Pediatric Health Information Technology in the American

Academy of PediatricsChristoph Lehmann, MD, FAAP

HL7 Child Health Meeting, OrlandoMay 16, 2011

Council on Clinical Information Technology (COCIT)

Comprised of 500 members with special interest and training in applying HIT to pediatrics

11-member executive committee

Instrumental in the development of the Academy’s Child Health Informatics Center (CHIC) and remains in close collaboration

Child Health Informatics Center (CHIC)

Authorized by AAP Board in October 2009

Serves as the AAP “home” for HIT initiatives

Directed by Christoph U. Lehmann, MD, FAAP (founding Medical Director)

Governed by an 7-person Project Advisory Committee (Chaired by Stephen Downs, MD MS FAAP)

HIT Mission and Goals Provide strategic direction/leadership for the promotion of

affordable, child-friendly HIT and HIE solutions

Increase awareness of HIT as it relates to improved quality and efficiency of pediatric care

Advocate for pediatricians’ HIT needs

Provide resources and education about EHR adoption/implementation

Support the translation and spread of knowledge for integration into electronic format

HIT & Pediatrics

Approximately 25% of pediatricians report using an EHR system, compared to 43% of adult providers

Systems often designed for adult care

Systems are expensive

Systems lack the functionality necessary to support pediatric care

Pediatric health system is not optimizing long-term health and financial returns on investments HIT

Pediatrics is SpecialChildren have different needs

Immunization management Weight-based dosing

Guardianship considerationsVariability in care location and setting Specific functionality is more important in pediatrics

Age Identification Guardianship Privacy

Meaningful Use and Meaningful Use

ARRA Legislation & Meaningful Use

Approximately 59% of pediatricians will not quality for Meaningful Use Incentives

Regardless of incentives, the Meaningful Use of HIT has implications for long term improvements in efficiency, quality, safety and cost savings to pediatric practice

AAP has tools to help pediatricians with TRUE meaningful use

Meaningful Use Tools

Child Health Informatics Center Website and Resource Library

Electronic Health Record Evaluation Site

Immunization Information Systems Toolkit

Child Health Informatics Advocacy Toolkit

Child Health Informatics Center Website & Resource Library

www.aap.org/CHIC

Electronic Health Record Evaluation Site

Offers the ability to research various EMR products with pediatrician reviews

Currently the site hosts 150 reviews on 31 different products

Buddy List feature = links pediatricians with peers to assist with EHR implementation

www.aapcocit.org/emr/

Immunization Information Systems (IIS) Toolkit

IIS are known as Immunization Registries

Legal statutes/regulation and funding usually at the state level.

Standards are available for exchanging data between IIS and EHRs; not all IIS use the standards

IIS Toolkit is for AAP chapters and other local advocates with a resource for discussions with IIS administrators and public health agencies

Child Health Informatics Advocacy Brief

Conveys the state and federal advocacy message around child health informatics

Includes background information and a menu of talking points to pull the most appropriate ideas depending on audience

Model EHR Format for Children AHRQ Grant Development of a Model EHR Format

$4.7M – 2 year project (Limited eligible bidders) AAP Subcontract from Westat

• Technical Expert Panel • Environmental scan - content experts• In-depth Interviews• Development and review of model EHR format

requirements• Dissemination of Model EHR Format

Electronic Translation of Academy Clinical Content (eTACC)

Develop a mechanism and process to translate key Academy clinical content into formats suitable for use within electronic systems Review of content and extraction of actionable guidelines (e.g.

assessment, screening, referrals, counseling, etc)

Ranking of critical clinical and psychosocial areas traditionally addressed in an office visit for format development

Translation and development of toolkit

Prioritizing of actionable items

Testing and integration feasibility

EHR Vendor Consortium – June 2011 Investigate ways to partner with the vendor

community Distribute AAP knowledge and expertise in an

electronic format that can be linked to, or embedded within, electronic health records

• Bright Futures (Guidelines, Toolkit)

• Clinical Practice Guidelines/Policy statements

• Safe & Healthy Beginnings

• Toolkits (Autism, ADHD, etc)

• Patient Education Online

AAP REC Meeting

AAP Regional Extension Center Meeting 2 day meeting to:

• Provide pediatric specific education to RECs

• Connect AAP members with REC resources

• Explore local collaboration between pediatric experts and RECs

ONC Knowledge Self Assessment

American Board of Pediatrics Grant Encourage and facilitate continuous professional

development Round 1 – Value of HIT in care Round 2 – Safety and HIT AMIA provided literature review Multi-specialty writing group CHIC Director chairs Item Writing Committee

ARRA | Meaningful Use CHIC Website: Meaningful Use Overview -

www.aap.org/informatics/AAPOverview.html

Standards HIT Standards Committee -

http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__health_it_standards_committee/1271

Health Level Seven International (HL7) - http://www.hl7.org/

Health Information Exchanges (HIE) and Regional Extension Centers (REC) CHIC Website: State Pages - www.aap.org/informatics/StateResource.html Regional Extension Centers -

http://healthit.hhs.gov/portal/server.pt/community/hit_extension_program/1495/home/17174

Continued Education COCIT Educational Programs -

www.aap.org/informatics/COCITEducationalPrograms.html

Toolkit Topics and Links