AAP Child Health Informatics Center presentation to the

AAP Child Health Informatics Center presentation to the PCPCC Center for e. Health Information, Adoption, & Exchange Jonathan D. Klein, MD, MPH Associate Executive DIrector December 2009

o The American Academy of Pediatrics (AAP) is an organization of 60, 000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists. o Our mission is to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults.

HIT at the AAP

Child Health Informatics Center o o Authorized by AAP Board in October 2009 Advisory Committee, Investigators - in formation n o Steve Downs, MD, FAAP Indianapolis, IN Bill Adams, MD, MPH, FAAP Boston Medical Center Chris Lehmann, MD, FAAP Johns Hopkins University Will serve as “home” for health information technology initiatives within the AAP

AAP CHIC Health Informatics Activities o Council on Clinical Information Technology o Policy, Advocacy, Education, Research o Partnership for Policy Implementation o Collaborative Activities o Research o Integration with AAP Quality Activities

AAP Council on Clinical Information Technology (COCIT) o 600 members with special interest or training in applying IT to pediatric practice o 11 -member Executive Committee o AAP Policy development o Web and educational resources

COCIT Goal - Support pediatric HIT and HIE in actual practice, addressing AAP priorities o Electronic health passport test cases for foster care o Interaction between EHRs and immunization registries o Adolescent confidentiality / privacy o Education of pediatricians n n n Pediatric Office of the Future Pediatric Documentation Challenge Council Program with Scientific Abstracts Technology Learning Center EHR Review Website and EHR Selection Toolkit

Policy and Advocacy n PCPCC o o n American Recovery & Reinvestment Act of 2009 o o n Center for e. Health Information, Exchange, & Adoption Meaningful Use; Clinical Decision Support Task Groups Health Information Technology Extension Program HIT Policy and Standards Committees CHIP Reauthorization Act (CHIPRA) o o o Model electronic health record format for children CMS Demonstration grants Agency for Healthcare Research & Quality task order

Education o National conference and workshop sessions o EMR Review Web site (http: //www. aapcocit. org/emr) o EMR Toolkit (http: //practice. aap. org, under Practice Toolbox)

Research Periodic Survey: Pediatricians Use of EHRs Basic – 19% (ALL 7 items) Fully functional – 6% (Basic + 11 additional functions = ALL 18 items) Patient demographics Highlights out-of-range lab results Patient problem lists Clinical notes include medical history, followup notes Orders for prescriptions Orders for laboratory tests Ability to view lab results Lab orders sent electronically Ability to view imaging results Warnings of drug interactions, contraindications Patient medication lists Prescriptions sent to pharmacies Clinical notes Orders for radiology tests Radiology orders sent electronically Electronic images returned Guideline reminders (preventive) Guideline reminders (chronic)

AAP Partnership for Policy Implementation (PPI) o o To integrate HIT functionality into Academy policy development and implementation 11 pediatrician/informaticians Practicing pediatricians with QI expertise Translate and implement policies n n Bright Futures Developmental Screening in the Medical Home Bronchiolitis; Influenza; Autism

Collaborative Efforts o Alliance for Pediatric Quality (APQ) n American Academy of Pediatrics (AAP) n Child Health Corporation of America (CHCA) n National Association of Children’s Hospitals and Related Institutions (NACHRI) n American Board of Pediatrics (ABP)

APQ Collaborative Efforts o HL 7 Child Health Work Group n n n o CCHIT n n o Child Health Profile as ANSI Standard Quality Reporting Document Architecture (currently is a draft standard for trial use) Working on Neonatal Care Report Participation in Child Health and other work groups Child Health add-on certification requirements based on HL 7 Child Health profile and AAP report on Special Requirements for Pediatric EHRs HL 7/CCHIT gap analysis underway between existing and needed requirements.

For more information about the AAP Center for Child Health Informatics, please contact: Jennifer Mansour jmansour@aap. org 847. 434. 4229 Manager, Health Information Technology Initiatives Beki Marshall bmarshall@aap. org 847. 434. 4089 Manager, HIT Education and Implementation Jonathan D. Klein, MD, MPH jklein@aap. org 847. 434. 4322 Associate Executive Director