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

22 K.B. Johnson et al.
Presenting numerical data to the appropriate precision (weight in grams and age
in hours for newborns and in kilograms, years, and months for older children)
3.4 Pediatric Core Data for Practice Administration
A common use of data is for practice administration functions, such as billing. Core
data includes patients’ demographic and insurance information, dates of encounters,
assigned diagnoses, and services used (including pharmacy prescriptions).
Claims data can be used to study service utilization and to improve health outcomes.
One example is the use of immunization information systems to identify
children with asthma for influenza vaccination reminders 1 for Medicaid populations.
The biases of claims data such as incompleteness (in identifying all patients
at risk) can limit generalization of use of such data. However, administrative
medication claims data may show adverse health trends, such as one study which
showed an association of high pharmacy cost-sharing with lower use of bronchodilators,
inhaled corticosteroids, and leukotriene receptor antagonists in for children
in private drug plans. 2
Claims data may be used to assess quality in ambulatory care, however, it frequently
underestimates measures. Although this is the most readily available data in most
practices, its current use is limited in clinical tasks related to quality and safety. 3
3.5 Pediatric Core Data for Clinical Care
In addition to the framework of data/knowledge/functionality and general clinical
information tasks, core data can be specified on the basis of age groups
(premature and term newborns, infants, toddlers, school-aged children, preteens,
adolescents, and young adults) and populations with specific needs and conditions
(well children, children with special health care needs, precocious children, foster
children, children with chronic and acute disease). Each group and condition range
has specific core data:
Infants: Chapter 4
Adolescents: Chapter 5
Forms and templates, as organizing devices for structured communication and
recording of core clinical data are well known to practitioners. The adaptation
and conversion of structured (and unstructured) data for use in electronic records,
practice management systems, health registries, and other tools that share pediatric
personal health information require consensus and planning:
Structured data for electronic health records: Chapter 18
Pediatric data standards and terminologies: Chapters 32 and 33
Structured data for research: Chapter 34