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IMPROVING QUALTY OF CARE FOR CHILDREN TROUGH HEALTH IT

IMPROVING QUALTY OF CARE FOR CHILDREN TROUGH HEALTH IT. Tennessee Project for Children with Special Health Care Needs AHRQ Annual Meeting September 26,2007 Carmen B. Lozzio, MD, FACMG Brent Shelton, PhD Rosalyn Lemak MPH, Billy R Hancock, Robert Eubanks, MS and Michelle Liao, MS

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IMPROVING QUALTY OF CARE FOR CHILDREN TROUGH HEALTH IT

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  1. IMPROVING QUALTY OF CARE FOR CHILDREN TROUGH HEALTH IT Tennessee Project for Children with Special Health Care Needs AHRQ Annual Meeting September 26,2007 Carmen B. Lozzio, MD, FACMG Brent Shelton, PhD Rosalyn Lemak MPH, Billy R Hancock, Robert Eubanks, MS and Michelle Liao, MS University of Tennessee-Graduate School of Medicine, Knoxville, TN Department of Medical Genetics, Univ. of Tennessee, Graduate School of Medicine, Knoxville, TN

  2. IMPROVING QUALITY CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS Agency for Healthcare Research and Quality (AHRQ) TRANSFORMING HEALTHCARE QUALITY THROUGH INFORMATION TECHNOLOGY (THQIT) 2004-Planning Grant 2005-2008:Implementation grant

  3. GOALS OF THE PROJECT • Improve quality of health care for CSHCN by summarizing all relevant information in an electronic health record called TN Child Health Profile (TN-CHP) • Expand HIT by linking public health databases with genetic, developmental and educational data on each child • Make available to providers and parents/legal guardians a secure, web based TN-CHP

  4. TN grants for Genetics and Health Information Technology • 2001/03- HRSA Planning grant: one of 22 grants awarded to states, the only one for close collaboration between TN Dept of Health and academic Genetic Centers. • 2003/07- HRSA Implementation grant as one of five states awarded grants for Joint Program Initiative (Collaboration: Genetic Services Branch & Office of Data Integration and Management). • 2004-AHRQ Planning grant: one of 38 grants awarded. One thousands letters of intend submitted • 2005-AHRQ Implementation grant: one of 16 grants to use e-health to improve quality and safety of medical care. The only one for genetic services. • 2005-2006-SERGG/HRSA: Mini-grants awarded to collaborate with other states in the Southeast region.

  5. Tennessee Genetics Plan for follow-up of NBS/NHS • Tennessee developed the Tennessee Genetics Plan in close collaboration of the Tennessee Department of Health, the academic genetic centers and members of a statewide Genetics Coordinating Committee. • The purpose of this plan is to integrate the information on Newborn Screening (NBS), Newborn Hearing Screening (NHS) and other genetic and developmental services to improve the long term follow-up and care of these children • A major accomplishment has been the development of an electronic child health profile: the Tennessee Child Health Profile (TN-CHP) that makes possible to provide information on NBS and NHS in a secure, accessible web format to providers registered with the state

  6. Tennessee Child Health Profile The Tennessee Child Health Profile (TN-CHP) is a web-based e-health record that condenses the highlights of each child’s medical diagnosis, special needs, and recent services and evaluations into a concise, easy-to-read summary, so that authorized providers can quickly determine appropriate next steps. In addition, parents who opt to have their children included in the system will be able to view their children’s profiles online.

  7. TN-CHP GOALS: • Improve health care delivery, coordination of services, continuity of care and timeliness of follow-up • Provide comprehensive medical, developmental and case management data from a single secure website • Allow long term tracking and avoid “lost” cases

  8. Participating Institutions • UT Graduate School of Medicine-Knoxville, Department of Medical Genetics • Memorial Hospital/UHS, Department of Information Service, Knoxville • Vanderbilt University Department of Pediatrics -Genetic Center, Center forChild Development • UT Health Sciences Center (Memphis) Boling Center for Developmental Disabilities and Genetic Center

  9. Additional Collaborations • Tennessee Department of Health • Vanderbilt e-Health Initiative • HRSA- Regional Grant: SERGG • Connections Community of Practice- Public Health Informatics Institute • AHRQ-Resource Center

  10. UT Genetic Center UT Genetic Center UT UT Newborn Screening (NBS) Newborn Screening (NBS) Newborn Screening (NBS) Newborn Screening (NBS) Link Link Link Link Genetic Genetic Center Center VPN VPN VPN VPN Newborn Hearing Screening Newborn Hearing Screening (NHS) (NHS) Link Link Link Link - - - - Repeat screening Repeat screening Repeat screening Repeat screening CSS CSS CSS CSS Secure Secure Secure Secure Case Managers Case Managers Case Managers Case Managers TN TN TN TN - - - - CHP CHP CHP CHP Web Web Web Web Diagnostic tests Diagnostic tests Diagnostic tests Diagnostic tests Treatment and Treatment and Follow-up Treatment and Follow-up Treatment and Follow Follow - - - - up up Pediatric Pediatric Pediatric Pediatric Endocrinologists Endocrinologists Endocrinologists Endocrinologists Parent Parent Parent Parent at at at at Consent Consent Consent Consent East TN East TN East TN East TN Children Hospital Children Hospital Children Hospital Children Hospital TN-CHP Pilot Phase 1 Newborn Hearing Screening (NHS) Newborn Hearing Screening (NHS) Newborn Hearing Screening (NHS) Newborn Hearing Screening (NHS)

  11. TN-CHP Pilot Phase 2in East TN

  12. Statewide implementation of Tennessee Child Health Profile(TN-CHP)

  13. : . Common Anchor Data for CSHCN : : Linked to Linked to Genetic and Electronic Birth Certificate and Vital Records Immunizations WIC EPSDT Lead screening Tennessee Early Intervention (TEIS) TennCare Mental Retardation TN - Dept. of T Child Dev. - Health NBS Centers and NHS Volunteer e - Health Initiative I TN-CHP Comprehensive Child Health Profile - Ultimate Proposed Data Linkage/Sharing Scheme

  14. URL for TN-CHP DEMO http://gen01/mliao_test2/ Default.aspx

  15. Identifiers to search NBS/NHS data • TDH number • Mother Social Security number • Mother last and first name, date of birth and county of birth

  16. Short Term Follow-up of presumptive positive results A summary of evaluations and diagnostic tests performed at the comprehensive genetic metabolic centers, sickle cell centers or pediatric endocrinologists is shown by clicking on the box : Confirmatory Test

  17. Click on Confirmatory Test Click on Confirmatory Test Click on Confirmatory Test Click on Confirmatory Test Click on Confirmatory Test

  18. Link Diagnosis to Resources For MCAD the following resources are linked to this diagnosis http://ghr.nlm.nih.gov/condition =mediumchainacylcoenzymeadehydrogenasedeficiency http://www.savebabies.org/disease descriptions/mcad.php

  19. Example of abnormal newborn hearing screening results After state report go to search page and click on Hearing Follow-up (interactive page for provider to record reports)

  20. For educational information on Hearing Loss Go to home page and click on Newborn Hearing Screening

  21. For information on long term follow-up of confirmed diagnosis Go to Home page and click on Child Data (this information requires parental consent)

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