Model Children's EHR Format

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Slide 1

Model Children's Electronic Health Record (EHR) Format

AHRQ 2012 Annual Conference
Session #97: Improving Quality of Care for Children
Bethesda, MD
September 11, 2012

Erin Grace, MHA
Senior Manager, Health IT

Slide 2

Overview

• CHIPRA Legislation.
• Project Team.
• Scope of the Project.
• Progress.
• Next Steps.

Slide 3

Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA)

• Section 401 (f) Development of a Model EHR Format for Children Enrolled in Medicaid or CHIP.
• By 1/1/2010 the Secretary shall establish a program to encourage the development & dissemination of a model EHR Format for children.

Slide 4

By law, the model EHR Format for children must be:

• Accessible to Caregivers for school and leisure compliance (e.g. immunizations).
• Designed to allow interoperable exchanges.
• Compatible with other EHR standards.
• Usable by Caregivers to assure care appropriateness and quality.

Image: A circle divided into four quarters is superimposed over the four items listed above. The four quarters of the circle are captioned "Accessible," "Interoperable," "Compatible," and "Viewable"; each caption is lined up to provide a heading for the corresponding item on the list.

Slide 5

Sponsoring Agencies

Images: The banners from the Agency for Healthcare Research and Quality (AHRQ) and Centers for Medicare & Medicaid Services (CMS) Web sites are shown.

Slide 6

Project Team

Prime Contractor:

Image: The Westat logo is shown.

Subcontractors:

Images: The Web site banners or logos from the American Academy of Pediatrics, American Academy of Family Physicians, Duke Medicine, University of Maryland Robert H. Smith School of Business, Intermountain Healthcare, and Fox Systems are shown.

Slide 7

What is a "Format?"

Requirements for:

• A minimum set of data elements.
• Applicable data standards.
• Usability.
• Functionality.
• Interoperability.

Image: A photograph shows two children carrying bookbags, walking away down the sidewalk with their backs to the camera, holding hands.

Slide 8

Project Purpose

• Existing EHR systems often do not optimally support the provision of health care to children.
• Project components:
  • Identify gaps between existing systems and an optimal EHR for children.
  • Design, develop, test, and disseminate a Format based on those gaps.
  • Assess existing products for conformance with the Format.
  • Demonstrate use of the Format in prototype development.

Slide 9

Model Children's EHR Format and Meaningful Use

• The goal is that the model format will be integrated into the EHR certification requirements for a future stage of Meaningful Use (MU).
  • MU definition in future stages to include additional pediatric-relevant objectives and clinical quality measures.
  • Office of the National Coordinator (ONC) for Health IT EHR certification criteria to follow suit.

Slide 10

Scope of Work

• Focus:
  • Requirements for the unique incremental needs of children.
  • Build on existing foundational work.
  • Suitable for existing and potential systems.
  • Primary care and general inpatient needs.
• Constraints:
  • Schedule for Format development.
  • Not a standards-setting process.

Slide 11

Technical Expert Panel (TEP)

• Provide guidance to project.
• Review key documents and deliverables.
• Provide expertise on issues with EHRs used for children.
• Serve as a resource on specific clinical, technical, and child welfare issues.

Slide 12

TEP Representation

• Physician Informaticians:
  • Children's health focus.
  • More general health focus.
• Non-Physician clinicians.
• Children's advocacy organizations.
• Medicaid.
• Vendor.
• Federal Agencies (ONC, Indian Health Service [IHS]).

Slide 13

Gap Analysis

• Conducted by Intermountain Healthcare.
• Identified key topic areas.
• Drafted initial requirements.

Slide 14

Topics

• Activity Clearance.
• Birth Information.
• Child Abuse Reporting Form.
• Child Welfare.
• Children with Special Health Care Needs.
• Growth data.
• Immunizations.
• Medication Management.
• Newborn Screening.
• Parents, Guardians, and Family Relationship Data.
• Patient (Child) Identifier.
• Patient Portals—Personal Health Record (PHR).
• Prenatal Screening.
• Primary Care.
• Quality Measures.
• Registry Linkages.
• School-based Linkages.
• Security and Confidentiality.
• Special Terminology and Information.
• Specialized Scales and Scoring.
• Well Child and Preventive Care.

Slide 15

Requirements Development Process

For each topic area:

• Review findings from gap analysis.
• Initial requirements for some topics drafted by TEP.
• Additional requirements drafted by subject matter expert (SME).
• Project team review.
• Outside SME and TEP review(s).

Slide 16

Current Work

• Completing conformance testing of select number of existing EHR systems.
• Adding more robust EPSDT requirements language.
• Cleaning up database before broad public release.
• Developing a feedback methodology.
• Targeted Release Fall 2012.

Slide 17

Target Audiences for Format

• CHIPRA Demonstration grantees.
• Developers of existing EHR products.
• New developers.
• System purchasers.
• Certifying bodies.
• Standards groups.
• Regulators.
• Users/developers of "Meaningful Use" criteria.

Slide 18

Contact Information

• Erin Grace, MHA
  AHRQ Project Officer
  Erin.Grace@AHRQ.hhs.gov.
• Tom Novak
  CMS Project Lead
  Thomas.Novak@CMS.hhs.gov.
• Scott Finley, MD, MPH
  Principal Investigator, Westat
  ScottFinley@Westat.com.
• Lois Olinger, MA
  Project Manager, Westat
  LoisOlinger@Westat.com.

Image: An icon of a telephone is shown.