Pediatric Care Coordination: The Business Case for a Medical Home

  • Donald E. Lighter
Part of the Health Informatics book series (HI)


Children and Youth with Special Health Care Needs (CYSHCN) have complex health care issues that require multiple providers, as well as numerous procedures and medications that potentially can interact with each other to endanger health and safety (Chapter 5). The American Academy of Pediatrics created the Medical Home program in 1992 in a policy statement that defined the concept and recommended an infrastructure for children with conditions that fit the special needs criteria. That policy statement was updated in 20021 to include several enhancements (with emphasis on the concept of the Medical Home for ALL children) and specifying the following list of services provided:
  1. 1.

    Family centered care

  2. 2.

    Unbiased and clear information

  3. 3.

    Primary care, in the broadest definition

  4. 4.

    Assurance that care for acute and chronic conditions is continuously available

  5. 5.

    Continuity of care, including transitions to other providers

  6. 6.

    Appropriate and timely referrals to pediatric medical and surgical specialists

  7. 7.

    Interaction with early intervention programs

  8. 8.

    Care coordination



Electronic Health Record Electronic Record Health Information Technology Electronic Health Record System Paper Chart 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    American Academy of Pediatrics Medical Home Initiatives for Children With Special Needs Project Advisory Committee. The medical home. Pediatrics. 2002;110(1):184–186.CrossRefGoogle Scholar
  2. 2.
    Lighter D, Fair D, eds. Quality Management in Health Care: Principles and Methods, Chapter 10: Making Quality Improvement in Health Care Work — Care Management. Sudbury, MA: Jones & Bartlett; 2004.Google Scholar
  3. 3.
    American Academy of Pediatrics Committee on Pediatric Emergency Medicine. Policy statement: overcrowding crisis in our nation's emergency departments: is our safety net unraveling? Pediatrics. 2004;114(3):878–888.CrossRefGoogle Scholar
  4. 4.
    Brennan P. Winning the paper chase: bedside terminals help clear the record. Health Prog. 1980;70(8):66–68.Google Scholar
  5. 5.
    Luxenberg SN, DuBois DD, Fraley CG, Hamburgh RR, Huang XL, Clayton PD. Electronic forms: benefits drawbacks of a World Wide Web-based approach to data entry. Proc AMIA Annual Fall Symposium. 1997;804–808.Google Scholar
  6. 6.
    Nielsen PE, Thomson BA, Jackson RB, Kosman K, Kiley KC. Standard obstetric record charting system: evaluation of a new electronic medical record. Obstet Gynecol. 2000;96(6):1003–1008.PubMedCrossRefGoogle Scholar
  7. 7.
    Bakker A. Digest of the discussion group sessions. Realising security of the electronic record. Int J Med Inform. 2004;73(3):325–331.PubMedCrossRefGoogle Scholar
  8. 8.
    Hagland M. Electronic record, electronic security. J AHIMA. 2004;75(2):18–22.PubMedGoogle Scholar
  9. 9.
    France FH, Gaunt PN. The need for security—a clinical view. Int J Biomed Comput. 1994;35(suppl):189–194.PubMedGoogle Scholar
  10. 10.
    Walker K, Flanagan JR, Lane T. Lightening the burden of the heavy regulatory hand an incentive for outpatient computer patient record. Proc AMIA Symp. 2001;736–740.Google Scholar
  11. 11.
    Boaden R, Joyce P. Developing the electronic health record: what about patient safety? Health Serv Manage Res. 2006;19(2):94–104.PubMedCrossRefGoogle Scholar
  12. 12.
    Microsoft Corp. Electronic medical record sets group apart as e-pioneers and delivers powerful advantages. Enterprise Servers, Microsoft Customer Solution Healthcare Industry. Available at: Holston_BDM_Healthcare_CS_Final.doc. Accessed December 21, 2008.
  13. 13.
    Grams RR, Moyer EH. The search for the elusive electronic medical record system—medical liability, the missing factor. J Med Syst. 1997;21(1):1–10.PubMedCrossRefGoogle Scholar
  14. 14.
    Omura G. Electronic records in a private practice. Presentation given at Colorado Medical Society Tech Fair. Available at: Accessed December 21, 2008.
  15. 15.
    Guzick D. Electronic Records at URMC. University of Rochester Dean's Newsletter; 2006. Available at: Accessed December 21, 2008.
  16. 16.
    National Quality Forum Executive Institute's Task Force on Electronic Health Record Systems. CEO Survival Guide to Electronic Health Record Systems. National Quality Forum; 2006.Google Scholar
  17. 17.
    The Leapfrog Group. Leapfrog Group Website; 2008. Available at: http://www.leapfroggroup. org. Accessed December 21, 2008.
  18. 18.
    The Institute for Healthcare Improvement. IHI Website; 2008. Available at: http://www.ihi. org. Accessed December 21, 2008.
  19. 19.
    Office of the National Coordinator for Health Information Technology. ONC Website; 2008. Available at: Accessed December 21, 2008.
  20. 20.
    Gioia PC. Quality improvement in pediatric well care with an electronic record. Proc AMIA Symp. 2001;209–213.Google Scholar
  21. 21.
    Honigman B, et al. Using computerized data to identify adverse drug events in outpatients. J Am Med Inform Assoc. 2001;8(3):254–266.PubMedGoogle Scholar
  22. 22.
    Andreae MC, Fawley M, Freed GL. Hitting the mark… sometimes. Improve the accuracy of CPT code distribution. MGMA Connex. 2005;5(1):39–43, 1.PubMedGoogle Scholar
  23. 23.
    Office of the National Coordinator of Health Information Technology. Goals of Strategic Framework; 2004. Available at: Accessed December 21, 2008.

Additional Suggested Resources

  1. Amatayakul M. Electronic Health Records: A Practical Guide for Professionals and Organizations. Chicago, IL: American Health Information Management Association; 2004.Google Scholar
  2. Gartee R. Electronic Health Records: Understanding and Using Computerized Medical Records. Upper Saddle River, NJ: Prentice-Hall.Google Scholar
  3. Johns M. Health Information Management Technology: An Applied Approach. Chicago, IL: American Health Information Management Association; 2002.Google Scholar
  4. Lighter D, Fair D. Quality Management in Health Care: Principles and Methods. Boston, MA: Jones & Bartlett.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Donald E. Lighter
    • 1
    • 2
  1. 1.The Institute for Healthcare Quality Research and EducationKnoxville
  2. 2.College of Business AdministrationUniversity of TennesseeKnoxville

Personalised recommendations