HL7 Child Health Work Group May 15-17, 2011 HL7 Work Group Meeting Lake Buena Vista, FL

| HL7 Child Health Work Group | February 22, 2011 HL7 Child Health Work Group Who We Are What We Do and Why Whats Next Agenda

| HL7 Child Health Work Group | February 22, 2011 Who We Are HL7 Child Health Work Group Founded: 2003 Leadership: David Classen, MD, Gaye Giannone Dolin, RN, Andy Spooner, MD and Feliciano Yu, MD Participation: Primarily CMIOs, physicians, medical informatics experts and vendor representatives Distribution: 100+ previously on ; listserv unknown Operations: One in person meeting and two webcast meetings in conjunction with HL7 work group meetings; Monthly calls and other calls and webcasts as needed

| HL7 Child Health Work Group | February 22, 2011 What We Do Functional Data Standards Standards for EHR systems include critical child health functions Published EHR system standards for general pediatrics Work was baseline for CCHIT child health certification criteria, other Terminology Data Standards Explored improving terminology systems for pediatrics using AAP policy statements (e.g. SNOMED) Funding not available to support further work Messaging Data Standards Created immunization activity diagrams and story boards – now part of HL7 messaging standards Provided incubation and leadership in HL7 to develop standard for reporting quality measure data – Quality Reporting Document Architecture using HL7 CDA Provided support to create standards-based neonatal care report using HL7 CDA

| HL7 Child Health Work Group | February 22, 2011 Why Improve data standards for health care Build pediatric consensus on new data standards Maintain broad representation and participation in HL7 initiatives on behalf of child health care Participate in relevant national HIT data standards public comment periods on behalf of child health care Influence adoption of pediatric requirements Impact vendor and provider awareness and adoption of adoption of pediatric standards Earn commitment from pediatric stakeholders Secure support and leadership for efforts

| HL7 Child Health Work Group | February 22, 2011 Whats Next EHR Functional Model Release 2 Neonatology Functional Profile for EHR Systems Child Health Functional Profile Release 2

| HL7 Child Health Work Group | February 22, 2011 Functional Standards: Relationships of Artifacts

| HL7 Child Health Work Group | February 22, 2011 Manage Immunization Administration Statement: Capture and maintain discrete data concerning immunizations given to a patient including date administered, type, manufacturer, lot number, and any allergic or adverse reactions. Facilitate the interaction with an immunization registry to allow maintenance of a patients immunization history. Description: During an encounter, recommendations based on accepted immunization schedules are presented to the provider. Allergen and adverse reaction histories are checked prior to giving the immunization. If an immunization is administered, discrete data elements associated with the immunization including date, type, manufacturer and lot number are recorded. Any new adverse or allergic reactions are noted. If required, a report is made to the public health immunization registry. 1. The system SHALL provide the ability to recommend required immunizations, and when they are due, during an encounter based on widely accepted immunization schedules. 2. The system SHALL provide the ability to recommend required immunizations based on patient risk factors. 3. The system SHALL perform checking for potential adverse or allergic reactions for all immunizations when they are about to be given. 4. The system SHALL provide the ability to capture immunization administration details, including date, type, lot number and manufacturer. 5. The system SHALL provide the ability to capture other clinical data pertinent to the immunization administration (e.g. vital signs, adverse reactions). 6. The system SHALL record as discrete data elements data associated with any immunization. 7. The system SHOULD provide the ability to associate standard codes with discrete data elements associated with an immunization. 8. The system SHALL provide the ability to update the immunization schedule. Function: Manage Immunization Administration Capture and maintain discrete data concerning immunizations… Edits in RED for CH Profile Criteria requested by Child Health for original model now standard Example Edits and Additions to EHR FM

| HL7 Child Health Work Group | February 22, 2011 Connect With Us for Child Health Listserv Monthly Conference Calls

| HL7 Child Health Work Group | February 22, 2011 Contact Information Joy Kuhl Principal Optimal Accords, LLC Offiice: (818) Mobile: (818) Administrative Co Chair, HL7 Child Health Work Group On behalf of Alliance for Pediatric Quality AAP, ABP, CHCA & NACHRI

DISCUSSION, NEXT STEPS

| HL7 Child Health Work Group | February 22, 2011 Alliance for Pediatric Quality Common goals: HIT works for children

| HL7 Child Health Work Group | February 22, 2011 Alliance Strategy Work for consensus and speak with one voice for pediatric quality and health information technology. Endorse and promote projects that advance our objectives for quality and health information technology in childrens health care. Convene stakeholders in childrens health care on key quality and health information technology issues. Advocate for policy, standards, systems, and products that will improve the quality of childrens health care.

| HL7 Child Health Work Group | February 22, 2011 Why is this important? Numerous Initiatives Underway to Support National Goals for Adoption and Interoperability of EHR technology Problem: Children are nearly one third of the population. They receive care through HIT in a variety of settings. National efforts are largely adult-focused; Pediatric efforts for influence are sometimes isolated and duplicative. Opportunity: Work together as pediatric HIT community with one strong voice to influence national initiatives and ensure needs of child healthcare are addressed.

| HL7 Child Health Work Group | February 22, 2011 Set National Agenda IFR Adopt Standards and other Requirements for Meaningful Use Health Information Technology vendors Child health practitioners, clinicians and hospitals Reduce system implementation costs due to duplication and customization Enable pediatric performance measurement by improving interchange of standardized information Support safe care for children HHS: Coordinator Develop and Pilot Standards HL7, SNOMED… NHINS, Projects, Collaboratives Integrating the Healthcare Enterprise NQF, CMS Vendor Consortia Certify Products ATCB Harmonize ONC, other tbd Identify and Respond to Opportunities Participants in Pediatric Healthcare Information Technology Community Identify Requirements HIMSS Pediatric Group Health Level Seven (HL7) Child Health Work Group AAP Child Health Informatics Center and COCIT NACHRI Pediatric Advisory Council CHCA CIO and CMIO Forums and Special Projects Support achievement of meaningful use of EHR technology in pediatrics Strategy for Influence Desired Outcomes Alliance for Pediatric Quality Support work, convene, build consensus, endorse and advocate

| HL7 Child Health Work Group | February 22, 2011 AAP HL7 Child Health HL7CCHIT Published EMR Position Papers Developed Pediatric EMR Functions Published Pediatric EMR Functional Model Standard Influenced EMR Vendor Certification Criteria Alliance Coordination, Support and Endorsement Vendor Compliance & Certification; Provider Adoption An Example