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Health Information Technology

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Are there benchmarks and best practices to measure or to promote quality and efficiency?

There are currently various benchmarks for measuring quality and efficiency of pediatric health care.  There has also been a call to develop clear and standard best practices for using health IT to improve quality and efficiency in pediatric settings.  The Agency for Health Care Research and Quality's (AHRQ) child health care quality toolbox provides an overview of some of these measures, such as the Consumer Assessment of Health Plans (CAHPS), AHRQ QIs, the Health Plan Employer Data and Information Set (HEDIS), Title V Maternal and Child Health Programs, and the Child and Adolescent Health Measurement Initiative (CAHMI).  The AHRQ toolbox also presents reasons why these established benchmarks are useful.  Some of these advantages stem from the fact that a preexisting set of guidelines has been created, including descriptions of the key facets of quality measurement, parameters on what type of data to collect, and procedures describing how to conduct the data analysis.

Benchmarks and best practices are not only relevant in the area of health care quality, but also are important for creating standards to health IT systems. Standards can be helpful in defining a minimum level of operation at which health IT tools are effective in improving health care.  However, many of these standards are currently not clear or well established.  To help remedy this, policymakers are working to establish guidelines for "meaningful use" of electronic health records (EHRs).  The Meaningful Use Matrix (PDF - 639KB) released on July 16, 2009 by the HIT Policy Committee, lists that the first health outcome policy priority of meaningful use is to ensure that EHRs "improve quality, safety, efficiency, and reduce health disparities."

A key caveat to the usefulness of health IT standards is that the utility of these standards in pediatrics is limited if they do not establish or promote best practices that incorporate certain functionalities necessary to provide quality care to children.  This idea is stressed in the 2007 EHR policy report from the American Academy of Pediatrics (AAP),go to exit disclaimer which advocates for important pediatric functions such as growth tracking, weight based dosing, and linkages to immunization registries.  The Children's Partnership go to exit disclaimer also urges policymakers to evaluate and to prioritize HIT with respect to the needs of children.

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