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Pediatric ophthalmologists are being encouraged to adopt electronic medical recrods (EMR or EHR) in the interest of perceived efficiencies and patient care. The components of the strabismus and pediatric eye record make it the most complex of all ophthalmic subspecialties, and perhaps of all medicine. The paucity of programming expertise, energy and economic investment places the pediatric eye specialist at a disadvanatage and poses yet another disincentive for ophthalmology residents to choose a career in pediatric eye.

A minority of commercially available EMR software provide specialized templates for the pediatric eye and strabismus exams. Inefficient templates, or complete lack of specialized input can render the medical record processing two or three times slower than paper charting. One alternative is a hybrid of paper charting, and electronic storage and retrieval of the scanned images. An example, designed by Pediatric Ophthalmologist Mark Steele is SRS. An excellent "home-built" custom pediatric /strabismus EMR has been designed by another pediatric ophthalmologist, David Robins- however it is not yet commercially available (yet).

Many commercial EMRs have failed to format data correctly- they substituted "alpha" characters for digital variables- so follow up analysis and research cannot be done efficiently/quickly. ABCD has offered a solution proposing DIGITAL Values for ALPHA Acuities.

Federal stimulus dollars*, and regulations, may push pediatric ophthalmologist into adopting, for being forced into transitioning into electronic records long before they evolve into efficient tools. Premature mandates have the potential to compromise safety and efficiency for America's children.

*(Bribing doctors to purchase EMRs they might not have clinically preferred - but needed to qualify for kick-backs such that their EMR sends confidential patient data to the government potentially against patient wishes)

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Digital-Alpha Acuity