Pe

D S SIG

Pediatric Data StandardsSIG Overview

Atlanta, GASeptember 20, 2007

Pe

D S SIGWhy We Exist

Problem: Children represent nearly one third of the U.S. population. They can receive care through HIT systems from a variety of individuals in a variety of settings. Initiatives are largely adult-focused.

Opportunity: Work through HL7 to improve quality of data standards for child health care.

Numerous National HIT Initiatives Underway to SupportPresident’s Goal to Make EHR Systems Accessible by 2014

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D S SIG

Alliance forPediatricQuality

Identify Requirements

Influence Adoption

Validate Standards

HIMSS Pediatric Health Informatics & Technology SIG

Nationwide Health Information Network

Office of the National Coordinator

American Health Information Community

HIT Standards Panel

Certification Commission for HIT

Systematized Nomenclature

of Medicine

Vendor PediatricConsortia

Health Level Seven (HL7)

Pediatric Data Standards SIG

AAPCouncil on

Clinical Information

Technology

Adopt Standards

Health InformationTechnology

vendors

Child health practitioners,

cliniciansand hospitals

Desired Outcomes

Reduce system implementation

costs due to duplication and customization

Enable pediatric performance

measurement by improving

interchange of standardized information

Support safe care for children

PeDSSIG is Part of National Pediatric HIT Community

Support workgroups,

buildconsensus and

adoption

HL7

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D S SIG Example: HIT Workflow

AAP PeDSSIG HL7 CCHIT

EMR Position Papers

Pediatric EHR Functions

EHR-FM Standard

EHR Vendor Certification

Criteria

Alliance Support and Endorsement

Vendor Compliance & Certification;

Provider Adoption

Pe

D S SIG What We Look Like

Founded: 2003

Parent: Patient Care Technical Committee

Leadership: Andy Spooner, MD and David Classen, MD

Support: Alliance for Pediatric Quality provides Administrative Co Chair and some financial support

Participation: Primarily CMIOs, physicians, medical informatics experts and vendor representatives

Distribution: 100+ on email distribution list

Operations: Work group meetings, monthly calls, webcasts and project meetings as needed

Recruitment: Presentations at national conferences, HIMSS PHIT SIG, AAP, CHCA, NACHRI, vendors, etc.

Pe

D S SIG Emphasis To-Date

Functional Standards EHR-S FM includes critical child health functions Child Health-FP registered with HL7 Contributing to PHR-S FM Exploring derived profiles (e.g. neonatology)

Messaging Standards Immunization Activity Diagrams and Story Boards part of

Care Provision DSTU Quality Reporting Document Architecture (QRDA) project

exploration

Terminology Standards Exploring opportunities

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D S SIG

HL7 EHR System Functional Model

Example – Pediatric Impact

Manage Immunization Administration

Statement: Capture and maintain discrete data concerning immunizations given to a patient including date administered, type, manufacturer, lot number, and any allergic or adverse reactions. Facilitate the interaction with an immunization registry to allow maintenance of a patient’s immunization history.

Description: During an encounter, recommendations based on accepted immunization schedules are presented to the provider. Allergen and adverse reaction histories are checked prior to giving the immunization. If an immunization is administered, discrete data elements associated with the immunization including date, type, manufacturer and lot number are recorded. Any new adverse or allergic reactions are noted. If required, a report is made to the public health immunization registry.

1. The system SHALL provide the ability to recommend required immunizations, and when they are due, during an encounter based on widely accepted immunization schedules.

2. The system SHALL provide the ability to recommend required immunizations based on patient risk factors.

3. The system SHALL perform checking for potential adverse or allergic reactions for all immunizations when they are about to be given.

4. The system SHALL provide the ability to capture immunization administration details, including date, type, lot number and manufacturer.

5. The system SHALL provide the ability to capture other clinical data pertinent to the immunization administration (e.g. vital signs, adverse reactions).

6. The system SHALL record as discrete data elements data associated with any immunization.

7. The system SHOULD provide the ability to associate standard codes with discrete data elements associated with an immunization.

8. The system SHALL provide the ability to update the immunization schedule.

E.g. Function requested by PeDSSIG (#1) is now a standard

Red text represents PeDSSIG edits to the EHR-S FM as reflected in the HL7 Child Health Functional Profile for EHR systems

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D S SIG

DRAFT HL7 Pediatric Data Standards SIG Tactical Plan2008

Objective Tactics

Build pediatric consensus on new data standards Maintain broad representation and participation in HL7 initiatives on behalf of child health care Participate in relevant national HIT data standards public comment periods on behalf of child health care

Bring Child Health Functional Profile for EHR systems through HL7 ballot Continue to work with EHR TC to include critical functions in the EHR-S FM model; Participate in opportunities for public comment Explore and encourage development of derived profiles to the Child Health-FP (e.g. neonatology) Participate in PHR FM project by providing pediatric input Explore collaborative opportunities with the HL7 Pharmacy SIG Participate in HL7 public health immunizations domain analysis model project by providing pediatric input Test clinical-context template method for addressing terminology problems in pediatrics and publish results Explore opportunities to collaborate on international level Support CCHIT Child Health Expert Panel work by coordinating responses to public comment periods Support recommendations of the Quality Reporting Document Architecture project; Work TBD

Impact vendor awareness and adoption of pediatric standards Impact provider awareness and adoption of pediatric standards Improve public awareness of value of pediatric data standards

Influence vendor adoption of Child Health-FP; Help educate vendors about the profile, and make ourselves available for questions, etc. as they work to conform Invite vendors to participate in meetings/SIG activities Publish articles/updates in HL7 newsletters Coordinate closely with the Alliance for Pediatric Quality (AAP, ABP, CHCA & NACHRI) as well as the HIMSS Pediatric Healthcare Informatics Technology SIG and vendor-specific pediatric work groups Present at HL7 and other relevant industry meetings to spread awareness of efforts and to recruit participants Explore opportunities to publicize successes to the general public

Secure support and leadership (financial and otherwise)

Develop budget and secure financial support for PeDSSIG activities Receive endorsement for work from Alliance for Pediatric Quality (AAP, ABP, CHCA & NACHRI)

Influence adoption of pediatric requirements

Improve data standards for child health care

Earn commitment from pediatric stakeholders

Goal

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D S SIG

Questions?

David Classen, MDdclassen@fcg.com

Andrew Spooner, MDandrew.spooner@cchmc.org

Joy Kuhljoy.kuhl@chca.com