Federal mandates, such as Meaningful Use and ICD-10, have brought their own challenges to pediatrics, according to Debbie Rupe, R.N., Clinical Analyst at Shriners Hospitals for Children.
For instance, a survey found that only 35 percent of the pediatric hospitals responding had received Meaningful Use incentive payments, Rupe writes in a blog post for HIMSS' website. Freestanding pediatric hospitals indicated that Meaningful Use criteria lacks relevance to pediatric care.
ICD-10 also has posed challenges, she says. For instance, a child with deformities on both sides could be coded with one code in ICD-9, but that requires multiple codes in ICD-10. Pediatric burn patients can have dozens of ICD-10 codes for their diagnosis.
With accountable care organizations, the lack of quality measures for data analysis specific to pediatric patients can be an issue, she adds. Lack of pediatric functionality in the EHR also has been reported, as well as different reporting methods required by different Medicaid programs.
The Southeastern Minnesota Beacon Community put family, schools and providers in the loop with "asthma action plans" for each affected child in which health information could be shared with school nurses and families through a patient portal.
Children's Health hospital system in North Texas has served as a model for a new law in Texas, which allows school-based telemedicine visits for children covered by Medicaid. The children see a doctor, yet miss less class time and parents don't have to take off work.
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