Pediatric Health Information Technology in the American Academy of Pediatrics Christoph Lehmann, MD, FAAP HL7 Child Health Meeting, Orlando May 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 Academys 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 Special Children have different needs Immunization management Weight-based dosing Guardianship considerations Variability 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

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

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 - Standards HIT Standards Committee - standards_committee/1271 Health Level Seven International (HL7) - Health Information Exchanges (HIE) and Regional Extension Centers (REC) CHIC Website: State Pages - Regional Extension Centers - home/17174 Continued Education COCIT Educational Programs - Toolkit Topics and Links