10.1016/j.cmpb.2018.03.009. Epub 2018 Mar 15.

Abstract

Background and objective: Early detection of cardiovascular (CV) disease or associated risk factors during childhood is of paramount importance, allowing for early treatment or lifestyle modifications, respectively. The objective of this study was to describe the development of an electronic health record (EHR), with integrated computerized decision support system (CDSS), specifically designed for supporting the needs of a pilot pediatric CV disease screening program applied on primary school students of a Mediterranean island.

Methods: Evidence-based knowledge, national and international practice guidelines regarding sport preparticipation CV screening of children and young athletes has been used for the design of the designated EHR. A CDSS, capable for providing alerts for further cardiology evaluation need, has been incorporated into the EHR, based on normative anthropometric and electrocardiographic data as well as predefined positive history responses.

Results: We developed a designated EHR with integrated CDSS supporting pediatric CV disease screening, capable for documenting CV-related personal and family history responses, physical evaluation data (weight, height, blood pressure), allowing for entering electrocardiogam (ECG) measurements and for uploading of multimedia files (including ECG images and digital phonocardiogram audio files). The EHR incorporates clinical calculators and referral alerts for the presence (and degree) of adiposity, hypertension, ECG abnormalities and positive history responses indicative of high CV disease risk. In a preliminary EHR validation, performed by entering data from 53 previously available paper-based health records, the EHR was proven to be fully functional.

Conclusions: The pediatric cardiology EHR with CDSS features which we developed might serve as a model for EHR for primary health care purposes, capable to document and early detect CV disease and associated risk factors in pediatric populations.

Keywords: Cardiovascular risk factors; Decision support systems; EHR; Electronic health record; Pediatric cardiovascular diseases; Screening.

MeSH terms

  • Blood Pressure Determination
  • Cardiology / methods
  • Cardiology / standards*
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular System
  • Child
  • Computers
  • Decision Support Systems, Clinical*
  • Electrocardiography
  • Electronic Health Records*
  • Evidence-Based Medicine
  • Female
  • Greece
  • Humans
  • Hypertension
  • Male
  • Mass Screening / methods*
  • Pediatrics / methods
  • Primary Health Care / methods*
  • Risk Factors