model children’s ehr format ahrq 2011 annual conference september 19, 2011 3:30pm-5:00pm scott...
TRANSCRIPT
Model Children’s EHR Format
AHRQ 2011 Annual Conference September 19, 2011
3:30PM-5:00PM
Scott Finley, MD, MPH, Principal Investigator, Westat
History and Process
Project Team
Subcontractors:
Prime Contractor:
Subcontractors:
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What is a “Format?”
Called for in the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA)
Further defined as requirements for: A minimum set of data elements Applicable data standards Usability Functionality Interoperability
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What is a requirement?
“The system SHALL present patient age using units appropriate to the actual age of the patient, using appropriate thresholds for unit selection”
SHALL / SHOULD / MAY
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Project Purpose
Existing EHR systems often do not optimally support the provision of health care to childrenProject 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
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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
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Prior Work
HL7 EHR-S Functional Model– Hierarchy– Not child-specific
HL7 Child Health Functional Profile– 125-150 child-specific changes from
Functional Model Numerous publications Selected home-grown systems
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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
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TEP Representation
Physician Informaticians–Children’s health focus–More general health focus
Non-Physician clinicians Children’s advocacy organizations State Medicaid agencies Vendors and product developers Office of the National Coordinator for Health IT Indian Health Service
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Other Input
CHIPRA Category D Grantees– Pennsylvania– North Carolina
Federal Workgroup
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Gap Analysis
Conducted by Intermountain Healthcare Identified key topic areas Drafted initial requirements
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Topic Areas in Format
Activity Clearance
Birth History
Child Abuse Reporting
Child Welfare
Children with Special Health Care Needs
Growth Data
Immunizations
Medication Management
Newborn Screening
Parents, Guardians, and Family Relationship Data
Patient Identifiers
Patient Portals/Personal Health Record Information Access
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
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Requirements Development Process
For each topic area: Review findings from gap analysis Initial requirements drafted by subject
matter expert (SME) Project team review Outside SME and TEP review(s)
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Concept Evolution #1
From the HL7 Child Health Functional Profile:
“The system MAY provide the ability to compute post conceptional age (corrected age) for the purposes of decision support.”
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Concept Evolution #2
From the Model Format: “The system SHOULD be able to display
head circumference adjusted for the degree of prematurity by subtracting the number of weeks premature the individual was born from each plot point during the first two years of life. The growth chart should reflect that this plot was corrected for prematurity.”
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Format Characteristics
Specialized requirements database (Accompa)
Chiefly functional requirements, including interoperability
Usability challenges Few existing standards to support
taxonomy or data elements >700 detailed requirements Suitable for system development and
system selection16
Requirements Tool
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Requirement Details
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Summary
>700 incremental EHR requirements for children
No new standards set Compatible with existing & potential
systems Primary care and general inpatient care Best accessed through Accompa guest
account (exports will also exist)
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Contact Information
Scott Finley, MD, MPHPrincipal Investigator, [email protected]
Lois Olinger, MA Project Manager, Westat
Erin Grace, MHA AHRQ Project Officer [email protected]
Jessica Kahn, MPH CMS Project Lead [email protected]
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Questions?
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