That old-fashioned method of measuring a child's height against the pantry door is getting an mHealth makeover in Wales.
The Aneuran Bevan University Health Board, which operates five sites and covers some 693,000 people (about 21 percent of the population of Wales), recently launched a web-based system that allows providers to create an online growth chart for children, which can then be shared with caregivers and family members through a portal.
The system replaces paper-based charts, which can be easily misplaced, are difficult to transport and chare and often contain errors. It can also be accessed and edited wherever the provider and patient are located, and could someday be included in a national public health project aimed at improving pediatric outcomes.
Pediatricians have long charted a child's height, weight and head circumference, both individually and as a means of comparing against national trends. Abnormalities are often an early indication of a chronic condition – but they could only be identified by a provider with access to records over a long period of time.
"With paper-based charts, there were a number of issues which slowed our clinics down," Jeff Morgan, MD, a pediatrician at Nevill Hall Hospital, said in a press release. "A child might have several incomplete growth records in their file charts, and with inter-observer variability in data plotting you could discover errors across the charts. Now, we have a neat solution which logs all the anthropometrical measures properly and displays the child's growth potential clearly on screen. The fact that it is computer-based means the growth chart is easy to access at any time which is useful when discussing patients with colleagues."
Aneurin Bevan worked with CCube Solutions, based in Milton Keynes, to launch an electronic document and records management system in 2013. The new growth charts app, which went live in October 2014 after a pilot, enables providers to access and edit a patient's growth chart from a PC (a read-only version will be made available for other agencies and family members). Healthcare officials said ease of access is important, as parents often take their children to multiple locations, including doctor's offices, clinics and hospitals.
The application includes charts for children in three age ranges (0-2, 0-4 and 0-18 years) as well as one for children with Down Syndrome, who have a different growth trajectory. Data on each child can be compared against national data from the Medical Research Council, and providers can create a target height range for each child by inputting parental data.
"The electronic system has great potential," Morgan said in the release. "If this project were to be extended to a regional or national level, we would have access to clinical information for massive cohort of the pediatric population, which would be very exciting for future child health monitoring studies."
"(B)uilding a reference set of data nationally which documents child growth in Wales and beyond would provide clinicians, health officials, politicians and, of course, the public with broad insight into the health and development of children, especially in terms of obesity," he added. "Put another way, this project could evolve into a massive Big Data public health opportunity of national importance."
Officials said the system is being enhanced to allow providers to link to other parts of the medical record, and to receive alerts if data entered into the chart falls outside expected parameters. Future iterations would also allow providers to view and amend the record from tablets and smartphones.
"The effective management of children's growth charts is an absolute requirement for every NHS organization, introducing electronic medical records systems," Vijay Magon, CCube's managing director, said in the press release. "The (UK's National Health System) is often much maligned for how IT projects are procured and delivered. In contrast, we have worked hard together to develop and implement a cost-effective, easy-to-use system which has the support of clinicians, such that the introduction of an electronic growth chart has totally replaced paper within the organization."