Context Charter Document Pediatric Preventive Care Measure Technical Workgroup Initiated: August 2011 (Updated Nov 2012 for Membership) MN Community Measurement is charged with reviewing, selecting and/or developing a pediatric preventive care measure. The process to develop a measure includes the formation of a technical workgroup with membership specific to the topic. The Pediatric Preventive Care Measure Technical Workgroup has been formed to address this topic area and members were solicited to represent different areas of concern specifically from the medical community, payers of health care, clinic administration and quality improvement professionals, interested consumers and public health agencies. Pediatric preventive care for children and adolescents is a corner stone of public health and well-being for the population. Through the use of screening, education and proper preventive medicine, many serious and devastating illnesses can be avoided. In ambulatory care, the delivery of pediatric preventive care is often structured around the well child visit and other opportunities that health care providers have to interact with patients. In Minnesota, children ages 0-18 make up about 25% of the population while approximately 400,000 children are ages 0-5. 1 Purpose statement This workgroup has been formed to develop a measure specific to pediatric preventive care for public reporting in Minnesota. This improved measure should reflect the criteria required of all measures reported by MN Community Measurement: Measurable o Evidence-based standard of care / consistent with guidelines The workgroup will keep in mind that for pediatric preventive services in general there is a general lack of strong evidence from randomized controlled trials. The strength of the evidence that is used to create clinical guidelines should be considered during discussions and when making recommendations. o Feasible (data sources available/standard specs available) o Tested (valid and accurate) o Data collection costs/resources reasonable Meaningful o Strategically aligned with local and national quality initiatives o Room for improvement o Variation of results Impactful o Measure reflects the quality and/or cost of care 1 Minnesota 2010 Needs Assessment: Services Title V Block Grant. website. http://www.health.state.mn.us/divs/cfh/na/. Accessed May 2, 2011. 1
Goals The Pediatric Preventive Care Technical Workgroup will work towards reviewing and identifying or creating a measure or measures for Pediatric Preventive Care to recommend for approval. Specific consideration should be given to a measure or measures that would be broadly applicable and useful for families seeking information about high-quality, well-child pediatric care. In-Scope Included in the development of a new measure: Reliance on current/recent clinical guidelines with an eye to the strength of the evidence on which the guidelines are based Use of any or all of the following data sources: administrative data (claims data), direct data submission (data from electronic or paper medical records), composite measures (multiple points must be met at minimum levels to be considered), hybrid measures (using a combination of data sources), other/alternate data sources Outcome measures (reporting on clinical outcomes), process measures (reporting on treatments administered), and other measures (quality measures, use of service measures, etc.) Focus on care for pediatric prevention, including but not limited to: well child visits, immunizations, mental health in children and adolescents, obesity and overweight children, disparities in health care Measurement attribution level (individual providers, clinics, facilities) and patient attribution (determining who is responsible for the patient, data, reporting, etc.) Risk adjustment: Include discussions about characteristics that might impact risk adjustment including patient demographics (e.g. insurance status) All places of service including: Ambulatory settings, urgent care, emergency rooms, and other settings Out-of-Scope Excluded from the development of a new measure: Pediatric acute care Condition-specific measures for specialty care or chronic care in pediatrics Definitions Pediatric preventive care is any type of preventive health service for children under the age of 18. These health services can include screenings, immunizations, counseling, and education. Terms such as, pediatrics, early childhood, childhood, teenage, and adolescence may be used separately (to describe distinct developmental periods) or interchangeably (to define the entire time period) depending on the source. Meeting Frequency This workgroup will meet on a limited basis. This group shall aim to meet no more than five times. Work may need to be completed outside of this group in order to achieve the meeting frequency goal. 2
Timeline The goal as concerns the timing of the development of a new pediatric measure will be as follows: a) Recommendation for pediatric preventive care measure or measures before the end of 2011; b) Measurement and Reporting Committee & Board of Directors approve recommendation by early 2012; c) Communication will go out to medical groups after approval; d) Aim for dates of service for the first round of data collection to start sometime in 2012 or 2013 depending on the measure selected and data source. Accountability and Audience This workgroup is accountable to the entire Minnesota community, including patients, providers, and purchasers. Workgroup Members (updated 11/07/2012) Name Carolyn Allshouse Elaine Arion (until 9/18/2012) Kiley Black (replaced David Jensen 10/18) Susan Castellano (until 11/07/2012) Vijay Chawla, MD Jill Coleman / Tammy Carlson, RN Peter Dehnel, MD Glence Edwall Anne Edwards, MD FAAP Emily Emerson Judy Fundingsland, RN Kim Gulliver Organization Family Voices of Minnesota Executive Director Children s Physician Network Quality Improvement Target Clinics Nurse Practitioner MN Department of Human Services Mayo Clinic Health System, Austin Pediatrician Essentia Health Quality Improvement / Health Care Home Coordinator Blue Cross Blue Shield MN Medical Director MN Department of Human Services Maternal/Child and Adult Health Park Nicollet Chair, Park Nicollet Pediatrics MN Department of Health MIIC Manager/IT Unit Supervisor Medica Quality Improvement Hennepin County Public Health Protection- Immunization Services 3
Penny Hatcher Robert Jacobson, MD Jean Larson, MS PHN Larry Morrissey, MD Patricia Lutz* (4/10/2012 12-31- 12) Terry Murray Diane Olson, RN BSN (until 6/04/2012) Brenda Paul* (until 12/03/2011) Rob Payne, MD Marilyn Peitso, MD FAAP Marie Reisdorfer (as of 6/04/2012) Lori Ricke, MD Laura Saliterman, MD Katy Schalla Lesiak Sudha Setty, MPH Terri Lloyd, RN, MA (as of 9/18/2012) Tim Stratton Diane Wehrle *Facilitator Senior Planning Analyst Mayo Clinic Pediatrics MN Department of Health - Duluth Public Health Nursing Consultant Health Care Homes Stillwater Medical Group Medical Director of Quality Improvement MN Community Measurement Project Manager, Measure/Program Development Quello Clinic - Division of Allina Hospitals & Clinics Clinic Quality Specialist Quality Improvement Advisor- Mayo Clinic Health System MN Community Measurement Manager, Measure / Program Development Children's Hospitals and Clinics of Minnesota Medical Director, Quality and Research Centracare Clinic Women and Children President, MN American Academy of Pediatrics Mayo Clinic HealthPartners Family Practice Provider South Lake Pediatrics Pediatrician Quality Improvement Coordinator Immunization, Tuberculosis, and International Health Director, Professional Services Children's Physician Network University of Minnesota, Duluth College of Pharmacy Professor of Pharmacy Practice HealthPartners Manager, Clinical Measurement 4
Expectations of Involvement for Workgroup Participants 1. Participate actively in meetings 2. Review and comment on documents/materials/work products 3. Champion the work of the MNCM in their organization and the community 4. Constructively represent the concerns and interests of their constituency in the collaborative process Aims and Goals The goal of the workgroup is to recommend a new pediatric prevention measure (or measures) for public reporting. The following aims will help to achieve our goal: 1. Remain patient-focused throughout the discussion and process 2. Review clinical guidelines 3. Review existing quality improvement pediatric measures 4. Consider national and local pediatric prevention care goals 5. Recommend a measure for approval 6. Gather input and consider feedback from relevant community stakeholders 7. Discuss implementation barriers, community messages, and impact 8. Review testing and pilot data Completion The group will consider their work complete once the Minnesota Community Measurement Board of Directors approves a new pediatric preventive care measure or measures for public reporting. 5