Alliance for Pediatric Quality Supports New ANSI-Approved Standard for Child Health Passed by HL7

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Electronic Health Record Systems Used to Care for Children to Carry New Functionality

Many electronic health record systems are built with the adult patient in mind. So when a child goes to his or her primary care doctor - whether in the hospital or at the physician's office - the fields in the child's electronic health record system are not pediatric-specific. For example, height and weight fields are not appropriate for newborns; growth tracking and immunization management features are not standardized; there are no pediatric-specific norm values for physicians, families and patients to use to monitor lab results, vital signs and body measurements; and privacy is not adequately defined for the child.

To improve patient safety and ensure more effective and efficient care of children, Health Level Seven (HL7), a healthcare IT standards development organization, recently passed the healthcare industry's first standard approved by the American National Standards Institute (ANSI) that specifies the basic functional requirements for child healthcare in an electronic health record system. The HL7 Child Health Functional Profile is based upon the HL7 EHR System Functional Model, which is also ANSI-approved. HL7 announced the new standard today: http://www.hl7.org/documentcenter/public/pressreleases/HL7_PRESS_20090108.pdf

The Child Health Functional Profile defines the general pediatric functions critical for electronic health record systems that are used to care for children in the United States, including immunization management, growth tracking, medication dosing, data norms and privacy. The HL7 Child Health Work Group (Child Health WG) created the new functionality over a period of four years with support from the Alliance for Pediatric Quality, a national collaboration of the American Academy of Pediatrics, the American Board of Pediatrics, Child Health Corporation of America and the National Association of Children's Hospitals and Related Institutions.

The Child Health Functional Profile includes electronic health record system functionality necessary to care for a child age 0-18 who receives routine wellness and preventive, acute illness, or acute trauma care that takes place in the following areas: the newborn nursery, the primary care provider's office, the emergency room or urgent care clinic, and the inpatient hospital setting. In addition, the profile also supports ambulatory and inpatient hospital care for common chronic pediatric diseases such as asthma, sickle cell disease and diabetes, as well as those with unusual social situations such as foster care, divided homes and state custody.

As one-third of the U.S. population is children, and more than half of those children visit clinicians in settings other than pediatric offices, health information technology vendors and their physician and hospital customers recognize the importance of embedding the Child Health Functional Profile in their electronic health record systems.

"The Child Health Functional Profile standard is useful as we work with our health information technology vendors to ensure our EHR products are reliable for the care of children," said Andrew Spooner, MD, FAAP, chief medical information officer at Cincinnati Children's Medical Center and co-chair of the Child Health WG. "The Child Health Functional Profile tells us which functionality is most critical in general pediatrics and paints a picture of the functionality that is desirable in the future. This is immensely helpful to us as we plan development priorities to meet our hospital's and physician practices' needs."

Vendors who have participated in the defining of the Child Health Functional Profile have had the unique advantage of using components of the Child Health Functional Profile even before it became an ANSI-approved standard, explained Spooner. "At our children's hospital, it is very important to the safety of our pediatric patients that we track developmental growth with the embedded growth charts. Tracking a child's growth is different than simply tracking height and weight as is necessary for an adult patient. With this standard in place, comparability is also possible, which is a critical part of quality improvement efforts here," Spooner added.

About the Alliance for Pediatric Quality
The Alliance for Pediatric Quality is a national collaboration of the American Academy of Pediatrics (AAP), The American Board of Pediatrics (ABP), Child Health Corporation of America (CHCA) and the National Association of Children's Hospitals and Related Institutions (NACHRI). The Alliance partners represent more than 200 children's hospitals and 60,000 pediatricians and pediatric subspecialists and surgeons. Together, they are bringing about immediate, measurable change in the quality of care provided to children. http://www.kidsquality.org

About HL7
Founded in 1987, Health Level Seven, Inc. is a not-for-profit, ANSI-accredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. HL7's more than 2,400 members represent approximately 500 corporate members, including 90 percent of the largest information systems vendors serving healthcare. http://www.hl7.org

For more information on the Alliance for Pediatric Quality, visit http://www.kidsquality.org

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Carol G. Dobies
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