Developing a Business Case
Model for Integrated Child
Health Information Systems
Academy Health
June 27, 2006
The Lewin Group
● Tim Dall ● Yaozhu Chen
PHII
● Kris Saarlas ● Jim Mootrey ● Dave Ross ● Alan Hinman
Why is integration of child health
information systems important?
• Provide comprehensive, timely and accurate child
health information to support the provision of service
through medical home, public health program
needs, and decision-making at the point of service
• Ensure children receive necessary preventive,
screening, therapeutic and follow-up services
• Coordinate medical care and public health activities
• Coordinate public health program services
• Eliminate duplicative services
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Integrated Child Health Information
Systems (ICHIS)
• What is integration?
• Which child health information systems are states
integrating?
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Immunizations (immunization registries)
Newborn dried blood spot screening systems (NDBS)
Early Hearing, Detection and Intervention program (EHDI)
Lead
EPSDT
WIC
Others (birth defects and disease registries, Early
Intervention, Children with Special Health Care Needs)
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What is a business case and why is it
necessary?
• What is a business case?
– A tool that supports planning and decisionmaking
– Assessment of the benefits and costs of various
alternatives
• Why is it necessary?
– States/communities need to justify return on their
investment—increased focus on accountability
– Need for sustainable funding for child health
information systems
– Increase participation in ICHIS
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What is the Business Case Model?
• An Excel-based tool to quantify benefits and costs
of integrating various child health systems
• Provides information important to different
perspectives: society, providers, parents, and
public health programs
• Answers the question, “what benefits can I expect
to see if I integrate this system(s) with that
system(s)?”
• Flexible tool that is responsive to various state
and local models and future growth of ICHIS
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Integration Benefits Modeled
• Focus on improved effectiveness of services,
efficiency, quality of care, coordination of care,
health outcomes
• Areas of Benefits:
– Benefits to Families
– Benefits to Physicians/providers
– Public Health Decisions
– Data Quality
– Case Management
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Examples of Data and Sources
• Government-collected statistics
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Newborn/child demographics
Newborn screening and follow-up rates
Disease prevalence rates
Child health program participation rates
• Medical and economics literature
– Health care utilization/sequelae/costs per disease case
– Special education, productivity, and long term care costs
• Expert opinion (pending additional research)
– Changes in screening, follow-up, and program participation
rates from ICHIS
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Process for Business Case Model
development and deployment
• Funding provided by HRSA/MCHB/GSB and RWJF
• Formed workgroup of stakeholders from PH, private
physicians, family advocates, health plans
• Solicited input from expert health economists and
program specialists
• Researched literature
• Beta testing of tool with 4 states January 2006
• Development of training materials spring 2006
• Model being provided free* to public health
departments and researchers
• Formation of a User Group and possibly limited
technical support**
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Business Case Model Overview
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Challenges to developing a
business case on ICHIS
• Added/marginal value of integration vs. value
of programs and independent systems
• Lack of data on costs and benefits on
individual programs and information systems
• Change in behavior that integration of data
brings—i.e., data not available now to
physicians, who’s responsible for follow up
• ROI not always basis for decision making
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Thank You!
Contact Information:
Tim Dall
tim.dall@lewin.com
www.lewin.com
Kristin Saarlas
ksaarlas@phii.org
www.phii.org
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Extra Slides
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Benefits to Families
• Parents have access to CHIS information in
consolidated format
• Reminders/recalls
• Convenience when moving/changing providers
• Time saved (scheduling appointments, missing
records, reduced data entry)
• Reduced visits/efficiency and coordination of
care
• Improved health outcomes (reduced lifetime
care costs, increased earnings of family/child)
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Benefits to Providers
• Providers have access to data they didn’t
have before
• Reduce chart pulls if electronic access is
available
• Quality of care—reduction in duplicative
services, timeliness of care, pay for
performance
• Increased number of visits? Increased
revenues?
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Benefits to Public Health
• Assess risk factors to completeness of care
• ID medical home and health care utilization
rates
• Linkage to other data—hospital discharge,
education, social services
• Long term surveillance—population trends
• Quality assurance—public health role
• Changes in policies?
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