The CHIPRA Pediatric Quality Measures Program: Health Information Technology and Patient Safety...
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Transcript of The CHIPRA Pediatric Quality Measures Program: Health Information Technology and Patient Safety...
The CHIPRA Pediatric Quality Measures Program:
Health Information Technology andPatient Safety
Edwin Lomotan, MD, FAAPOffice of Extramural Research, Education, and
Priority PopulationsAHRQ Annual Conference
September 10, 2012
Learning Objectives
Identify the patient safety measures being developed by the Centers of Excellence
Describe challenges to developing pediatric quality measures designed for implementation within electronic health records
CHIPRA
Children’s Health Insurance Program Reauthorization Act of 2009
Title IV – Strengthening Quality of Care and Health Outcomes– Section 401 (a) – Development of Child Health
Quality Measures for Children Enrolled in Medicaid or CHIP Initial core set of measures
– Section 401 (b) – Advancing and Improving Pediatric Quality Measures Creation of the Pediatric Quality Measures Program
CHIPRA – Initial Core Set
Identified by AHRQ National Advisory Council Subcommittee on Children's Healthcare Quality Measures for Medicaid and CHIP
Required consideration of existing measures
24 recommended measures covering a wide range of topics and ages
Released December 2009
Initial Core Set: Summary
Prevention and health promotion– Prenatal/perinatal (4)– Immunizations (2)– Screening (3)– Well child care visits (3)– Dental (1)
Management of acute conditions– Appropriate use of
antibiotics (2)– Dental (1)– Emergency department (1)– Inpatient safety (1):
CLABSI rates in PICU and NICU
Management of chronic conditions– Asthma (1)– ADHD (1)– Mental health (1)– Diabetes (1)
Family experiences of care– CAHPS , child version (1)
Availability– Children and adolescent
access to PCPs (1)
Pediatric Quality Measures Program (PQMP)
Purpose– To identify new recommended core sets annually
beginning January 1, 2013– To fill gaps left by the initial core set
Core measure requirements– Full range of services, conditions, and ages– Enable assessment of health care disparities– Leverage health IT and collected in a standard
format– For broad public and private use– Publicly-informed process
PQMP – Components
7 Centers of Excellence– Cooperative agreement grants (U18)– Each is a consortium of academic institutions,
State partners, consumers, and others 2 CMS Quality Demonstration Grantee States (IL, MA) Coordinating and Technical Assistance Center
contract (RTI) AHRQ-CMS collaboration Public input 4 year program beginning March 2011
Getting to Improved Core Sets
Assess measures
(Summer – Fall)
Recommend measures (Winter)
Receive measures (Spring)
Centers of Excellence submissions
Improved core set (annually on January 1st)
Subcommittee to AHRQ’s National Advisory Council (SNAC)
Patient Safety Measure Assignments
Global patient safety tool Imaging for seizures and headache Medication reconciliation Psychotropic medication use Alcohol and substance use screening,
diagnosis, treatment, and follow up Temperature on admission to NICU Pediatric Intensive Care
Health IT: CHIPRA and Meaningful Use
5 measures appear in both Meaningful Use and in the CHIPRA initial core set– Weight assessment/counseling for children
and adolescents– Childhood immunization status– Chlamydia screening for women– Appropriate testing for children with
pharyngitis– Follow-up care for children prescribed
ADHD medication
PQMP Informatics
Presentation by NQF on the Quality Data Model at kick-off meeting
Informatics Workgroup– Co-chaired by Marjorie Rallins (AMA-PCPI)
and Aldo Tinoco (NCQA) Working with ONC and CMS
– Measures for potential use in future stages of Meaningful use
Moving the PQMP and Health IT Forward
Sample challenges– Re-tooling vs. developing de novo measures– Applying standards vs. conventions– Testing for validity and feasibility– Realizing that e-measurement depends heavily on
local implementation – Getting to common value sets– Building an evidence base and eventually a set of
best practices– Staying focused on kids
Resources
AHRQ CHIPRA– http://www.ahrq.gov/chipra/
CHIPRA Initial Core Set and Centers of Excellence Measure assignments– http://www.ahrq.gov/chipra/pqmpmeasures.htm
CMS CHIPRA– http://www.medicaid.gov/Medicaid-CHIP-Program-Informatio
n/By-Topics/Childrens-Health-Insurance-Program-CHIP/CHIPRA.html
– http://www.insurekidsnow.gov/
Model children’s EHR format– http://www.ahrq.gov/chipra/ehrformatfaq.htm
Questions?– [email protected]
2012 SNAC Meeting– Wednesday, September 12, 2012– Bethesda Marriott Hotel, 5151 Pooks Hill
Road, Bethesda, Maryland 20814– Begins at 7:45 am