Aims Electronic patient records are the future. We are proceeding toward full digitisation of the past, and, until direct electronic entry is fully established, contemporaneously for written notes and other documents. However a scanning solution cannot be applied to the growth chart. Developing our own electronic version was for control of development, and ensuring integration with the established portal to all electronic records (CWS) in the Health Board. CWS is available to all 9000 clinical users in primary, secondary and community care.
Methods Development was clinically led, working with the company conducting digitisation of medical records. A graphing product plots measurements onto a chart image. Images were created from growth data available from the Medical Research Council. Charts are for 0–2, 0–4, 0–18 years, boys and girls, with ability to display gestation correction, bone age and target height. Charts can be optionally displayed in any age range, either as a single measurement or in combination of height and weight, and in the 0–2 age, also with head circumference. Table information shows calculations of BMI, and height velocity. Location of data entry is mandated, and user identity recorded according to the CWS login. Different levels of access, determined by clinical role, and training allow measurements to be entered from any site.
Results A pilot phase began June 2014. By October the use of paper was supplanted for most patients. Presently 3199 children have active growth charts with data entry largely from secondary care, but use is rapidly increasing, and becoming more established from community and primary care. Feedback overall has been very positive, with many examples where clinical practice has been enhanced, primarily related to the fact that all clinicians in all settings can see and use the same chart on-line. Refinements are steadily being added, influenced by user opinion. A Down syndrome chart will shortly be available.
Conclusions The electronic growth chart is proving a successful substitute to paper, and working well across our Health Board. Future development and design will be directly influenced by user feedback. There is enormous potential in future enhancements, including use on mobile devices.
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