Abstract
Progress in using information technology to achieve the goal of high-quality health care is hindered by the lack of coordinated data standards. To accelerate quality improvement in pediatrics, child health providers must participate actively in the creation of health care data standards. To do so will require far greater understanding on the part of pediatricians and other pediatric providers regarding the scope and role of data standards in advancing health information systems for children, as well as how data standards could improve quality in child health, what kinds of data standards hold the most promise for quality improvement in child health, and how child health professionals can engage in the work of creating data standards. Child health professionals in organized and academic medicine should participate in standards development organizations, to present the pediatric point of view as data standards emerge. They also should support efforts to certify electronic health record systems that include pediatric functionality. A major challenge to academic pediatrics is to prove that data standards can lead to improved health outcomes for children; this is only a compelling conjecture as of this writing.
References
49
Referenced
21
- Institute of Medicine, Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001
-
Delpierre C, Cuzin L, Fillaux J, Alvarez M, Massip P, Lang T. A systematic review of computer-based patient record systems and quality of care: more randomized clinical trials or a broader approach?Int J Qual Health Care. 2004;16(5):407–416
(
10.1093/intqhc/mzh064
) -
Dougherty D, Simpson LA. Measuring the quality of children's health care: a prerequisite to action. Pediatrics. 2004;113(1):185–198
(
10.1542/peds.113.S1.185
) -
Hammond WE. The making and adoption of health data standards. Health Aff (Millwood). 2005;24(5):1205–1213
(
10.1377/hlthaff.24.5.1205
) -
Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med. 2003;348(25):2526–2534
(
10.1056/NEJMsa020847
) -
Kaushal R, Jaggi T, Walsh K, Fortescue EB, Bates DW. Pediatric medication errors: what do we know? What gaps remain?Ambul Pediatr. 2004;4(1):73–81
(
10.1367/1539-4409(2004)004<0073:PMEWDW>2.0.CO;2
) -
Bates DW, Teich JM, Lee J, et al. The impact of computerized physician order entry on medication error prevention. J Am Med Inform Assoc. 1999;6(4):313–321
(
10.1136/jamia.1999.00660313
) - Shiffman RN, Liaw Y, Navedo DD, Freudigman KA. User satisfaction and frustration with a handheld, pen-based guideline implementation system for asthma. Proc AMIA Symp. 1999:940–944
- Gioia PC. Quality improvement in pediatric well care with an electronic record. Proc AMIA Symp. 2001:209–213
-
Adams WG, Mann AM, Bauchner H. Use of an electronic medical record improves the quality of urban pediatric primary care. Pediatrics. 2003;111(3):626–632
(
10.1542/peds.111.3.626
) -
Bury J, Hurt C, Roy A, et al. LISA: a web-based decision-support system for trial management of childhood acute lymphoblastic leukaemia. Br J Haematol. 2005;129(6):746–754
(
10.1111/j.1365-2141.2005.05541.x
) -
Lister NA, Smith A, Fairley CK. Introduction of screening guidelines for men who have sex with men at an STD clinic, the Melbourne Sexual Health Centre, Australia. Sex Health. 2005;2(4):241–244
(
10.1071/SH05006
) -
Rood E, Bosman RJ, van der Spoel JI, Taylor P, Zandstra DF. Use of a computerized guideline for glucose regulation in the intensive care unit improved both guideline adherence and glucose regulation. J Am Med Inform Assoc. 2005;12(2):172–180
(
10.1197/jamia.M1598
) -
Hsieh TC, Kuperman GJ, Jaggi T, et al. Characteristics and consequences of drug allergy alert overrides in a computerized physician order entry system. J Am Med Inform Assoc. 2004;11(6):482–491
(
10.1197/jamia.M1556
) -
Johnson KB, Davison CL. Information technology: its importance to child safety. Ambul Pediatr. 2004;4(1):64–72
(
10.1367/1539-4409(2004)004<0064:ITIITC>2.0.CO;2
) -
Boxwala AA, Tu S, Peleg M, et al. Toward a representation format for sharable clinical guidelines. J Biomed Inform. 2001;34(3):157–169
(
10.1006/jbin.2001.1019
) -
Shiffman RN, Karras BT, Agrawal A, Chen R, Marenco L, Nath S. GEM: a proposal for a more comprehensive guideline document model using XML. J Am Med Inform Assoc. 2000;7(5):488–498
(
10.1136/jamia.2000.0070488
) -
Boxwala AA, Peleg M, Tu S, et al. GLIF3: a representation format for sharable computer-interpretable clinical practice guidelines. J Biomed Inform. 2004;37(3):147–161
(
10.1016/j.jbi.2004.04.002
) -
Shiffman RN, Michel G, Essaihi A, Thornquist E. Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementation. J Am Med Inform Assoc. 2004;11(5):418–426
(
10.1197/jamia.M1444
) -
Shiffman RN, Dixon J, Brandt C, et al. The GuideLine Implementability Appraisal (GLIA): development of an instrument to identify obstacles to guideline implementation. BMC Med Inform Decis Mak. 2005;5:23
(
10.1186/1472-6947-5-23
) - NQF endorses patient safety event taxonomy. Healthc Benchmarks Qual Improv. 2005;12:113–115
-
Beal AC, Co JPT, Dougherty D, et al. Quality measures for children's health care. Pediatrics. 2004;113(1):199–209
(
10.1542/peds.113.S1.199
) -
Mekhjian HS, Kumar RR, Kuehn L, et al. Immediate benefits realized following implementation of physician order entry at an academic medical center. J Am Med Inform Assoc. 2002;9(5):529–539
(
10.1197/jamia.M1038
) -
Evans RS, Pestotnik SL, Classen DC, et al. A computer-assisted management program for antibiotics and other antiinfective agents. N Engl J Med. 1998;338(4):232–238
(
10.1056/NEJM199801223380406
) -
Classen DC, Pestotnik SL, Evans RS, Lloyd JF, Burke JP. Adverse drug events in hospitalized patients: excess length of stay, extra costs, and attributable mortality. JAMA. 1997;277(4):301–306
(
10.1001/jama.277.4.301
) -
Council on Children With Disabilities. Care coordination in the medical home: integrating health and related systems of care for children with special health care needs. Pediatrics. 2005;116(5):1238–1244
(
10.1542/peds.2005-2070
) -
Shiffman RN, Brandt CA, Freeman BG. Transition to a computer-based record using scannable, structured encounter forms. Arch Pediatr Adolesc Med. 1997;151(12):1247–1253
(
10.1001/archpedi.1997.02170490073013
) -
Johnson KB, Cowan J. Clictate: a computer-based documentation tool for guideline-based care. J Med Syst. 2002;26(1):47–60
(
10.1023/A:1013042920905
) - O'Connor PJ, Crain AL, Rush WA, Sperl-Hillen JM, Gutenkauf JJ, Duncan JE. Impact of an electronic medical record on diabetes quality of care. Ann Fam Med. 2005;3(4):300–306
- Thompson TG, Brailer DJ. The Decade of Health Information Technology: Delivering Consumer-centric and Information-Rich Health Care. Washington, DC: Department of Health and Human Services; 2004:178
- Merritt D, Gier J. Accelerating Transformation Through Health Information Technology: Summary of Findings From October 18, 2005 CHT Connectivity Conference. Washington, DC: Center for Health Transformation; 2005. Available at: www.healthtransformation.net/galleries/specialevents/CHTConnectivityConferenceReport-112805(4).pdf. Accessed November 12, 2008
-
Riva A, Mandl KD, Oh DH, et al. The personal internetworked notary and guardian. Int J Med Inform. 2001;62(1):27–40
(
10.1016/S1386-5056(00)00136-2
) - Kibbe DC, Phillips RL Jr, Green LA. The Continuity of Care Record. Am Fam Physician. 2004;70(7):1220, 1222–1223
-
Boluyt N, Lincke CR, Offringa M. Quality of evidence-based pediatric guidelines. Pediatrics. 2005;115(5):1378–1391
(
10.1542/peds.2004-0575
) - Tovey DCW, ed. Clinical Evidence: Pediatrics. London, UK: BMJ Publishing Group Ltd; 2005
-
Rosenbloom ST, Miller RA, Johnson KB, Elkin PL, Brown SH. Interface terminologies: facilitating direct entry of clinical data into electronic health record systems. J Am Med Inform Assoc. 2006;13(3):277–288
(
10.1197/jamia.M1957
) -
Current Procedural Terminology (CPT). JAMA. 1970;212(5):873–874
(
10.1001/jama.212.5.873b
) - Spooner SA, Danish RK. Coverage of pediatric endocrinologic concepts in the Unified Medical Language System. Presented at the Pediatric Academic Societies Annual Meeting; May 4–7, 2002; Baltimore, MD
- Implementation Guide for Immunization Data Transactions Using Version 2.3.1 of the Health Level Seven (HL7) Standard Protocol: Implementation Guide Version 2.2. Atlanta, GA: Centers for Disease Control and Prevention; 2006
- Center for Health and Health Care in Schools. Parents Speak Out on Health and Health Care in Schools: Findings From a Survey of Parents With School-Aged Children. Washington, DC: Center for Health and Health Care in Schools; 2003
- Medicare part D subsidies: final rules. Fed Regist. 2005;70(250):77663–77685
- Vukadinovich DM. Minors' rights to consent to treatment: navigating the complexity of state laws. J Health Law. 2004;37(4):667–691
-
Szilagyi PG, Rodewald LE, Savageau J, Yoos L, Doane C. Improving influenza vaccination rates in children with asthma: a test of a computerized reminder system and an analysis of factors predicting vaccination compliance. Pediatrics. 1992;90(6):871–875
(
10.1542/peds.90.6.871
) -
Gaglani M, Riggs M, Kamenicky C, Glezen WP. A computerized reminder strategy is effective for annual influenza immunization of children with asthma or reactive airway disease. Pediatr Infect Dis J. 2001;20(12):1155–1160
(
10.1097/00006454-200112000-00012
) -
Fiks AG, Grundmeier RW, Biggs LM, Localio AR, Alessandrini EA. Impact of clinical alerts within an electronic health record on routine childhood immunization in an urban pediatric population. Pediatrics. 2007;120(4):707–714
(
10.1542/peds.2007-0257
) -
Kemper AR, Uren RL, Clark SJ. Adoption of electronic health records in primary care pediatric practices. Pediatrics. 2006;118(1). Available at: www.pediatrics.org/cgi/content/full/118/1/e20
(
10.1542/peds.2005-3000
) -
Rosenbloom ST, Qi X, Riddle WR, et al. Implementing pediatric growth charts into an electronic health record system. J Am Med Inform Assoc. 2006;13(3):302–308
(
10.1197/jamia.M1944
) -
Ogden CL, Kuczmarski RJ, Flegal KM, et al. Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics. 2002;109(1):45–60
(
10.1542/peds.109.1.45
) -
Hammond WE, Cimino JJ. Standards in medical informatics. In: Shortliffe EH, Perreault LE, eds. Medical Informatics: Computer Applications in Health Care and Biomedicine. 2nd ed. New York, NY: Springer; 2001:212–256
(
10.1007/978-0-387-21721-5_6
)
Dates
Type | When |
---|---|
Created | 16 years, 8 months ago (Dec. 16, 2008, 1:07 p.m.) |
Deposited | 2 years, 3 months ago (May 22, 2023, 8:05 p.m.) |
Indexed | 3 months, 3 weeks ago (May 8, 2025, 9:29 a.m.) |
Issued | 16 years, 8 months ago (Jan. 1, 2009) |
Published | 16 years, 8 months ago (Jan. 1, 2009) |
Published Online | 16 years, 8 months ago (Jan. 1, 2009) |
Published Print | 16 years, 8 months ago (Jan. 1, 2009) |
@article{Spooner_2009, title={Data Standards and Improvement of Quality and Safety in Child Health Care}, volume={123}, ISSN={1098-4275}, url={http://dx.doi.org/10.1542/peds.2008-1755e}, DOI={10.1542/peds.2008-1755e}, number={Supplement_2}, journal={Pediatrics}, publisher={American Academy of Pediatrics (AAP)}, author={Spooner, S. Andrew and Classen, David C.}, year={2009}, month=jan, pages={S74–S79} }