Health Information Technology and YOU!
The Role of AAP Chapters
in Supporting Member Practices
District IV and IX
6/23/2012
Joseph H Schneider, MD
Objectives
• Provide an overview of Meaningful Use (MU)
• Detail the role of AAP Health Information
Technology Leadership in supporting chapters
with adoption and use of health information
technology (HIT)
• Provide ideas for Chapter activities
ARRA Legislation
•
Passed on February, 2009
•
Stage 1 Meaningful Use criteria
released in July 2010
•
Stage 2 Meaningful Use Notice of
Proposed Rule Making released
February 2012
 Final Rule expected Summer 2012
 Start Dates: October 2013/January 2014
HITECH Meaningful Use Framework
MU & EHR Adoption in Pediatrics
• Over $2B in Medicaid EHR Incentive payments
made between 1/11 - 3/12 (Office of the National
Coordinator, 2012).
• 2009: ~25% of pediatricians using an EMR (AAP
Periodic Survey of Fellows, 2009 ; 2012 being fielded this fall).
• 2012: Over 50% of physicians using EHRs system
• ~16% of physicians working with Regional
Extension Centers are pediatricians (Office of the
National Coordinator, 2012).
MU Objectives
• Improve quality, safety, efficiency
• Reduction in health disparities
• Improve care coordination
• Ensure privacy and security of personal
health information
• Improve population health and interact with
public health programs
Key Differences in MU Stages
• Multiple Stage 1 objectives would be combined
into more unified Stage 2 objectives
 Changes to seven objectives
 Elimination of two objectives
• CQMs would be aligned with existing quality
programs (e.g. PQRS, NCQA, CHIPRA)
• CQM reporting would be part of the definition
of “meaningful EHR user” instead of as a
separate meaningful use objective
AAP Advocacy
• Children in CHIP programs in States with
Medicaid expansion (7) or combined
Medicaid/CHIP programs (26 states) now count
towards patient volume thresholds.
• The expansion of the current definition of
"encounter" to also include any service
rendered on any one day to an individual
"enrolled" in a Medicaid program
How is the AAP supporting
chapters with
HIT implementation?
HIT Leadership Entities
• Child Health Informatics Center
 Serves as the AAP “home” for HIT initiatives
 Directed by Christoph U. Lehmann, MD, FAAP
(founding Medical Director)
 Governed by an 7-person Project Advisory
Committee (Chaired by Stephen Downs, MD MS
FAAP)
• Council on Clinical Information Technology
 Comprised of 500 members with special interest
and training in applying HIT to pediatrics
 11-member executive committee
Key Resources and Education
• Resources on EHR Adoption and Use
 www.aap.org/chic
•State Pages
•Meaningful Use Resources
•EMR Review Site (aapcocit.org/emr)
• Collaboration with the Office of the National
Coordinator and Regional Extension Centers
Top 10 by Count
EncounterPRO
Office Practicum
NextGen EMR
Amazing Charts
eClinicalWorks
Allscripts (formerly Misys)
Centricity EMR (formerly Logician)
Epic Ambulatory
MEDENT EMR System
Allscripts Enterprise
Allscripts Professional
e-MDs
Noteworthy
#
Average
34
4.62
30
4.7
13
2.46
11
4.09
10
3.5
7
2.57
7
2.57
7
4.43
7
3.71
5
2.6
5
4
5
4.6
5
4.2
Key Resources and Education
• 2012 NCE Educational Programs
COCIT H-Program
The Pediatric Office of Today
HIT Networking Forum
HIT related general sessions
Advocacy
• Meaningful Use
• Pediatric Specific EHR Functionality
 EHR Vendor Consortium
 Regional Extension Centers (RECs)
• AAP Resources:
 Immunization Information Systems Toolkit
 Child Health Informatics Advocacy Brief
 HIT and Medical Home Fact Sheet
Vendor Consortium
•
Investigate ways to partner with the vendor community to
distribute AAP knowledge and expertise in an electronic format
that can be linked to, or embedded within and EHR
•
•
Includes 11 vendors
Areas for Collaboration






Advocacy around common pediatric forms
Decision Support Based on Evidence‐Informed Guidelines
Standardized pediatric vocabulary
Improved implementation of Bright Futures
Advancing the Medical Home and the development of patient facing
technologies to collect data
Standardization of growth and specialty growth charts
How can AAP Chapters Support
Member Practices
with HIT implementation?
AAP Chapters Can:
• Educate and spread learnings to chapter
members
 Recognize member successes (and lessons learned!)
 Identify the needs of your members regarding HIT
education & plan around those needs
• Encourage participation in Academy HIT
initiatives & groups
• Encourage Advocacy at the Chapter member
level
Chapter Educational Grants
• Connecticut, Hawaii, Indiana, and Pennsylvania
were awarded $4,000 to:
 Provide education to help chapter members
adopt/implement electronic health records.
 Engage their regional extension centers (REC) and
sharing of strategies for how members can access
REC services.
 Share pediatric specific success stories and
challenges about EHR adoption.
Chapter Educational Grants
•
•
•
•
Connecticut
 Meaningful Use, incentive money, CT & pediatric
specific EHR implementation, security of EMRs, Hall
of Experts
Hawaii
 Adoption of EHR for the solo practitioner
Indiana
 Implementing Meaningful Use and EHRs in pediatric
practices with a specific focus on MU Stage 2
Pennsylvania
 Pediatric-specific support for EHR adoption and
effective use
Considerations for AAP Chapters
• Develop an HIT committee or appoint a chapter
champion
• Interact with your local Regional Extension
Center (REC) or Health Information Exchange
(HIE)
• Work with Immunization Information Systems
at the state level to ensure optimal product
development
Thank you !!
Appendix Slides
MU Stage 1 Objectives
• Provide access to comprehensive patient health data for
patient’s healthcare team
• Use evidence-based order sets and computerized
provider order entry (CPOE)
• Apply clinical decision support at the point of care
• Generate lists of patients who need care and use them
to reach out to those patients
• Report information for quality improvement and public
reporting
NPRM for MU Stage 2 Objectives
• Increased expectations for health information
•
•
•
exchange
Greater use for e-Rx, incorporation of
structured laboratory results, and exchange of
patient care summaries across unaffiliated
physicians, settings, and EHR systems
Encourage the use of health IT for continuous
quality improvement at the point of care
Focus on patient engagement
Appendix: Implications for Pediatricians
•
Record smoking status for patients 13 years old or
older (core objective #5)
•
Provide clinical summaries for patients for each office
visit (core objective #7)
•
Provide patients with the ability to view online,
download, and transmit their health information
within 4 business days of the information being
available to the EP (core objective #12)
.
Appendix: States with Separate Child Health Plans
Alabama
Arizona
Colorado
Connecticut
Georgia
Kansas
Mississippi
New York
Nevada
Source: www.medicaid.gov
Oregon
Pennsylvania
Utah
Vermont
Washington
West Virginia
Wyoming
Texas