References Spooner SA, Council on Clinical Information Technology, American Academy of Pediatrics. Special requirements of electronic health record systems in pediatrics. Pediatrics. 2007 Mar;119(3):631-7. PMID: 17332220. Agency for Healthcare Research and Quality. Demonstrating the impact of a model pediatric EHR format. Rockville, MD: Agency for Healthcare Research and Quality; 2013 May. . Accessed March 11, 2015. Agency for Healthcare Quality and Research. National Evaluation of the CHIPRA Quality Demonstration Grant Program. Rockville, MD: Agency for Healthcare Research and Quality; 2014 August. . Accessed March 11, 2015. Community Care of North Carolina. Pediatric electronic health record. . Accessed March 11, 2015. M-Chat. M-CHAT.org; 2009 . Accessed March 11, 2015. ASQ. How can you give kids the best start in life? Baltimore, MD: Brookes Publishing Co.; 2015 . Accessed March 11, 2015. American Academy of Pediatrics. Bright Futures Tool and Resource Kit. Elk Grove Village, IL: American Academy of Pediatrics . Accessed March 11, 2015.
Requirement ID - Name (Topic) HL7 Child Health Functional Profile, Release 1 2014 Edition 170.314 2014 Proposed 2015 Edition – 170.315 2015 Req-2028 – Use established immunization messaging standards (Immunizations, Registry Linkages) Close Match “IN. 5.1 - Support the ability to operate seamlessly with other systems, either internal or external, that adhere to recognized interchange standards. “Other systems” include other EHR Systems, applications within an or other authorized entities that interact with an EHR-S #5 - The system SHOULD provide the ability to exchange data using an explicit and formal information model and standard, coded terminology.” p 84-85 Close Match “(1) Immunization information. Enable a user to electronically record, change, and access immunization information. (2) Transmission to immunization registries. EHR technology must be able to electronically create immunization information for electronic transmission in accordance with: (i) The standard and applicable implementation specifications specified in§ ; and (ii) At a minimum, the version of the standard specified in§ . (3) Transmission to public health agencies—syndromic surveillance. EHR technology must be able to electronically create syndrome-based public health surveillance information for electronic transmission in accordance with: (i) Ambulatory setting only. (A) The standard specified in§ . (B) Optional. The standard (and applicable implementation specifications) specified in § . (ii) Inpatient setting only. The standard (and applicable implementation specifications) specified in § .” 170.314(f) Close Match “We propose to adopt a 2015 Edition “transmission to immunization registries” certification criterion that is revised in comparison to the 2014 Edition “transmission to immunization registries” criterion (§ 170.314(f)(2)). We propose to adopt an updated IG, require National Drug Codes (NDC) for recording administered vaccines, require CVX codes for historical vaccines, and require a Health IT Module presented for certification to this criterion to be able to display an immunization history and forecast from an immunization registry.” 170.315(f)(1) (continued)
Requirement ID - Name (Topic) HL7 Child Health Functional Profile, Release 1 2014 Edition 170.314 2014 Proposed 2015 Edition – 170.315 2015 Req-2029 – Age-based educational cues (Primary Care Management) Concept Addressed “DC.1.6.1 - Present organizational guidelines for patient care as appropriate to support planning of care, including order entry and clinical documentation. DC.1.8.3 - Present, annotate, and route current and historical test results to appropriate providers or patients for review. Provide the ability to filter and compare results. #14 - The system SHOULD trigger decision support algorithms from the results” p. 24-25 *Bright Futures not mentioned specifically Not Addressed Not Addressed Req-2030 - Document authority of patient representative (Security and Confidentiality) Close Match “S.3.5 - Document relationships between patients and others to facilitate appropriate access to their health record on this basis if appropriate” p.113 *does not specifically outline all requirements in 1212 Not Addressed Not Addressed Req-2031 - The system shall have the ability to record a child's adoption history (Child Welfare) Not Addressed Not Addressed Not Addressed Req-2032 - Authorized viewers of EHR data (Child Welfare, Patient Portals) Close Match “IN.1.2 - Manage the sets of access-control permissions granted to entities that use an EHR-S (EHR-S Users). Enable EHR-S security administrators to grant authorizations to users, for roles, and within contexts. A combination of these authorization categories may be applied to control access to EHR-S functions or data within an EHR-S, including at the application or the operating system level.” Not Addressed Not Addressed Req-2033 - Placement setting in out-of-home care (Child Welfare) Not Addressed Not Addressed Not Addressed Req-2034 - Alert for foster care without Medicaid (Child Welfare) Not Addressed Not Addressed Not Addressed Req-2035 - Rounding for administrable doses (Medication Management) Not Addressed Not Addressed Not Addressed (continued)
Table 1. 2015 Priority List Requirement IDs by Topic Topic Name 2015 Priority List Requirement ID* Birth Information 2001, 2009 Child Abuse Reporting 2006 Child Welfare 2031, 2032, 2033, 2034 Children with Special Healthcare Needs 2014, 2022 EPSDT 2020 Genetic information 2009 Growth Data 2002, 2003, 2019, 2042 Immunizations 2011, 2027, 2028 Medication Management 2005, 2010, 2012, 2035, 2036, 2037 Newborn Screening 2015, 2016, 2017, 2018 Parents and Guardians and Patient Relationship Data 2006, 2008, 2021, 2038 Patient Identifier 2021 Patient Portal/PHR 2007, 2026, 2032 Prenatal Screening 2009 Primary Care Management 2006, 2013, 2029, 2044, 2045 Registry Linkages 2011, 2028 School-Based Linkages 2026 Security and Confidentiality 2008, 2026, 2030, 2038, 2039, 2040, 2041 Specialized Scales/Scoring 2043 Well Child/Preventive Care 2004, 2013, 2019, 2020, 2023, 2024, 2025, 2027, 2044, 2045, 2046, 2047 *Requirement IDs refer to individual requirements on the 2015 Priority List. Recommended Uses The MSWG prepared this document to accompany the 2015 Priority List to suggest how the software requirements might best be used by key stakeholders to improve the care of children. The most immediate, “direct” use of a 2015 Priority List software requirement is to change the way software is designed and used. Direct use in product planning and design activities usually involves users, domain experts, product planners, and software engineers. However, the MSWG recognized that additional stakeholders and downstream uses, after software changes were made, would be essential. Much work would be needed to leverage improved EHR data and tools to support public health, quality measurement, individual care, and communication among all who participate in the health and care of the child. The MSWG identified a number of “indirect” uses of the 2015 Priority List (beyond software development) by stakeholders focused on these downstream effects. Stakeholders may find it valuable to review and understand the 2015 Priority List as part of their planning activities, funding decisions, policy development, or community advocacy work. Each recommended use in this report is labelled as direct or indirect to reflect this distinction. The list of recommended uses is shown below, organized by direct or indirect use, and by stakeholder.