Characterizing the Utilization of the Problem List for Pediatric Trauma Care

The EHR problem list has the potential to support care coordination among the multidisciplinary care team that cares for pediatric trauma patients. To realize this potential, the need exists to ensure appropriate utilization by formulating acceptable usage and management policy. In this regard, understanding the prevailing utilization pattern is pivotal. To this end, we analyzed EHR in tandem with trauma registry data at a Level I pediatric trauma center. Almost all (97.8%) of the actions executed on the problem list were addition of items. Among the 517 patient encounters in the cohort, 263 (48.9%) encounters involving sicker patients had at least one problem list item added, mostly within the first 4 hours of arrival, while in the emergency department, and by providers in the service of record. This represents a foundation to build upon. Subsequent research will explore completeness, accuracy, and the impact of the utilization on patient outcomes.