Commentary on the Promises and Pitfalls of HIT for Improving Children’s Healthcare Lisa A. Simpson, MB, BCh, MPH, FAAP National Director, Child Health Policy, NICHQ and Endowed Chair, Child Health Policy, University of South Florida “It is Time!”

Five Questions n Can we create and maintain the focus? –In general? –On children? –At what cost? n Can children “go where no one has gone before”? n What is the role of states in HIT for children? n How can the HIT agenda and Medicaid reform be linked? n What is the role of the CHSR community?

1.Can We Create and Maintain the Focus? n The indicators are positive… –It is a Presidential priority –It survived a Secretarial transition –There is public and private consensus –It even brought Bill and Hillary together

1.Can We Create and Maintain the Focus? n The indicators are positive… –It is a Presidential priority –It survived a Secretarial transition –There is public and private consensus –It even brought Bill and Hillary together … Bill Frist, that is!

1. Can We Create and Maintain the Focus? n The indicators are positive… n Children’s interests are gaining a voice… –Through activism within ONCHIT, CDC, AHRQ, HRSA and others –Through the efforts of the Pediatric Steering Group –Through the efforts of HL7 –Through the efforts of the National Child Health Data Standards Workgroup & related NICHQ efforts

1. Can We Create and Maintain the Focus? n The indicators are positive n Children’s interests are gaining a voice n At what cost? –Having a clear priority means other issues are NOT –Broader quality efforts are sidelined –HIT is a means to an end only – It’s about quality after all!

2. Can Children “Go Where No One Has Gone Before”? CHALLENGES n Child health providers are behind others in HIT adoption n Child health IT is “different” – but maybe not so much n Translation and diffusion challenges are multiplied by 50+ different states/programs n Evidence base on HIT & safety/quality/costs is smaller

2. Can Children “Go Where No One Has Gone Before”? CHALLENGES n Child health providers are behind others in HIT adoption n Child health IT is “different” – but maybe not so much n The “business case” for quality is even harder n Translation and diffusion challenges are multiplied by 50+ different states/programs OPPORTUNITIES n Child health community has a history of collaboration n Public policy could move the market n We have 50+ settings for testing out the best approaches n Hillary likes kids

2. Can Children “Go Where No One Has Gone Before”? CHALLENGES n Child health providers are behind others in HIT adoption n Child health IT is “different” – but maybe not so much n The “business case” for quality is even harder n Translation and diffusion challenges are multiplied by 50+ different states/programs OPPORTUNITIES n Child health community has a history of collaboration n Public policy could move the market n We have 50+ settings for testing out the best approaches n Hillary likes kids – and as far as we know, so does Bill – Frist that is!

3. Role of States n Use policy to promote HIT adoption –Florida Medicaid and PDAs n Test out models of PFP for HIT n Monitor and reduce the digital divide n Measure impact

4. HIT and Medicaid Reform n AHIC and Medicaid Commission n Legislative and administrative strategies –FFP rates –Provider Conditions of Participation –Incentives –Reporting requirements

5. Charge to the CHSR Community n What difference will HIT make to children’s healthcare? –Its safety, quality, costs, timeliness, patient-centeredness and equity? n Can we develop, test and spread innovations that promote effective HIT applications? n Can we “speak truth to power”?

Thank You! n Aladdin n Bambi n The Lion King n Finding Nemo n The Incredibles

Thank You! n Aladdin n Bambi n The Lion King n Finding Nemo n The Incredibles