Update on well-baby and well-child care from 0 to 5 years

We encourage the incorporation of the Rourke Baby Record (RBR) into electronic medical records (EMRs) used in Canada. There is now a licensing agreement for EMR firms wanting to incorporate the RBR into their EMR. The agreement expresses the intent that we all share: that of making the Rourke Baby Record freely and widely available for physicians and other health care providers in a format for electronic medical records that can take into consideration the information management capability of the EMR. If your EMR firm has not yet signed the license agreement, please encourage them to contact the authors at lrourke@mun.ca. Respectfully submitted, Leslie Rourke, MD, FCFP

I have used the RBR for years and my office now uses an emr. However, thus far the RBR is not incorporated into the emr, making it cumbersome to use as the RBR must be printed, completed by hand, then scanned back into the emr. I understand that outside of Ontario there are some proprietary issues pending, in order to be able to integrate the RBR into (other) proprietary emr's. I sincerely hope this can be resolved soon to facilitate best care for children regardless of what part of the country I live or which emr I choose to use!

Thank you for the updated article. I was pleased to see that the Rotavirus vaccine was mentioned in plans for the next RBR version. I think its abscence thus far from the RBR has played a part in the low rotavirus vaccine rates. It is important to remind physicians to remind parents of this important vaccine that is not on our typical vaccine schedules. It is a shame that this vaccine is not yet publicly funded, as there is good evidence for its effectiveness in preventing illness.

The reader makes a good point that adding one sample of the Rourke Baby Record (RBR) for a well baby visit would help to demonstrate it in the clinical setting. Indeed the original article introducing the RBR included two cases showing the use of the RBR forms (Rourke J, Rourke L. Well Baby Visits: Screening and Health Promotion. Can Fam Phys 1985;31:997-1002.). Given today’s journal space constraints and also the availability of web resources, this was not an option for the current article. The RBR website (www.rourkebabyrecord.ca) incorporates a “Walk through the RBR” section showing the guides and demonstrating background information and resources.

We agree with the reader that the RBR is not meant for the ER setting. The Current Evidence section of the RBR website, however, can assist with anticipatory guidance on paediatric healthcare issues such as injury prevention that are appropriately discussed in the ER setting. Respectfully submitted, Leslie Rourke, MD, FCFP