1. Reconciling the pediatric requirements with the EHR model May 2006 Age Representation Allow recording of post conceptional age and distinguish it from post-natal age Closest conformance criterion: N/A… DC.1.2 (Manage patient demographics) comes closest ([no CC contains this specific concept]). NOT INCLUDED, noncontroversial Reference number: 2

2. Reconciling the pediatric requirements with the EHR model May 2006 Age Representation Allow recording of the exact time of birth down to the minute Closest conformance criterion: N/A… DC.1.2 (Manage patient demographics) comes closest ([no CC contains this specific concept]). NOT INCLUDED, noncontroversial Reference number: 3

3. Reconciling the pediatric requirements with the EHR model May 2006 Age Representation Display age with the appropriate units, based on the child's age (for example, infants who are four days old should have their age displayed in days, as opposed two weeks or months) Closest conformance criterion: N/A… DC.1.2 (Manage patient demographics) comes closest (N/A). NOT INCLUDED, noncontroversial Reference number: 4

4. Reconciling the pediatric requirements with the EHR model May 2006 Custody Provide patient identification mechanisms that can withstand changes in family structure, such as loss of a child from the family in a custody decision Closest conformance criterion: N/A ((I am pretty sure this needs some significant clarification)). NOT INCLUDED, noncontroversial Reference number: 19

5. Reconciling the pediatric requirements with the EHR model May 2006 Custody Provide patient identification mechanisms that can withstand changes in family structure, such as removal of the child from the home Closest conformance criterion: N/A ((I am pretty sure this needs some significant clarification)). NOT INCLUDED, noncontroversial Reference number: 20

6. Reconciling the pediatric requirements with the EHR model May 2006 Custody Provide authentication procedures for adults who claim to be parents or guardians of a child, in cases where the child is under investigation for abuse and neglect Closest conformance criterion: Needs more detail… hard to put this one into a conformance criterion (Perhaps this one could be achieved merely by supporting some kind of alerting mechanism for kids whose custody is not straightforward). NOT INCLUDED, noncontroversial Reference number: 18

7. Reconciling the pediatric requirements with the EHR model May 2006 Decision Support Allow the deferral of alerts and reminders to a subsequent episode of care Closest conformance criterion: N/A ((If a system decided that service X was needed today, and the user decided not to do it, then the system generally would decide that is needed tomorrow, too, right?)). NOT INCLUDED, noncontroversial Reference number: 24

8. Reconciling the pediatric requirements with the EHR model May 2006 Decision Support Display deferred actions Closest conformance criterion: N/A ((If a system decided that service X was needed today, and the user decided not to do it, then the system generally would decide that is needed tomorrow, too, right?)). NOT INCLUDED, noncontroversial Reference number: 27

9. Reconciling the pediatric requirements with the EHR model May 2006 Decision Support In cases where gender is unknown, and in the case where certain decision support is gender specific, provide both male and female versions in cases where the gender is unknown Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 30

10. Reconciling the pediatric requirements with the EHR model May 2006 E-Prescribing & Ordering Include body weight (or any other data used to decide dose, like gestational age or diagnosis) in the data sent with a prescription Closest conformance criterion: (These data elements would be dictated by e-prescribing standards). NOT INCLUDED, noncontroversial Reference number: 58

11. Reconciling the pediatric requirements with the EHR model May 2006 E-Prescribing & Ordering Allow drug dose and based on compounded oral solutions, in the case where no oral solution is available in standard formularies Closest conformance criterion: DC.1.8.1 ([Order Medication]). NOT INCLUDED, noncontroversial Reference number: 47

12. Reconciling the pediatric requirements with the EHR model May 2006 E-Prescribing & Ordering When allow ordering of blood products in units appropriate to pediatric care Closest conformance criterion: DC.1.9.4 ([Order blood products and other biologics]). NOT INCLUDED, noncontroversial Reference number: 68

13. Reconciling the pediatric requirements with the EHR model May 2006 E-Prescribing & Ordering Communicate with pediatric providers on medication use: Weight/height/BSDA, conditions and any disease management information from pharmacy. Closest conformance criterion: Makes no sense (These data elements would be dictated by e- prescribing standards). NOT INCLUDED, noncontroversial Reference number: 55

14. Reconciling the pediatric requirements with the EHR model May 2006 E-Prescribing & Ordering Make the patients age, weight, body surface area, and gestational age visible when viewing orders at every stage of the ordering process Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 62

15. Reconciling the pediatric requirements with the EHR model May 2006 E-Prescribing & Ordering Transmit relevant body measurements (usually weight) with prescriptions Closest conformance criterion: N/A ([EHRs are going to do what the eRx messaging standards say to do… if weight is a field, then they'll send it. If not, they won't.]). NOT INCLUDED, noncontroversial Reference number: 66

16. Reconciling the pediatric requirements with the EHR model May 2006 Family Linkage Allow the recording of a relationship by living situation Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 77

17. Reconciling the pediatric requirements with the EHR model May 2006 Family Linkage Facilitate the scheduling of siblings to be seen as a group or in contiguous time slots Closest conformance criterion: N/A (S.1.6: Scheduling) (N/A). NOT INCLUDED, noncontroversial Reference number: 78

18. Reconciling the pediatric requirements with the EHR model May 2006 Growth Allow graphic display of growth data against a user- selectable set of normative curves Closest conformance criterion: DC.1.4? (Growth charting is briefly mentioned in the text of DC.1.4 "Manage Assessments," but there are no specifics). NOT INCLUDED, noncontroversial Reference number: 82

19. Reconciling the pediatric requirements with the EHR model May 2006 Growth Plot body mass index against normative curves Closest conformance criterion: DC.1.4? (Growth charting is briefly mentioned in the text of DC.1.4 "Manage Assessments," but there are no specifics). NOT INCLUDED, noncontroversial Reference number: 85

20. Reconciling the pediatric requirements with the EHR model May 2006 Growth Provide graphical growth chart and norms for children with varying conditions (e.g., Down syndrome and Turner syndrome) Closest conformance criterion: DC.1.4? (Growth charting is briefly mentioned in the text of DC.1.4 "Manage Assessments," but there are no specifics). NOT INCLUDED, noncontroversial Reference number: 87

21. Reconciling the pediatric requirements with the EHR model May 2006 Growth Provide alerts about variances in the growth chart Closest conformance criterion: Needs more detail… hard to put this one into a conformance criterion (Growth charting is briefly mentioned in the text of DC.1.4 "Manage Assessments," but there are no specifics). NOT INCLUDED, noncontroversial Reference number: 86

22. Reconciling the pediatric requirements with the EHR model May 2006 Growth Provide mechanism for monitoring of growth over time Closest conformance criterion: Needs more detail… hard to put this one into a conformance criterion (Growth charting is briefly mentioned in the text of DC.1.4 "Manage Assessments," but there are no specifics). NOT INCLUDED, noncontroversial Reference number: 88

23. Reconciling the pediatric requirements with the EHR model May 2006 Guardianship Support the recording of multiple guardians and residences for given child whose parents are divorced or who have joint custody Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 90

24. Reconciling the pediatric requirements with the EHR model May 2006 Guardianship Allow reference to subsets of the demographic data of the patients guardian to serve for parts of the patients demographic data, to avoid re-entry of data and avoid data anomalies Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 91

25. Reconciling the pediatric requirements with the EHR model May 2006 Immunizations Allow reporting of immunization status of populations of children within the practice Closest conformance criterion: DC.1.3.3 #3 ([This is not directly mentioned in the conformance criteria, but it would be a derivative of the process used to compute immunizations for individuals]). NOT INCLUDED, noncontroversial Reference number: 95

26. Reconciling the pediatric requirements with the EHR model May 2006 Immunizations Allow recording of parental consent to immunizations, according to applicable state law, as part of the point of care interface Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 94

27. Reconciling the pediatric requirements with the EHR model May 2006 Immunizations Compute immunization recommendations for a time other than the time of the current encounter (for example if a parent wants to know what immunizations are due at the next visit, the system would facilitate this analysis) Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 98

28. Reconciling the pediatric requirements with the EHR model May 2006 Immunizations Display immunizations by antigen Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 99

29. Reconciling the pediatric requirements with the EHR model May 2006 Interface Include age and DOB on every display, both printed and on the screen Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 102

30. Reconciling the pediatric requirements with the EHR model May 2006 Medical Home Allow the recording of a primary care physician for each patient Closest conformance criterion: N/A (N/A - this has GOT to be an oversight). NOT INCLUDED, noncontroversial Reference number: 105

31. Reconciling the pediatric requirements with the EHR model May 2006 Medical Home have the capability to identify multiple primary providers as well as multiple sub-specialists Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 106

32. Reconciling the pediatric requirements with the EHR model May 2006 Medical Home Indicate multiple primary care providers, in the case were a pediatrician and a family practitioner are assuming that role Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 108

33. Reconciling the pediatric requirements with the EHR model May 2006 Norms Calculate and immeditely display, along with the original data, percentile values for any piece of data entered into the system for which a percentile distribution is known (height, weight, head circumference, body mass index, blood pressure) Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 111

34. Reconciling the pediatric requirements with the EHR model May 2006 Norms Indicate normal range for items (lab values and physical exam data) based on stage of sexual maturity Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 112

35. Reconciling the pediatric requirements with the EHR model May 2006 Parental Data Entry provide a Web-based interface for entering data by parents, patients, school nurses, pharmacy labs/medical devices technicians. Closest conformance criterion: DC.1.1.4 #3 (specifying "web-based" is beyond the scope of this document; this CC should handle the EHR end of this requirement) (The system SHALL capture, explicitly label the source of clinical data provided on behalf of the patient.). NOT INCLUDED, noncontroversial Reference number: 121

36. Reconciling the pediatric requirements with the EHR model May 2006 Parental Data Entry Allow designation of a given patient as competent to enter his or her own information at a point selected by the clinician Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 117

37. Reconciling the pediatric requirements with the EHR model May 2006 Parental Data Entry Permit oversight by parents of the patient entered information Closest conformance criterion: N/A (May be to ill- defined in this form). NOT INCLUDED, noncontroversial Reference number: 120

38. Reconciling the pediatric requirements with the EHR model May 2006 Patient Identification Allow entry of temporary ID numbers, which can be replaced with more formal identification number systems Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 127

39. Reconciling the pediatric requirements with the EHR model May 2006 Patient Identification To the extent afforded by existing national patient identifier systems, allow replacement of an identifier assigned in the pediatric period to a new, adult identifier at the age of majority Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 133

40. Reconciling the pediatric requirements with the EHR model May 2006 Pedigree Allow construction of graphical patient pedigrees Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 134

41. Reconciling the pediatric requirements with the EHR model May 2006 Prenatal Allow creation of a record of a patient before the patients birth Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 137

42. Reconciling the pediatric requirements with the EHR model May 2006 Prenatal Allow the retention of data related to prenatal procedures within the record of the patient postnatally Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 138

43. Reconciling the pediatric requirements with the EHR model May 2006 Privacy In cases of care given to patients during adolescence, offer reminders based on diagnoses of the need for special privacy handling Closest conformance criterion: N/A (N/A). NOT INCLUDED, noncontroversial Reference number: 141

44. Reconciling the pediatric requirements with the EHR model May 2006 Privacy Include donor management support: Functions in an EMR related to organ and tissue donation may need to accommodate information about the gamete or zygote donated that resulted in pregnancy that gave rise to the patient, within applicable privacy laws. Closest conformance criterion: S.1.2: Donor Management Support… but does not include ART (). NOT INCLUDED, noncontroversial Reference number: 143

45. Reconciling the pediatric requirements with the EHR model May 2006 Telehealth Provide access to the electronic medical record to sites where telehealth is being implemented Closest conformance criterion: N/A (Whether an application is available through a network is an implementation issue). NOT INCLUDED, noncontroversial Reference number: 167

46. Reconciling the pediatric requirements with the EHR model May 2006 Terminology include special terminology used in pediatric care: Example: EMR systems include common pediatric terms (pediatric lexicon) used to describe pediatric preventive health care (e.g., developmental milestones, educational progress, and anticipatory guidance) and physical findings (e.g., weak cry, bulging anterior fontanels, and umbilical granuloma). Closest conformance criterion: Nonsensical; making terminology systems adequate for pediatric care is beyond the present scope (We need an entirely separate document detailing what we mean by pediatric terminology.). NOT INCLUDED, noncontroversial Reference number: 168

47. Reconciling the pediatric requirements with the EHR model May 2006 Terminology Support terminology systems specifically designed for use in pediatrics Closest conformance criterion: Nonsensical; no such terminoligy systems exist (). NOT INCLUDED, noncontroversial Reference number: 169