Health Information Technology and the Medical Home

Abstract

The American Academy of Pediatrics (AAP) supports development and universal implementation of a comprehensive electronic infrastructure to support pediatric information functions of the medical home. These functions include (1) timely and continuous management and tracking of health data and services over a patient's lifetime for all providers, patients, families, and guardians, (2) comprehensive organization and secure transfer of health data during patient-care transitions between providers, institutions, and practices, (3) establishment and maintenance of central coordination of a patient's health information among multiple repositories (including personal health records and information exchanges), (4) translation of evidence into actionable clinical decision support, and (5) reuse of archived clinical data for continuous quality improvement. The AAP supports universal, secure, and vendor-neutral portability of health information for all patients contained within the medical home across all care settings (ambulatory practices, inpatient settings, emergency departments, pharmacies, consultants, support service providers, and therapists) for multiple purposes including direct care, personal health records, public health, and registries. The AAP also supports financial incentives that promote the development of information tools that meet the needs of pediatric workflows and that appropriately recognize the added value of medical homes to pediatric care. Pediatrics 2011;127:978-982 INTRODUCTION The Medical Home, the Strategic Plan of the American Academy of Pediatrics, and Health Information ManagementThe medical home 1 model is the central organizing principle for health care management for all children, including those with special health care needs. 2 The ideal medical home (1) translates evidence into highquality pediatric care that is measurable, (2) provides coordinated pediatric primary and specialty care for all children, and (3) sustains pediatric practice through fair payment, cost-efficiency, and recognition of the value of pediatric primary care. The medical home model supports the strategic plan of the American Academy of Pediatrics (AAP) 3 by unifying evidence-based practice and the business of pediatric care through patient/family-provider relationships that are based on trust and effective, reliable information management. Medical Home Information FunctionsThe medical home must centralize and support the primary care relationship between the patient/family and health care provider through

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

“…There has been rapid growth in EMR system adoption in recent years, fueled by federal funding [96] and EMR systems’ potential to improve care quality, efficiency, and safety [97]. Beyond basic features, such as the ability to record a patient’s problem, medication lists, and physician notes, EMRs can allow exchange of clinical information across care settings and online patient access to medical records, prescription refills, appointment booking, and previsit questionnaires through “patient portals” [98].…”

Use of the internet by Italian pediatricians: habits, impact on clinical practice and expectations

“…The opinion on the usefulness of web-based tools for communication with families may depend on the perception of a potential for an easier disease management, especially regarding chronic diseases, as suggested by another study [26]. Interestingly, the use of these tools during clinical practice, although endorsed by the American Academy of Pediatrics, poses implementation challenges regarding confidentiality, integrity, and availability of patients' data [27]. …”

Status of health information exchange: a comparison of six countries

“…Even in apparently unified national health systems, political and professional preferences can shape the context of HIE, for example in the UK, policies have fluctuated between favoring centralized national systems and multiple vendor systems, with recent moves towards cloud-based infrastructure offering something in between. It is also important to recognize that HIE is just one approach for advancing patient-centered care and information fragmentation, which also includes other strategies such as Health Record Banking [40] and the Patient Centered Medical Home in the US [41]. Major changes in health system organization are also leading to new models of HIE.…”