Pediatric Informatics: Computer Applications in Child Health (Health ...

Chapter 17
Aligning Pediatric Ambulatory Needs
with Health IT
Michael G. Leu, George R. Kim, Ari H. Pollack and William G. Adams
Objectives
To outline the motivations for and clinical uses of health IT in the ambulatory
care setting
To describe the current state of ambulatory health IT adoption, and describe the
effect of practice size on adoption decisions
To illustrate organizational, financial, and technical considerations when adopting
health IT
17.1 Introduction
Primary motivations for health IT adoption, from a federal policy level, are to
improve quality and reduce costs in health care. In ambulatory care, incentive
alignment among stakeholders is a major obstacle. While patients and payors benefit
from adoption, it is the practices and provider groups that must bear the burdens
of financial investment, workflow redesign, and organizational change. Even for
institutions and practices skilled in managing the necessary changes, the task of
health IT adoption is risky (Table 17.1).
17.2 Motivations for Health IT Use
Pediatric care is rendered primarily in ambulatory settings (private offices, urgent
care centers, specialty clinics, emergency departments) by a variety of clinicians
(including general and specialist pediatricians, general practitioners, nurse practitioners,
physician assistants, and emergency physicians). There has been increased
interest in using health IT to support efforts to implement evidence-based guidelines
and indicators in pediatric ambulatory care to improve quality. 1 Health IT has
also been viewed as a means to reduce costs.
C.U. Lehmann et al. (eds.), Pediatric Informatics: Computer Applications 233
in Child Health, Health Informatics,
© Springer Science + Business Media, LLC 2009