AAP Statement Homes in on Health Information Technology

Norra MacReady

April 27, 2011

April 27, 2011 — Health information technology is essential for the effective function of the pediatric medical home, the American Academy of Pediatrics (AAP) has said in a statement.

The AAP has embraced the medical home concept, which can provide cost-effective, high-quality primary care and coordinate specialty care when operating as envisioned, the AAP's Council on Clinical Information Technology states in an article published online April 25 and in the May issue of Pediatrics. Among other things, "the medical home must centralize and support the primary care relationship between the patient/family and health care provider through well-designed and well-implemented health information management," they explain.

To accomplish these goals, the council calls for the "development, implementation, and widespread deployment of a comprehensive electronic infrastructure to support pediatric information-management functions of the family-centered medical home."

From a medical home perspective, the most important information management tasks include:

  • secure and comprehensive maintenance of patient records;

  • organizing all of a patient's information, including family medical history, as well as information about medical care, immunizations, and prescriptions over the patient's lifetime, into a single easily accessible database;

  • tracking treatment outcomes;

  • educating and sharing information with the patient and his or her family; and

  • use of data for research and quality improvement.

At the core of medical home information management systems is the patient's lifelong electronic health record (EHR), the authors, led by George R. Kim, MD, and William Zurhellen, MD, write. Properly designed and implemented, EHRs can help ensure the continuity, safety, and efficiency of patient care. They will help improve the quality of care in 2 basic ways: by giving researchers the data they need to translate evidence into practical clinical interventions, and by encouraging adherence to current practice guidelines.

Significant challenges to the widespread establishment of these systems still exist, the authors warn. The systems must be capable of sharing data among different practitioners, as well as with insurance companies, billing and scheduling systems, and health information exchanges. There must be one central organizing entity to oversee specific technical, legislative, and advocacy efforts. Financial incentives should be created to lessen the risk small practices will take in acquiring and setting up these systems, and in keeping up with technological changes and upgrades. Privacy laws will have to balance patient confidentiality with the need for information sharing among different entities. Finally, advocates of EHRs will have to overcome the reluctance of practitioners to cope with the headaches involved not only in selecting and implementing these systems but also in entering practice data and converting existing practice infrastructures to meet the systems' requirements.

"The AAP supports development and universal implementation of a comprehensive electronic infrastructure to support pediatric information functions of the medical home," the authors state. They call for financial incentives that "appropriately recognize the added value of medical homes to pediatric care."

The authors have disclosed no relevant financial relationships.

Pediatrics. 2011;121:978-82. Full text

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