Automating Quality and Safety Benchmarking for Children

Abstract: Our aim is to implement and test electronic measures of outpatient pediatric healthcare
quality and safety using the PCORI Common Data Model. The PCORnet Common Data Model
is a way of organizing data, including data mined directly from the electronic health record,
into a standard structure. This research will take place in two PCORI funded networks which
use the PCORI Common Data Model: PEDSnet and OneFlorida. This will be the first study to
use the PEDSnet and OneFlorida data, and will include analysis of the data pulled directly
from the electronic health record for over 5 million children, and validation of this data
using a manual review of a sample of approximately 500 charts. We will test the creation of a
benchmarking report so health systems can compare their performance to others. Without
this information, hospitals do not know if they have the best quality care or the worst, and
cannot learn from each other, which limits improvement.

We will focus on 3 well-established measures of quality: (1) transcranial Doppler screening
for children with sickle cell disease; (2) appropriate antibiotics for ear infections; and
(3) cholesterol and glucose testing for children on antipsychotic medications. Only 30% of
children with sickle cell disease receive transcranial Doppler screening, which identifies high
risk for stroke and initiates treatments that reduce risk by 92%. Only 70% of children with ear
infections receive the appropriate antibiotics. Over 600,000 children take antipsychotic
medications which greatly increase the risk for diabetes and high cholesterol; only 19% of these
receive glucose and cholesterol tests.