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What functions are required of a health IT system in order to improve quality?

In order to fully realize the potential of health IT to improve quality, additional functions should be incorporated into the health IT system.  There are particular health IT functions that can facilitate quality improvement in pediatric care.  These functions include capabilities for data reporting to external entities, clinical decision support (CDS), patient panels, and chronic disease management.

  • Often providers are required by State or federal agencies to report data that can provide an indication of quality.  This page from the AHRQ website on Federal and State reporting requirements for quality provisions specifies that reporting can enable analyses of quality indicators such as the appropriateness of care and the quality of health coverage provided.   Providers can utilize electronic health records (EHRs) or electronic registries to extract data for reporting purposes. According to a paper published in the American Medical Informatics Associations (AMIA) Annual Symposium Proceedingsgo to exit disclaimer, "Quality reporting tools, integrated with ambulatory electronic health records, can help clinicians and administrators understand performance, manage populations, and improve quality."
  • Clinical Decision Support (CDS) systems can also improve quality.  For example, a 2009 article in the journal Pediatric Critical Care Medicinego to exit disclaimer found that CDS can be particularly useful and effective in pediatric intensive care units where care needs to be delivered in a timely but safe manner and decisions must be made quickly. CDS guides providers towards making certain decisions about care, aiding them in adhering to evidence-based best practices.  CDS can also provide physicians with reminders to provide recommended health services such as vaccinations for children.  A chapter on Clinical Decision Support from a report prepared for AHRQ by the University of California at San Francisco (UCSF)-Stanford University Evidence-based Practice Center highlights that CDS can also include drug dosage calculators, a potentially important tool since weight-based dosing is one of the AAP's requirements of pediatric EHR systems.
  • Patient panels and panel management can support health IT systems that encourage quality improvement. Health IT systems utilizing patient panels would be able to supply providers with an idea of the quality of treatment they are delivering to certain populations, for example, details of the treatment and health of all of a pediatrician's patients with chronic asthma.  By using health IT to extract this information, providers are better equipped to address the issues of a particular population of patients to improve quality and health outcomes. An example of this use of health IT is iCare, the population management tool of the Indian Health Service (IHS).  According to the IHS, iCare allows providers to view patient data by organizing their patients in panels with similar traits.
  • Having a system that includes functionalities for chronic disease management is another means for health IT to fully address the aspects of quality improvement.  The Community Clinic Health Network discusses the i2iTracks softwarego to exit disclaimer as an example of a health IT tool used to improve quality. 

Simply instituting health IT systems is not enough to promote quality improvement in pediatric care.  In order to improve the quality of care received by children and adolescents, the health IT systems should incorporate the specific functionalities listed here.  These functionalities are not specific to quality improvement in pediatrics, but are relevant when serving the unique needs of the pediatric population.

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