1. Alliance for Pediatric Quality An Overview August 28, 2006

2. 2 A collaboration of four major national pediatric organizations formed to measurably improve the quality of health care for America’s children. What is the Alliance? Hospital Community Physician Community Joining to Improve Pediatric Quality

3. 3 Every child will have the opportunity to grow up healthy, supported by a health care system where care is safe, effective, patient-centered, timely, efficient, equitable and based on the best possible science and technology. Vision

4. 4 1. Promote the use of meaningful pediatric measures industry wide. The Alliance will accelerate the identification and use of measures by the pediatric community that will best drive change and improvement in the quality of health care for children. It will also define those measures that should emerge as measures of accountability for pediatrics. 2. Make sure health information technology works for kids. The Alliance will bring together multiple technology organizations and individuals to create one pathway for ensuring the adoption of pediatric data standards that work across all care settings. Goals

5. 5 Strategies Work for consensus – speak with one voice on behalf of children Endorse and promote projects that advance pediatric quality and health information technology in children’s health care Convene stakeholders Advocate in media and legislature

6. 6 Strong Foundation Alliance for Pediatric Quality Formed Developed first set of core measures Special Interest Group for pediatric data Standards approved by HL-7 CHCA, NACHRI, MMP work w/ JCAHO on pediatric measures Pedi-QS asthma core measure set to JCAHO NQF endorses asthma measure set AMA (CQI) Consortium releases acute gastroenteritis, asthma measures 2000 2001 2002 200320042005 20061990s 2000 2001 2002 200320042005 2006 1990s Convened to discuss data standards AAP releases evidence-based clinical guidelines (eQUIPP) AAP starts COCIT First electronic medical records requirements for pediatrics AAP EMR specs updated w/ HL7 Sig. input HL7 Sig. releases pediatric specs for EMR

7. 7 Asthma measure set endorsed by NQF Current work includes: - Additional asthma measures - Neonatal care - Nursing sensitive measures - Pediatric intensive care - Surgical infection prevention identification and use - Analyze national priorities for future measure development - Develop new performance measure sets using Pedi-QS Accomplishments to Date Pedi-QS Workgroup Drives Inpatient Measures Pedi-QS methodology recognized by industry

8. 8 Accomplishments to Date AAP evidence-based clinical guidelines – ripe for measure development AMA Consortium for Physician Performance Improvement (pediatric gastroenteritis and asthma measures) Active pediatric representation at AQA, NQF, NCQA and private payor panels Ambulatory Pediatric CAHPS survey Miller et al study (2005) – Build upon findings of existing/needed quality measures Physician Community Drives Ambulatory Measures

9. 9 Developed pediatric requirements for EHR specifications Developed information flow charts for pediatric immunization; vendor adoption in process Submitted to CCHIT inpatient EHR functionality requirements on behalf of Alliance HL7 Pediatric Profile creation underway Accomplishments to Date Role of Special Interest Group 58 organizations, including AAP, CHCA and NACHRI and vendors  Identify critical pediatric-specific data standards for quality and outcomes measurement reporting  Create nomenclature lexicon and required terminology  Seek approval of HL7 for pediatric recommendations HL7 Special Interest Group Drives Pediatric Data Standards HL7 Pediatric Data Standards Special Interest Group (HL7 PeDSSIG)

10. 10 Council on Clinical Information Technology (COCIT)  Representatives at CCHIT, ANSI HITSP, ASTM Committee E31 (CCR)  EHR policy statement published  Inpatient HIT systems policy underway  Strong vendor participation in Pediatric Documentation Challenge TM  Active EMR review web site Accomplishments to Date Sample Ongoing AAP HIT Efforts  Develops and publishes policy documents on pediatric health IT  National advocacy/involvement  Health IT education  Physicians Electronic Health Record Commission (PEHRC)  Evaluation of pediatric electronic medical record vendors at TEPR

11. 11 NHIN How We Work Together American Health Information Community COCITHL7 CHOBIndiana COCITHL7 Federally chartered commission makes recommendations to HHS HISPC Addresses business policy and state law affecting privacy and security Certification commission uses HL7 standards as baseline for health IT vendor certification Standards panel harmonizing standards for health IT vendors Conducts pilots with hospitals to build interoperability Pay for Performance CCHIT HITSP

12. 12 National advocacy/involvement with national health IT organizations on behalf of pediatrics Develop and publish policy documents on pediatric health information IT issues Educate stakeholders, disseminate, and implement communication approaches for pediatric IT standards Educate public about vendor pediatric capabilities (e.g. through Documentation Challenge™ and EMR review web site) Identify critical pediatric-specific data standards for quality and outcomes measurement reporting Develop, propose, and get approval for standards in HL7 Coordinate with other groups interested in using pediatric data standards, including vendors Identify required terminology; Create nomenclature lexicon AAP Council on Clinical Information Technology (COCIT) HL7 Pediatric Data Standards Special Interest Group (PeDSSIG) National Policy Makers Health Information Technology Vendors Pediatric Care Providers APQ Technology Workgroup Provide input into areas of focus; Support through education, advocacy, policy creation Provide pediatric HL7 standards; Identify current standards that apply to focus areas How We Could Work Together

13. 13 APQ Information Technology Workgroup A group of technical experts in the pediatric community who identifies and coordinates opportunities for unified action through the Alliance - providing strength to current pediatric healthcare IT activities through consensus building, advocacy and endorsement Immediate APQ Activities 1.Host regular workgroup calls to review activities underway and to identify opportunities for unified action 2.Coordinate response to HITSP interoperability specifications 3.Support representative to HL7 EHR TC 4.Support other representatives to national initiatives 5.Upon completion, endorse HL7 PeDSSIG pediatric profile and assistance with market communication and education 6.Joint response to CCHIT re. inclusion of growth charts A Proactive, Unified Approach

14. 14 Organizational Structure Founders/CEOs Executive Committee /VPs Executive Director Admin support Consultants Pedi-QS Workgroup Information Technology Workgroup Day-to-day activity Ex Officio Executive Committee Manage work groups, consultants Front-line liaison to stakeholders Informal coalition Shared decision-making In-kind resources

15. 15 Year One Focus Evaluate and prioritize measures and move them very quickly to the public domain for use in improvement and accountability  Endorse a common set of measures  Evaluate and accelerate pay for performance strategies for pediatrics  Determine opportunities for sharing data Concurrently our four organizations are exploring a data sharing initiative; work is independent of the Alliance at this time Seek industry-wide adoption of data standards for pediatrics  CCHIT integration of HL7 standards  Endorse pediatric data standards (as supplied by the Special Interest Group)  Support Special Interest Group efforts in embedding pediatric-specific EHR requirements in vendor systems

16. 16 Initial Measures of Success The Alliance will conduct an annual evaluation of our accomplishments and develop success metrics Some of our success factors follow:  JCAHO and industry will widely use pediatric measures recommended by the Alliance  CCHIT adopts standards recommended by HL7 Special Interest Group  The Alliance will be recognized by national quality organizations as the “go-to” organizations for pediatric quality

17. 17 Support the Alliance When you see opportunities to advance quality or health information technology standards at the national level, please contact: AAP:Ed Zimmerman (847) 434-1917 ABP:Paul Miles (919) 929-0461 CHCA: Donna Payne (913) 262-1436 NACHRI:Mary Gorman (703) 684-1355