At a Glance
2015 Priority List
Flag special healthcare needs
The system shall support the ability for providers to flag or unflag individuals with special health care needs or complex conditions who may benefit from care management, decision support, and care planning; and shall support reporting.
This requirement is meant to support a provider’s ability to use the EHR to identify a child who could benefit from care coordination or care management. It does not require that the system use algorithms to identify such children, based on services delivered, or billing codes used, as that method would likely lead to over- or under-identification of children in need of such services. It instead provides functionality to allow practices to use the system to track the children for whom a care plan or a care coordination plan might be needed. And, as the identification of such children requires provider judgment, and as children move in and out of needing care coordination or care planning, sometimes based on medical status or psychosocial situation, this requirement allows for that judgment to be applied, by allowing providers to flag and unflag children with such needs.
A component of this functionality should be the ability to extract the information through a query on a population of children who fit specific criteria such as a specific common diagnosis, laboratory tests or test results, screening tools or screening results (like ADHD screening treatments, or demographic information and shall be able to display (in the form of dashboards or lists the populations and export data like names, contact information, pending health maintenance tasks and other information for use in other applications requiring such data. As an example, the system should be able to identify all Type I diabetic patients, display them in a dashboard, highlight those with pending health maintenance tasks (like submitting glucose readings and are able to export the names and contact information to a word processor to send letters to those with overdue tasks. This data should also be available for export for individual patients in a manner that allows it to be shared with necessary parties, such as school-based health care workers and others who may be involved in the care coordination and care management team.
Associated diagnoses should be included as a component of any reports that are run on children with the special health care needs flag, to allow for further sorting and categorization by the practice (advanced query functionality Each provider working with specific groups of patients, such as children with special healthcare needs and other vulnerable or priority populations should have EHR functionality allowing them to query the system based on specific data elements of interest, and generate reports on a panel of patients of interest, based on specific diagnoses, screening status, test results, medication use, demographics, or other data fields that support a provider’s ability to manage care for those patients. The need for reports that aggregate data across a panel of patients is high for *all* patients (adult and child but certain pediatric conditions like ADHD, asthma, diabetes, immunization status, and genetic disorders make this functionality a high priority in the context of pediatric care. These reports, sometimes known as dashboard functionality, allow the provider to review, in one report, any patients that have been flagged as requiring care management for special or complex conditions, and to stratify or drill down based on diagnosis. The ability to review summary information on a panel of patients that require special planning and support is paramount to providing better quality of care within a pediatric patient population.