All children to have electronic health records by 2014

Key Points

"Children's health, which is important to us all, will have great benefit in having this opportunity, this single view of a child's health as they move within the state or as they move to other states," said Anthony Rodgers, director of the Arizona Health Care Cost Containment System. Rodgers co-chaired one of the three task forces of professionals that drafted recommendations for the Alliance. "The task force was energized and adamant about this particular recommendation, and feels that it really jump-starts a lifelong important record for the population of all the states," he said.

Why 2014? Rodgers told the Alliance, "We wanted to get a date that was realistic, but that also provided a sense of urgency. We looked at 2012 versus 2014. We felt that some states probably could achieve it earlier." He told the members that the recommendation was meant for every child, not just those under Medicaid or other public programs. "We think this is a good model in terms of pushing states in a common collaborative effort around the children's electronic health record. We believe that the technology has advanced such that this is very doable within the time frame," said Rodgers.

The 17-member task force drafted the recommendations related to publicly funded programs, including child record proposals. It was composed of professionals from public health departments, informatics experts, and executives of private companies. It held about seven meetings over the last year, and looked at electronic health record recommendations from the American Academy of Pediatrics.

Among numerous other recommendations, the Alliance's upcoming report will also call for a cross-state physician licensure system that works "in a uniform manner" to permit interaction with doctors across boundaries. That coordinated system should promote electronic health processes, but it also "may serve as a model for other forms of medical practice." It should not be considered a national license, though.

When a physician wants to practice in another state, he or she would notify the medical board via a standard, electronic process. The state boards would still have the authority to prohibit a physician from practicing in their state. The panel will call for similar coordination for nurses' and pharmacists' licenses.

Another Alliance recommendation will say that, as states establish medical homes in their Medicaid, SCHIP [State Children's Health Insurance Program], and state employee health programs, they should also drive electronic health information exchange development and health IT adoption.

"Some states are already moving to the medical home model," said Rhonda Medows, MD, commissioner of the Georgia Department of Community Health. "In addition, most states are also making the effort to look at the quality of care as well as the outcomes of health care." The combination "is an opportunity where health information exchange can be used as a very effective tool.

"It makes perfect sense to us, that if we are going to have a central focus of care," Medows said, that the medical home would do a better job if all health data flows to and from that home.

Kathryn Foxhall is a contributing editor to Contemporary Pediatrics. The author has nothing to disclose in regard to affiliations with, or financial interests in, any organization that may have an interest in any part of this article.