What does 'Meaningful Use' Mean for Pediatrics?

Christoph U Lehmann; Jennifer Mansour; Jonathan D Klein

Disclosures

Pediatr Health. 2010;4(4):361-363. 

In This Article

Abstract and Introduction

Abstract

"The different stages of growth, development and socialization of childhood require different meaningful use criteria that must be developed carefully for the diverse pediatric patient population."

Introduction

The American Recovery and Reinvestment Act of 2009 authorizes the Centers for Medicare and Medicaid Services (CMS) to provide reimbursement incentives for eligible professionals and hospitals who become 'meaningful users' of certified electronic health record (EHR) technology. The Office of the National Coordinator for Health Information Technology (ONCHIT) published a Notice of Proposed Rule Making that defines meaningful use. The goal of this rule is to assure that EHR technology is used to improve the quality of patient care. Children's needs demand specific consideration when health information technology is developed and implemented. The different stages of growth, development and socialization of childhood require different meaningful use criteria that must be developed carefully for the diverse pediatric patient population. The American Academy of Pediatrics (AAP) suggests a number of principles for meaningful use in pediatrics.

The American Recovery and Reinvestment Act of 2009 (Stimulus Bill) authorizes the CMS to provide reimbursement incentives for eligible professionals and hospitals who become meaningful users of certified EHR technology. The ONCHIT published a Notice of Proposed Rule Making that defines meaningful use[101] and we are currently awaiting the final ruling. The goal of this rule is to ensure that EHR technology is used to improve the quality of patient care. In the words of the National Coordinator David Blumenthal: "The […] Act makes clear that the adoption of records is not a sufficient purpose: it is the use of EHRs to achieve health and efficiency goals that matters."

Children's needs demand specific consideration when health information technology is developed and implemented.[1–3] Children are a diverse and complex group. Their physiology, metabolism, size, development and special legal, educational and social needs result in unique vulnerabilities and special requirements that must be considered when planning and implementing EHRs. Children are at higher risk for adverse drug events than adults.[3] In children (unlike in adults) the change between two consecutive measurements (e.g., weight and height, or developmental milestones) are often more important than the actual measurement.

Children and adolescents also include many subgroups with unique medical needs. It is easy to recognize that children are not just little adults when you picture a 180 lb adolescent and a 2 lb premature infant. Their activities, metabolism, nutritional needs, anticipated development, preventive care needs, privacy and confidentiality, name or family history changes, anticipatory guidance, metabolism, response to medications, and risks for specific infections could not be more different. The different stages of growth, development and socialization of childhood require different meaningful use criteria. The Notice of Proposed Rule Making recognizes that meaningful use criteria for an orthopedic surgeon should be different from those of an internist. But, these two physicians have more in common in their daily practice than a neonatologist and an adolescent medicine physician.

Meaningful use criteria for the diverse pediatric patient population must be developed carefully. The AAP suggests that it be done with the following principles in mind.

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