Few 'Bright Futures' Guidelines Suitable for EHR Format
(HealthDay News) — Only a small portion of the Bright Futures Guidelines meet criteria for actionability, according to a study published in the current issue of Applied Clinical Informatics.
Noting that there is demand for an electronic version of the leading American pediatric preventive care guideline, Bright Futures, S. Maria E. Finnell, MD, from the Indiana University School of Medicine in Indianapolis, and colleagues examined the extent to which Bright Futures meets criteria for actionability. All action statements in Bright Futures were consolidated into recommendations, and the actionability of the recommendations was assessed using two dimensions: decidability (i.e., that the recommendation states under what conditions to perform these actions) and executability (i.e., that actions are stated specifically, unambiguously, and in sufficient detail).
The researchers consolidated 2,161 action items into 245 recommendations. Of these, 21% (52 items) were identified as actionable. These recommendations almost exclusively addressed screening or child safety. Thirteen actionable recommendations were identified for other areas of anticipatory guidance. The criteria for actionability were not met by recommendations on child discipline, family function, or mental health.
"Only a portion of the Bright Futures Guidelines meets criteria for actionability," the authors write. "Substantial work lies ahead to develop most recommendations for anticipatory guidance into a computer implementable format."