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Pediatric Growth Charts & Vitals

Children aren’t little adults, and what’s considered a “normal” vital for an adult can be anything but for a child. It’s why you need a pediatric-specialty EHR that considers the norms at each age and stage to make sure that pediatric growth is tracked appropriately, based on the Harriet Lane guidelines, so you can trust the values you’re seeing are pediatric-specific and tailored to your patients.

Creating the foundation for lifelong health

Any visit to a pediatrician’s office includes checking a child’s height, weight, and vital signs to get a snapshot of their overall health. By tracking a child’s growth and development over time, pediatric healthcare providers can identify potential health problems early and take appropriate action. After all, these are the building blocks that create the foundation of a child’s lifelong health.

Here’s why a pediatric-specialty EHR matters

Birth Histories

A detailed birth history helps lay the foundation for your patient’s medical record. With OP, you can quickly document a baby’s Apgar scores, newborn hearing screening, metabolic newborn screening, nursery history, adoption history, and other pertinent details. Recording a gestational age will allow the system to automatically recalculate growth charts and developmental milestones based on a newborn’s prematurity.

Specialty Growth Charts

OP offers a variety of pediatric growth charts that meet the unique needs of your patients. We incorporate AAP-recommended WHO/CDC hybrid growth charts as well as specialty growth curve plotting adjusted for Down Syndrome and preemies. Growth charts convert to English or metric measurements with percentile and can be printed on a single page or delivered directly to the patient portal.

BMI

Because a child’s weight status is different from adult BMI categories, you need to use a pediatric EHR to factor in those differences. Children’s body composition varies by age and gender, so BMI levels among children and teens need to be expressed relative to other children of the same age and sex. OP auto-calculates correct BMIs and flags the abnormal values for you. The only thing you need to do is read the results. No more workarounds or time-consuming manual calculations are needed.

Why it matters: With obesity now affecting almost 20% of children and adolescents, tracking BMIs is critically important. Problems that were once considered adult problems — such as diabetes, high blood pressure, and high cholesterol are now being seen in pediatric patients. Flagging children in the 95th percentile allows you to intervene and develop a care plan to promote improvements in weight that support a healthier lifestyle.

Here’s how OP helps!

You have the option to include the diagnosis for BMI% when charting a well visit or encounter visit after the patient’s height and weight are measured. From there, you can create a customizable care plan to reflect additional interventions, such as providing a nutritionist referral, lab work, and frequency of visits. You can also pull a report of all active patients with a BMI ≥ 95% and use that report as an opportunity to discuss nutrition and fitness during in-office or telemedicine counseling visits. Or, send a personalized message through the patient portal asking how your patients are doing with their care plans.

Eating Disorders

Eating disorders like anorexia, bulimia, and binge eating are being diagnosed in younger and younger children. Pediatricians are in a unique position to detect eating disorders early and change the course of their progression. Annual well visits and sports participation exams offer an excellent opportunity to screen for eating disorders. Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents offers sample screening questions about eating patterns and body image that are easily incorporated into OP’s well visit workflow.

Why it matters: Caring for children and adolescents with eating disorders can be complex and resources for the treatment of eating disorders are often limited. Pediatricians may be called on to provide medical supervision for their patients, coordinate care, implement behavioral interventions, and advocate for appropriate services. OP helps you manage that with ease.

Here’s how OP helps!

Anticipatory guidance sections of several of the well-check templates include nutrition, and diet is included in the ROS section. Bright Futures patient and parent handouts can be linked to those visits too. If you want to expand or change the Bright Futures previsit questionnaires in templates, you can easily add specific questions to individual templates in the ROS or history section.

When people hear the words “growth chart” they oftentimes associate it with a baby’s development or use it for a predictive height. But growth charts also play a significant role in monitoring tweens and teens for eating disorders. 

Blood Pressure Monitoring

More than 1 in 7 youth ages 12 to 19 have high blood pressure or elevated blood pressure. Left untreated, high blood pressure in children can result in serious, long-term health effects, including heart disease, kidney disease, and stroke.

Why it matters: Because high blood pressure is diagnosed differently in children than it is in adults, you need a pediatric specialty EHR that tracks and correctly flags concerning blood pressure readings. If an adult presented with a blood pressure of 90/60, they’d be pumped full of meds and flagged for care. Yet the same reading is considered normal for a baby. It’s why OP uses the 2017 AAP guidelines for hypertension – to help you flag abnormals and develop a plan of care for treatment that is appropriate for the child you are treating.

Here’s how OP helps!

OP has a SQL report that shows all the active patients in your practice who have had at least one elevated blood pressure in the last year (or another time period you specify). It also shows how many normal blood pressures you’ve measured in that same time frame. If your patient has one elevated BP and 4 normals, they’re probably OK. But if they have 4 elevated BPs and no normals, it’s a red flag and you should quickly recall those patients for follow-up care.

I like how OP can be modified to fit the needs of your practice. The growth charts that accommodate preterm and Down Syndrome babies are amazing.

Maureen Gladden, NP, Kidz1st Pediatrics, MI