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

 The American Academy of Pediatrics (AAP) is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists.  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  Authorized by AAP Board in October 2009  Advisory Committee, Investigators - in formation Steve Downs, MD, 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  Council on Clinical Information Technology  Policy, Advocacy, Education, Research  Partnership for Policy Implementation  Collaborative Activities  Research  Integration with AAP Quality Activities

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

COCIT Goal - Support pediatric HIT and HIE in actual practice, addressing AAP priorities  Electronic health passport test cases for foster care  Interaction between EHRs and immunization registries  Adolescent confidentiality / privacy  Education of pediatricians 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 PCPCC  Center for eHealth Information, Exchange, & Adoption  Meaningful Use; Clinical Decision Support Task Groups American Recovery & Reinvestment Act of 2009  Health Information Technology Extension Program  HIT Policy and Standards Committees CHIP Reauthorization Act (CHIPRA)  Model electronic health record format for children  CMS Demonstration grants  Agency for Healthcare Research & Quality task order

Education  National conference and workshop sessions  EMR Review Web site (  EMR Toolkit ( under Practice Toolbox)

Research Periodic Survey: Pediatricians Use of EHRs Basic – 19% (ALL 7 items)Fully functional – 6% (Basic + 11additional functions = ALL 18 items) Patient demographicsHighlights out-of-range lab results Patient problem listsClinical notes include medical history, follow- up notes Orders for prescriptionsOrders for laboratory tests Ability to view lab resultsLab orders sent electronically Ability to view imaging resultsWarnings of drug interactions, contraindications Patient medication listsPrescriptions sent to pharmacies Clinical notesOrders for radiology tests Radiology orders sent electronically Electronic images returned Guideline reminders (preventive) Guideline reminders (chronic)

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

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

APQ Collaborative Efforts  HL7 Child Health Work Group Child Health Profile as ANSI Standard Quality Reporting Document Architecture (currently is a draft standard for trial use) Working on Neonatal Care Report  CCHIT Participation in Child Health and other work groups Child Health add-on certification requirements based on HL7 Child Health profile and AAP report on Special Requirements for Pediatric EHRs  HL7/CCHIT gap analysis underway between existing and needed requirements.

For more information about the AAP Center for Child Health Informatics, please contact: Jennifer Mansour Manager, Health Information Technology Initiatives Beki Marshall Manager, HIT Education and Implementation Jonathan D. Klein, MD, MPH Associate Executive Director