Health Information Technology (HIT)

Well-designed and well-implemented health information technology (HIT)—such as electronic health record (EHR) systems, personal health records (PHRs), patient registries, and the use of clinical decision support—can play a critical role in facilitating the access to and sharing of important patient information amongst a care coordination team, in supporting provider-patient communication, and by encouraging patient engagement.

  • AAP Policy Statement—Health Information Technology and the Medical Home
    Pediatrics—May 2011
    This policy statement discusses how HIT is the tool that can help support important pediatric information functions within the medical home—the place where each patient’s medical care is coordinated. Not only should EHR systems house the patient’s data completely, safely, accessibly and for a lifetime; they also should allow pediatricians to share information easily with patients and improve the quality of care. Using HIT as the tool for portability and accessibility between and among health care providers should help to enhance the role of the primary care practice as the patient’s medical home.
  • Improving the Medical Home Through the Use of Health Information Technology—Fact Sheets
    American Academy of Peditarics (AAP), National Center for Medical Home Implementation, AAP Child Health Informatics Center

Electronic Health Records (EHRs)

Health care providers across the country and around the world are feeling pressure to convert their paper medical records to electronic health records (EHRs). A good pediatric EHR must be designed from the beginning with pediatric requirements in mind.

American Academy of Pediatrics (AAP)Resources

Children’s Electronic Health Record Format
The Agency for Healthcare Research and Quality (AHRQ) and Centers for Medicare and Medicaid Services (CMS) recently released the Children’s Electronic Health Record (EHR) Format. The format is not an actual EHR, but provides the functional requirements that an EHR should meet to perform optimally for the particular needs of children (eg, newborn screening tests, immunizations, well child and preventive care, information for children with special health care needs). It includes more than 700 requirements organized by 21 topic areas.

Electronic Health Record (EHR) Implementation Tool       
Office of the National Coordinator for Health Information Technology
This 5-step implementation tool assists provider organizations in making the decision about whether or not to adopt an EHR. The online program guides providers through assessing their practice’s readiness, planning an approach, selecting or upgrading to a certified EHR, training and implementation, and achieving meaningful use and quality improvement.

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Meaningful Use of Electronic Health Records (EHRs)

On July 13, 2010, the US Centers for Medicare and Medicaid Services (CMS) released the Meaningful Use Final Rule which establishes the criteria with which eligible pediatricians, other health providers and hospitals must comply in order qualify for the incentive payments that are available through the American Recovery and Reinvestment Act. 

  • AAP Child Health Informations Center (CHIC) Meaningful Use Resources
  • Health Information Technology (HIT) and Meaningful Use Workshops
    The Health Resources and Services Administration (HRSA) has announced a series of HIT and Meaningful Use Workshops as part of the agency’s ongoing technical assistance efforts. The workshops will provide insights and tools for successfully negotiating the stages of EHR implementation from planning to post-implementation optimization of use which will qualify users for the CMS Incentive Payment. These workshops will be hosted by several HRSA grantees that have successfully implemented EHR technology. Further, hosts will be providing a portion of these workshops through webcast or webinar technologies to reach a wider remote audience. For additional information, contact healthit@hrsa.gov.

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Practice Web Sites/Patient Portals

A Web site is one of the best ways to provide round-the-clock information to your patients and their families about your office and provided services, especially in regards to access. Following are examples of interactive pediatric practice Web sites:

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Implementing Secure Electronic Patient-Provider Web Portal Communications Systems
As patients become increasingly interested in managing their health through Internet-based technologies, health care organizations face significant challenges in meeting the need for highly personal and sensitive communication. An Agency for Healthcare Research and Quality (AHRQ) funded study, Issues and Questions to Consider in Implementing Secure Electronic Patient-Provider Web Portal Communications Systems, developed a framework that can be used as a guide for organizations looking to employ secure electronic patient-provider communication systems.

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AAP Member Benefit—Practice Web Sites from Officite
The AAP has announced a new member benefit program with Officite, a national medical Web site developer and Internet marketing company. The program provides AAP members with professional Web site development and Internet marketing services. Officite provides 24/7 online and phone support for troubleshooting and a full menu of package upgrades that includes search marketing, social media, integrated blog, and AAP Patient Education Online (PEO) library.

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Promising Practices

Not Just Recordkeeping: Electronic Medical Records Quicken Services, Reduce Errors and Inform Patients
This article from the National Initiative for Children's Healthcare Quality shares how electronic medical records are helping pediatric practices accelerate service delivery, reduce errors and keep patients informed.

Agency for Healthcare Research and Quality (AHRQ)

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Aligning Health Information Technology and Delivery System Transformation Efforts PDF
National Academy for State Health Policy (NASHP)
This issue brief discusses strategies to achieve alignment between HIT and care delivery transformation, such as development of an electronic, streamlined reporting and feedback structure; creation of standard and simplified state metrics; engagement of multiple payers; and promotion of provider and consumer education and engagement. The brief also includes success stories from states and recommended next steps for leaders in health care to optimize the use of HIT to improve the quality of care.

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Center for Health Care Strategies, Inc.

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Centering on the Patient: How Electronic Health Records Enable Care Coordination PDF
eHealth Initiative

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Health Information and Management Systems Society (HIMSS)

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iPhone App from Duke Aims to Help Bridge Communication Gap
The Duke Area Health Education Center has launched a new iPhone app that aims to bridge the communication gap between health care providers and Spanish-speaking patients. The free Polyglot Med Spanish app is simple-to-use and offers immediate audio translation of more than 3,000 common words, phrases, and assessment questions from English to Spanish and Spanish to English.  

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Medical Home Tools in the News—East TN Kids iPhone App PDF
East Tennessee Children's Hospital has a new iPhone/iPod application that allows parents, grandparents, and caregivers to input children's medical history into the convenient, portable, and password protected application. Use of this application is an example of parents taking an active roll in partnering with their physician to manage and track their child’s care. The East TN Kids app also has a KidsHealth section that is stocked with hundreds of articles on health, first aid, safety, medical problems, infections, emotions and behavior, growth and development, nutrition and fitness, pregnancy and newborn care.

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Over 100,000 Primary Care Providers Sign Up to Adopt EHRs through Regional Extension Centers
The Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology has announced that over 100,000 primary care providers have signed up to adopt electronic health records (EHRs) in practice.

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Registries

The use of a patient registry can help primary care providers effectively manage a patient population as part of a successful medical home, especially in the management of chronic conditions. Registries vary in format, from simple Excel spreadsheets to more advanced electronic record systems. If implementing registries for the first time, it is recommended to start with one condition or area in which the practice would like to improve on care delivery.

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Telehealth

Telehealth care is an increasing component of pediatric practice. Under pressure to limit office and emergency department utilization and with increasing expectations for access by working parents, pediatricians are finding themselves dispensing more and more advice over the telephone, via e-mail visit, both during and after office hours.

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Additional Resources

American Academy of Pediatrics (AAP) Resources

  • Child Health Informatics Center (CHIC)
    To meet the need for supporting HIT, the AAP launched the CHIC. The CHIC has focused its efforts on positioning itself as the “home” for HIT initiatives and demonstrates the AAP's commitment to ensuring that pediatrics is considered in national discussions about HIT, that members are provided with timely information and guidance during this time of rapid change, and most importantly, that children have access to high quality care.
  • Mobile Products List
  • Clinical Report—E-mail Communication Between Pediatricians and Their Patients PDF
    This AAP clinical report addresses specific e-mail patient communication issues relevant to pediatricians and the appropriate use of e-mail in the office setting. The report briefly reviews e-mail privacy and security concerns, e-mail in the office environment, the legal status of e-mail, and available e-mail technologic solutions.
  • The Pediatrician Blogger PDF
    (Available to AAP Members) COCIT News Fall 2009 - pgs 8-9
    This article describes how blogging can benefit patients, parents, and pediatric practices.
  • Policy Statement—Standards for Health Information Technology to Ensure Adolescent Privacy
    This policy statement, developed by the AAP Committee on Adolescence and the Council on Clinical Information Technology, reviews the challenges to privacy for adolescents posed by commercial health information technology systems and recommends basic principles for ideal electronic health record systems. This policy statement has been endorsed by the Society for Adolescent Health and Medicine.

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Consumer Platform for Health IT—Advancing Patient and Family Engagement Through Technology PDF
Consumer Partnership for eHealth (CPeH), led by the National Partnership for Women & Families
This resource offers a detailed vision for a patient-centered health care system in which vastly improved access to timely, electronic information equips consumers to actively participate in health care as both partners and leaders.

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Health IT for You Animated Video and Fact Sheet
The Office of the National Coordinator for Health IT (ONC) has released a 3-minute animated video and corresponding fact sheet PDF for consumers that explain how electronic health records (EHRs) and other health information technologies (HIT) are giving consumers the opportunity to better manage their own health. The video is currently available on www.healthit.gov.

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Health Resources and Services Administration (HRSA) Resources
HRSA and its Office of Health Information Technology and Quality (OHITQ) have begun to play a unique and critical role in the national strategy for health IT. The HRSA vision is to leverage the power of health IT to improve patient outcomes, quality, and reduce health disparities for people who are uninsured, isolated, or medically vulnerable. As part of its mission, HRSA aims to provide health centers, other safety net providers, and ambulatory care providers with tools to successfully implement health IT in a manner appropriate for their and their patients' needs and abilities. The toolbox is a central component of this effort. In addition, OHITQ has initiated a Health IT Technical Assistance Center to support grantees that use the toolbox or who are otherwise engaged in health IT implementation.

  • The CMS ‘Meaningful Use’ Rule, the ONC EHR Standards and Certification Rule and How They Affect the Safety Net Community and HRSA Grantees Webinar
    On July 23, 2010, this Webinar was held by HRSA/CMS/ONC. This webinar has been placed on the HRSA’s YouTube channel for replay.
  • Health Center Controlled Networks (HCCNs)
    In 1993, HRSA established HCCNs to promote the use of health information technology by providing management, financial, technology and clinical support services to HRSA grantees.
  • HRSA/Maternal and Child Health Bureau (MCHB) Awards Grant for EMR Sub-Network
    Pediatric Research in Office Settings (PROS), the practice-based research network of the AAP, has been awarded a three year $3.5 million grant from HRSA-MCHB to establish an EMR sub-network within PROS. The ePROS network, once established, will be used to conduct both observational and interventional comparative effectiveness research. The first ePROS study will test the utility of EMR point-of-care clinical decision support in improving ADHD medication management. Collaborators in this work include individuals at the University of Colorado, the Children's Hospital of Philadelphia, and the Clinical Integration Networks of America (CINA). Three EMR vendors (Physician's Computer Company, Connexin Software, and EHS) agreed to work with PROS to provide additional pediatric-focused vendors to supplement CINA's existing data extraction capacity. For more information, contact pros@aap.org or call 800/433-9016 x7623.
  • HRSA Toolboxes:
    • Health IT Adoption Toolbox
      A compilation of planning, implementation and evaluation resources to help community health centers, other safety net providers, and ambulatory care providers implement health IT applications in their facilities.
    • Health IT for Children Toolbox
      A compilation of health IT information targeted at children's health care needs, ranging from pediatric electronic medical records to children's health insurance coverage. It also discusses opportunities to link other systems that serve children, including Head Start, schools, foster care, etc. 
    • Pediatric Oral Health and Health IT Toolbox
      Information, tools, and resources that illustrate the importance of pediatric oral health, how the stakeholders can impact oral health, and how health IT can facilitate the delivery of high quality oral health care.
    • Rural Health IT Adoption Toolbox
      Addresses the needs of rural providers in the planning and implementation of health information technology. Resources compiled for this toolbox are from both public and private sector entities, including government agencies, academic institutions, and research organizations. While designed for rural health providers, this toolbox also informs state and federal policy makers, insurers, and other interested stakeholders regarding the special considerations for health information technology adoption in rural settings.
  • Regional Extension Centers (RECs)
    HRSA, CMS and ONC offer a multitude of resources for HRSA grantees. ONC has established sixty health information technology RECs that offer technical assistance, guidance, and information on best practices to support and accelerate health care providers’ efforts to become meaningful users of EHRs. Under the state Cooperative Agreements of the HITECH Act, RECs serve as independent resources to specifically help your organization successfully implement health information technology.

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Patient-Centered Primary Care Collaborative (PCPCC) HIT Resources

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Workflow Assessment for Health IT
This toolkit was funded by the Agency for Healthcare Research and Quality (AHRQ) and prepared by the University of Wisconsin-Madison’s Center for Quality and Productivity Improvement (CQPI). This toolkit will assist small and medium sized practices in workflow analysis and redesign before, during, and after health IT implementation. It includes tools to analyze workflow and others’ experiences with health IT and workflow.

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