Objective: Electronic health records (EHRs) have increasingly become integral to contemporary medical consultations, including pediatric care. This study aims at exploring the interactional use of the EHR during naturally occurring pediatric well-child visits, focusing specifically on how pediatricians and parents manage knowledge concerning infants' growth inscribed in the EHR.
Methods: Conversation analysis is used to analyze 23 video-recorded Italian well-child visits involving two pediatricians and twenty-two families with children aged 0-18 months.
Results: The analysis focuses on the delicate activity of assessing infants' growth, a widespread parental concern. It illustrates how a no-problem assessment is collaboratively achieved through the interactional mobilization of the EHR. While parents draw upon their experiential knowledge to assess their child's "normality" (or not), pediatricians resort to expert knowledge inscribed in the EHR (e.g., growth percentiles and growth charts), thereby making the EHR a locally and institutionally relevant agent in the interaction.
Conclusion: A hierarchy of types and sources of knowledge is presupposed and ratified by both parents and pediatricians in these visits. Expert information inscribed in the EHR is collaboratively built as the most authoritative voice to the detriment of parent-reported experiential knowledge.
Practice Implications: While acknowledging potential risks, leveraging the EHR can be a valuable interactional and epistemic resource for healthcare professionals working in pediatric care to a) soothe parental concerns regarding infants' development, and b) offer evidential support for their evaluations, thereby displaying professional accountability.
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http://dx.doi.org/10.1016/j.pec.2025.108664 | DOI Listing |
Patient Educ Couns
January 2025
Department of Education Studies, University of Bologna, Via Filippo Re 6, Bologna, 40126, Italy. Electronic address:
Objective: Electronic health records (EHRs) have increasingly become integral to contemporary medical consultations, including pediatric care. This study aims at exploring the interactional use of the EHR during naturally occurring pediatric well-child visits, focusing specifically on how pediatricians and parents manage knowledge concerning infants' growth inscribed in the EHR.
Methods: Conversation analysis is used to analyze 23 video-recorded Italian well-child visits involving two pediatricians and twenty-two families with children aged 0-18 months.
J Dev Behav Pediatr
January 2025
Juniper Gardens Children's Project, University of Kansas, Lawrence, KS; and.
Objective: To report on the feasibility and outcomes of universal language promotion intervention (Talk With Me Baby [TWMB]) embedded within routine well-child care for children from birth to 3-years old.
Methods: Across 2 primary care clinics, 29 health care team members participated in a 12-month trial to deliver TWMB within well-child care visits. Feasibility was based on clinician feedback during the trial, clinician knowledge assessments, and clinic data.
BMC Prim Care
January 2025
Department of Family Medicine, School of Medicine, Queen's University, Kingston, ON, Canada.
Background: For children under age six, regular preventative primary care is needed for administration of vaccinations, surveillance of development, and early diagnosis and intervention for any potential health conditions or developmental delays. The COVID-19 pandemic created many barriers to providing and accessing primary care. While many studies have explored these barriers, it is important to understand how primary care adapted to ensure these crucial early-years appointments were not missed throughout the pandemic.
View Article and Find Full Text PDFPediatrics
January 2025
Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Background And Objectives: Human papillomavirus (HPV) vaccination rates are suboptimal, and missed vaccination opportunities are common. We hypothesized that a bundled intervention improves missed HPV vaccination opportunities.
Methods: We used a pre-post design to assess differences in HPV vaccine missed opportunities (visits when vaccine-eligible adolescents are not vaccinated).
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