Maternal and Child Health Research Program

Advancing Applied MCH Research

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Pediatric Primary Care Electronic Health Record (EHR) Network for Comparative Effectiveness Research (CER)

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Project Number: UB5MC 20286-01
Grantee: American Academy of Pediatrics
Department/Center: Pediatric Research in Office Settings (PROS) Network
Project Date: 9/1/2010

Final Report

Pending

Principal Investigator

Richard (Mort) Wasserman, MD, MPH
Project Director
141 Northwest Point Blvd
Elk Grove Village, IL  60007-1098
Phone: 802-656-3046
Email: Richard.Wasserman@uvm.edu

Age

  • Infancy (0-12 months)
  • Toddlerhood (1-2 years)
  • Early Childhood (3-5 years)
  • Middle Childhood (6-11 years)
  • Adolescence (12-18 years)

Abstract

PROBLEM: The nation's largest pediatric primary care research network, Pediatric Research in Office Settings (PROS), has worked since 1986 to identify gaps in the quality of pediatric health care and to improve both adherence to child health care guidelines and children's health. The work of this network traditionally has been conducted through paper-based research. In the 21st century, however, child health clinicians are steadily switching from paper to electronic health records. This change has created both an obstacle to traditional paper-based studies, and an opportunity for harvesting electronic data about health care process and outcomes to conduct comparative effectiveness research. GOAL(S) AND OBJECTIVES: Pediatric Research in Office Settings (PROS) will address this challenge and opportunity by: (1) creating and testing an electronic health record subnetwork within PROS consisting of pediatric clinics and practices using electronic health records a network with the capacity to conduct both observational comparative effectiveness research and comparative effectiveness research on interventions to improve care; (2) employing the electronic health record subnetwork to extract and analyze deidentified data on primary care pediatrics and conducting proof of concept studies; (3) conducting a randomized trial of the comparative effectiveness of using the electronic health record subnetwork to improve the medication management of patients with attention-deficit hyperactivity disorder - a comparative effectiveness research priority topic listed by both the Institute of Medicine and Agency for Healthcare Research and Quality; and (4) disseminating critical information on research findings from the electronic health record subnetwork to child health professionals, policy makers, and the public. METHODOLOGY: PROS will recruit the practices to participate in the subnetwork and will also partner with organizations experienced in extracting, standardizing, and deidentifying data from primary care electronic health record systems. Partnerships with organizations with advanced technical skills and relevant experience are critical to the success of the electronic health record subnetwork. The comparative effectiveness research study will test, via a cluster randomized trial, a point-of-care clinical decision support system linked to electronic health records in improving the quality of care for a chronic pediatric condition. This study will involve an additional partnership with a research entity skilled in clinical decision support design. DISSEMINATION OF RESULTS: Results from this work will be used to inform guidelines and policies of the American Academy of Pediatrics and will be disseminated via publications and through collaborations with policymakers, educators, and leadership at the American Academy of Pediatrics and other child health organizations.

Publications

Listed is descending order by year published.

Fiks AG, Grundmeier RW, Margolis B, Bell LM, Steffes J, Massey J, Wasserman RC. Comparative effectiveness research using the electronic medical record: an emerging area of investigation in pediatric primary care. J Pediatr. 2012 May;160(5):719-24.

Ip EH, Wasserman R, Barkin S. Comparison of intraclass correlation coefficient estimates and standard errors between using cross-sectional and repeated measurement data: the safety check cluster randomized trial. Contemp Clin Trials. 2011 Mar;32(2):225-32.

Sege R, Flaherty E, Jones R, Price LL, Harris D, Slora E, Abney D, Wasserman R; Child abuse recognition and experience study (CARES) study team. To report or not to report: examination of the initial primary care management of suspicious childhood injuries. Acad Pediatr. 2011 Nov-Dec;11(6):460-6.

Slora EJ, Bocian AB, Finch SA, Wasserman RC. Pediatric research in office settings at 25: a quarter century of network research toward the betterment of children's health. Curr Probl Pediatr Adolesc Health Care. 2011 Nov;41(10):286-92.

Wasserman R, Bocian A, Harris D, Slora E. Limited capacity in US pediatric drug trials: qualitative analysis of expert interviews. Paediatr Drugs. 2011 Apr 1;13(2):119-24.

Wasserman R, Serwint JR, Kuppermann N, Srivastava R, Dreyer B. The APA and the rise of pediatric generalist network research. Acad Pediatr. 2011 May-Jun;11(3):195-204.

Wasserman RC. Electronic medical records (EMRs), epidemiology, and epistemology: reflections on EMRs and future pediatric clinical research. Acad Pediatr. 2011 Jul-Aug;11(4):280-7.

Keywords

Primary Care, Clinical Practice, Medical Home, Well-Child Pediatric Care, Telehealth & Health Information Technology

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