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

35 The Moving Picture of Pediatric Informatics 459
The purpose of the registry is to collect data on the impact of low cost telemedicine
tools in schools to extend pediatric care and reduce preventable emergency department
visits for asthma exacerbations in children.
Over 1 year, there is a clinical and statistical reduction of morbidity, mortality,
and emergency department utilization in the counties that used telemedicine,
resulting in improved health in the pediatric asthma population and a significant
savings for the insurance program. These results are presented to the state legislature,
and result in expanded funding to provide telemedicine services, training for
school nurses, and pediatric Medical Homes for better asthma care in all counties
throughout the state. Publication of these results draws interest from researchers
and health information technology vendors interested in reproducing their results in
other states and in making similar health outcome improvements for other pediatric
conditions.
35.1.2 Ideals and Constraints of Pediatrics
The vision and ideal of pediatrics, regardless of technology, is the attainment (and
maintenance) of optimal physical, mental, and social health and well being of
all infants, children, adolescents and young adults. This vision encompasses the
bio-psycho-socio-cultural spectrum of children, from genetics and environmental
exposures to economic, ethical and legal issues; from primary prevention to
technology-based invasive procedures. This ideal includes:
Universal and lifelong health care access and coverage
Personalized medicine for all, coordinated through a Medical Home, with timely
and ongoing translation of a patient’s genomic, historical, and environmental
data into effective customized care plans for maintaining health, managing
emergent problems, and planning care
Measurable and equitable improvements in health outcomes and care quality
with reductions in morbidity and mortality that have heretofore been elusive
Ongoing public health surveillance for threats to children’s health with timely
interventions
Widespread and ubiquitous implementation and deployment of pediatricspecific
care processes that are error-free and that provide complete transparency
and accountability
Complete partnership between patients/parents/caretakers who make informed
decisions about their children’s health care and a health care system that empowers
patients to achieve and maintain optimum health
Current (and ongoing) constraints to realizing the pediatric vision include:
The rising costs of health care, including technology-driven interventions
Limitations in capital, health workforce, and pediatric expertise
Disparities in the availability and distribution of pediatric expertise among urban
and rural, academic, and community settings