Information about the demonstrating the impact of the model electronic health record (EHR) format for children is available as HTML text below and for download as a two-page PDF (511 KB; Plugin Software Help).
- Importance of a Model EHR Format for Children
- Demonstration Project Activities
- Evaluating these Projects
- Learn More
In February 2010, the Centers for Medicare & Medicaid Services (CMS) awarded grants to 10 States under a 5-year, $100 million effort to improve health care quality and delivery systems for children enrolled in Medicaid and the Children's Health Insurance Program (CHIP). The five grant categories are projects that:
- Show how a core set of children's quality measures can be used to improve quality of care for children (Category A).
- Promote the use of health information technology to enhance service quality and care coordination (Category B).
- Implement new or more comprehensive provider-based models of service delivery (Category C).
- Demonstrate the impact of a model electronic health record format for children (Category D).
- Test an approach to quality improvement of a State's own design (Category E).
This report summarizes projects the States are implementing under the fourth category (Category D), "demonstrating the impact of a model electronic health record (EHR) format for children," and highlights some of the key questions addressed by the national evaluation.Top of Page
Importance of a Model EHR Format for Children
As increasing numbers of child-serving practices adopt EHRs, measures of quality will be derived from the information contained in these recordkeeping systems. There are two dangers: (1) EHRs will be developed primarily for adults, and (2) a variety of systems, developed and sold by different companies, will record and store information so differently that standardized measures will not be possible. A model format that has demonstrated utility and feasibility could become the foundation for future certification requirements for all EHR systems for children. The demonstration projects implemented in this category will provide CMS with information on the use and impact of standard EHR components for children. In turn, this information will help to inform technical assistance to promote broader adoption of the model format, contribute to quality measures based on EHR data, and support the Federal effort to promote meaningful use of health information technology (IT).Top of Page
Demonstration Project Activities
Two States, North Carolina and Pennsylvania, are implementing projects to evaluate the model EHR format for children, which is being developed through a separate contract overseen by the Agency for Healthcare Research and Quality (AHRQ).
Although both States have similar goals, they are using different strategies. Pennsylvania is:
- Recruiting practice sites from five health systems and collaborating with several vendors to: (a) implement and test the model format, and (b) determine the extent to which EHRs using this format can yield data for the initial set of core quality measures for children.
- Providing training, technical support, and possibly financial incentives for the selected practice sites to use an EHR that most closely complies with the model format to report and track core measures.
- Developing and testing other electronic quality improvement projects (EQUIPs) based on the format-compliant EHR.
North Carolina is:
- Working with multiple vendors to test the model format in the practices that are participating in provider-based model demonstrations.
- Exploring strategies for using data elements in format-compliant EHRs in the process of gaining medical home certification from the National Committee for Quality Assurance (NCQA) .
- Providing selected practices with technical assistance through EHR consultants and identifying incentives and best practices to promote adoption and use of format-compliant EHRs.
Evaluating these Projects
The States themselves will be evaluating the model format in selected sites and will be doing so in a dynamic environment (including multiple health IT initiatives in the public sector and the ongoing competitive development of EHR platforms in the private sector). The national evaluation team will be conducting key informant interviews with selected stakeholders to document the States' efforts and findings. The national evaluation will use information from these interviews, in addition to information obtained from grantees' progress reports and evaluation findings, to address the following broad questions:
- Were the grantees able to get format-compliant EHRs adopted and used by practices for any quality improvement initiatives?
- To what extent were these format-compliant EHRs used for quality improvement initiatives?
- What types of technical assistance did the grantees need?
- What was the impact of the model format on children's health care quality?
- Did the use of the model format help make pertinent EHR information available to parents, and how did parents use this information?
This document summarizes projects that States are implementing under the fourth category (Category D), demonstrating the impact of a model electronic health record (EHR) format for children. To learn about the other grant categories, please use the left navigational bar, organized by 5 areas of focus.
The Model Format is a set of child-specific requirements (and other requirements of special importance for children) that an electronic health record (EHR) should meet to perform optimally for the particular needs of children. Select for some frequently asked questions and answers about the Model Format.
To learn more about the evaluation of these demonstrations, send an email to CHIPRADemoEval@ahrq.hhs.gov.Top of Page
Please note: This Web site uses the term "national evaluation" to distinguish this evaluation of the entire demonstration program from evaluations commissioned or undertaken by grantees. The word "national" should not be interpreted to mean that findings are representative of the United States as a whole.