Alliance for Pediatric QualityAn Overview

August 28, 2006

2

A collaboration of four major

national pediatric

organizations formed to

measurably improve

the quality of health care for

America’s children.

What is the Alliance?

HospitalHospitalCommunityCommunity

PhysicianPhysicianCommunityCommunity

Joining to Improve Pediatric Quality

3

Every child will have the opportunity to grow up

healthy, supported by a health care system

where care is safe, effective, patient-centered,

timely, efficient, equitable and based on the

best possible science and technology.

Vision

4

1. Promote the use of meaningful pediatric measures industry

wide.

The Alliance will accelerate the identification and use of measures by the pediatric community that will best drive change and improvement in the quality of health care for children. It will also define those measures that should emerge as measures of accountability for pediatrics.

2. Make sure health information technology works for kids.

The Alliance will bring together multiple technology organizations and individuals to create one pathway for ensuring the adoption of pediatric data standards that work across all care settings.

Goals

5

Strategies

• Work for consensus – speak with one voice on behalf of children

• Endorse and promote projects that advance pediatric quality and health information technology in children’s health care

• Convene stakeholders

• Advocate in media and legislature

6

Strong Foundation

Alliance forPediatricQuality Formed

Developed first set of coremeasures

Special Interest Group for pediatric dataStandardsapproved by HL-7

CHCA, NACHRI, MMP work w/JCAHO on pediatricmeasures

Pedi-QSasthma core measure setto JCAHO

NQF endorsesasthma measureset

AMA (CQI) Consortiumreleases acutegastroenteritis, asthma measures

2000 2001 2002 2003 2004 2005 20061990s

2000 2001 2002 2003 2004 2005 20061990s

Convened to

discuss data standards

AAP releases evidence-basedclinicalguidelines(eQUIPP)

AAP starts COCIT

First electronicmedical recordsrequirements forpediatrics

AAP EMRspecs updatedw/ HL7 Sig.input

HL7 Sig.releasespediatric specsfor EMR

7

• Asthma measure set endorsed by NQF

• Current work includes:- Additional asthma measures- Neonatal care- Nursing sensitive measures- Pediatric intensive care- Surgical infection prevention identification and use- Analyze national priorities for future measure development- Develop new performance measure sets using Pedi-QS

Accomplishments to Date

Pedi-QS Workgroup Drives Inpatient Measures

Pedi-QS methodology recognized by industry

8

Accomplishments to Date

• AAP evidence-based clinical guidelines – ripe for measure development

• AMA Consortium for Physician Performance Improvement (pediatric gastroenteritis and asthma measures)

• Active pediatric representation at AQA, NQF, NCQAand private payor panels

• Ambulatory Pediatric CAHPS survey• Miller et al study (2005) – Build upon findings of

existing/needed quality measures

Physician Community Drives Ambulatory Measures

9

• Developed pediatric requirements for EHR specifications

• Developed information flow charts for pediatric immunization; vendor adoption in process

• Submitted to CCHIT inpatient EHR functionality requirements on behalf of Alliance

• HL7 Pediatric Profile creation underway

Accomplishments to Date

Role of Special Interest Group58 organizations, including AAP, CHCA and NACHRI and vendors

Identify critical pediatric-specific data standards for quality and outcomes measurement reporting

Create nomenclature lexicon and required terminology

Seek approval of HL7 for pediatric recommendations

HL7 Special Interest Group Drives Pediatric Data Standards

HL7 Pediatric Data StandardsSpecial Interest Group(HL7 PeDSSIG)

10

Council on Clinical InformationTechnology (COCIT)

Representatives at CCHIT, ANSI HITSP, ASTM Committee E31 (CCR)

EHR policy statement published

Inpatient HIT systems policy underway

Strong vendor participation in Pediatric Documentation ChallengeTM

Active EMR review web site

Accomplishments to Date

Sample Ongoing AAP HIT Efforts

Develops and publishes policy documents on pediatric health IT

National advocacy/involvement

Health IT education

Physicians Electronic Health Record Commission (PEHRC)

Evaluation of pediatric electronic medical record vendors at TEPR

11

NHIN

How We Work Together

American Health Information Community

COCIT HL7

CHOB Indiana

COCIT HL7

Federally chartered commission makes

recommendations to HHS

HISPC

Addresses business policy and state law affectingprivacy and security

Certification commission uses HL7 standards asbaseline for health IT vendor certification

Standards panel harmonizing

standards forhealth IT vendors

Conducts pilots withhospitals to build

interoperability

Pay for Performance

CCHITHITSP

12

National advocacy/involvement with national health IT organizations on behalf of pediatrics

Develop and publish policy documentson pediatric health information IT issues

Educate stakeholders, disseminate, andimplement communication approaches for pediatric IT standards

Educate public about vendor pediatriccapabilities (e.g. through DocumentationChallenge™ and EMR review web site)

Identify critical pediatric-specific data standards for quality and outcomesmeasurement reporting

Develop, propose, and get approval for standards in HL7

Coordinate with other groups interested inusing pediatric data standards, including vendors

Identify required terminology; Create nomenclature lexicon

AAP Council on Clinical Information Technology (COCIT)

HL7 Pediatric Data StandardsSpecial Interest Group (PeDSSIG)

National Policy Makers

Health InformationTechnology Vendors

Pediatric CareProviders

APQTechnology Workgroup

Provide input into areas of focus; Support

through education, advocacy, policy creation

Provide pediatricHL7 standards; Identifycurrent standards thatapply to focus areas

How We Could Work Together

13

APQ Information Technology WorkgroupA group of technical experts in the pediatric community who identifies and coordinates opportunities for unified action through the Alliance - providing strength to current pediatric healthcare IT activities through consensus building, advocacy and endorsement

Immediate APQ Activities1. Host regular workgroup calls to review activities underway and

to identify opportunities for unified action2. Coordinate response to HITSP interoperability specifications3. Support representative to HL7 EHR TC4. Support other representatives to national initiatives5. Upon completion, endorse HL7 PeDSSIG pediatric profile and

assistance with market communication and education6. Joint response to CCHIT re. inclusion of growth charts

A Proactive, Unified Approach

14

Organizational Structure

Founders/CEOsFounders/CEOs

Executive Committee/VPs

Executive Committee/VPs

Executive DirectorExecutive DirectorAdmin support

Consultants

Pedi-QSWorkgroup

Information TechnologyWorkgroup

Workgroup WorkgroupWorkgroup

Day-to-day activityEx Officio Executive Committee

Manage work groups, consultantsFront-line liaison to stakeholders

Informal coalition

Shared decision-making

In-kind resources

15

Year One Focus

• Evaluate and prioritize measures and move them very quickly to the public domain for use in improvement and accountability Endorse a common set of measures Evaluate and accelerate pay for performance strategies for pediatrics Determine opportunities for sharing data

• Concurrently our four organizations are exploring a data sharing initiative; work is independent of the Alliance at this time

• Seek industry-wide adoption of data standards for pediatrics CCHIT integration of HL7 standards Endorse pediatric data standards (as supplied by the Special Interest Group) Support Special Interest Group efforts in embedding pediatric-specific EHR

requirements in vendor systems

16

Initial Measures of Success

• The Alliance will conduct an annual evaluation of our accomplishments and develop success metrics

• Some of our success factors follow: JCAHO and industry will widely use pediatric measures recommended by the Alliance CCHIT adopts standards recommended by HL7 Special Interest Group The Alliance will be recognized by national quality organizations as the “go-to”

organizations for pediatric quality

17

Support the Alliance

• When you see opportunities to advance quality or health information technology standards at the national level, please contact:

AAP : Ed Zimmerman (847) 434-1917

ABP: Paul Miles (919) 929-0461

CHCA: Donna Payne (913) 262-1436

NACHRI: Mary Gorman (703) 684-1355