Electronic Medical Records (EMRs), Epidemiology, and Epistemology: Reflections on EMRs and Future Pediatric Clinical Research

  • Richard C. Wasserman
    Address correspondence to Richard C. Wasserman, MD, MPH, University of Vermont, N310 Courtyard at Given, 89 Beaumont Ave, Burlington, Vermont 05405.
    Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vt, Pediatric Research in Office Settings (PROS), American Academy of Pediatrics, Elk Grove Village, Ill, and Children’s Hospital of Philadelphia, Philadelphia, Pa
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      Electronic medical records (EMRs) are increasingly common in pediatric patient care. EMR data represent a relatively novel and rich resource for clinical research. The fact, however, that pediatric EMR data are collected for the purposes of clinical documentation and billing rather than research creates obstacles to their use in scientific investigation. Particular issues include accuracy, completeness, comparability between settings, ease of extraction, and context of recording. Although these problems can be addressed through standard strategies for dealing with partially accurate and incomplete data, a longer-term solution will involve work with pediatric clinicians to improve data quality. As research becomes one of the explicit purposes for which pediatricians collect EMR data, the pediatric clinician will play a central role in future pediatric clinical research.


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