Exceptional Experiences at Community Health Network

One component that is frequently missed or downplayed in other personal health records (PHRs) is the patient education aspect.   I read some articles that state that this is one necessary component of a personal health record.  About 75% of online users search for health information on the Internet according to the Pew Internet Group and this statistic has held true for a several years now.

Community Health Network’s PHR is tightly integrated with the consumer health library and has been since it was designed and built two years ago.  A patient can add a record to their PHR and become better informed about their health at the same time.  And when a patient uses their personal health record eCommunity.com recommends other health content related to what the patient entered into their PHR.

Transactions are important on a health care website but also, just as important is patient education.  Most health care providers realize this but we have not only bought the obligatory consumer health information library, we have embraced it and used it for other applications on the website like the PHR.

AAP Issues New Guidelines on Cholesterol Screening (Significant Revision)

Below is a policy on a clinical report appearing in the July issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP).

The American Academy of Pediatrics has issued new cholesterol screening and treatment recommendations for children. The policy statement, “Lipid Screening and Cardiovascular Health in Childhood,” recommends cholesterol screening of children and adolescents with a family history of high cholesterol or heart disease. It also recommends screening patients whose family history is unknown or those who have other factors for heart disease including obesity, high blood pressure or diabetes. Screening should take place after age two, but no later than age 10.  The best method for testing is a fasting lipid profile. If a child has values within the normal range, testing should be repeated in three to five years. For children who are more than eight years old and who have high LDL concentrations, cholesterol-reducing medications should be considered. Younger patients with elevated cholesterol readings should focus on weight reduction and increased activity while receiving nutritional counseling. The statement also recommends the use of reduced-fat dairy products, such as two percent milk, for children as young as one year of age for whom overweight or obesity is a concern.

Vitamin D Deficiency in Young Children

Suboptimal vitamin D levels are common in healthy infants and toddlers.
From: Arch Pediatr Adolesc Med. 2008;162(6):505-512.

Recent research suggests that vitamin D deficiency is more common than we once thought. To examine vitamin D status in young children, Boston investigators determined vitamin D levels (25-hydroxyvitamin D) in 247 infants (age, birth to 1 year) and 133 toddlers (age, 1–2 years) during routine visits at an urban primary care clinic.

The prevalence of vitamin D deficiency (<20 ng/mL) was 12%, and 40% of children had suboptimal vitamin D levels (<30 ng/mL). Prevalences were similar in infants and toddlers. Among children with vitamin D deficiency, wrist and knee radiography revealed that 8% had rachitic changes, and 33% had evidence of demineralization. The only factors independently associated with vitamin D deficiency were breast-feeding without supplementation in infants and low milk intake in toddlers.

Comment: As noted by an editorialist, the level of vitamin D that truly represents deficiency in asymptomatic children is uncertain. However, because demineralization of bone during childhood can have lifelong consequences, ensuring adequate intake of vitamin D is important. The American Academy of Pediatrics recommends 200 IU of supplemental vitamin D for all breast-fed infants, unless they are receiving 500 mL daily of vitamin D–fortified formula or milk. They also recommend that toddlers consume 500 mg of calcium in their diet daily to assure adequate stores.