HRSA/MCHB 2005 FEDERAL/STATE PARTNERSHIP MEETING

PUBLIC HEALTH ACROSS THE LIFESPAN

NAN STREETER: Good afternoon, how is everybody? Still with it huh? All right. Well I’m really glad to be here. I’m really proud of what Utah has accomplished and this is a great opportunity to share with you what we have accomplished. So I’m going to talk in the same vein as Jill did in terms of integration of information systems and so if I can just do this right. So here is another dream, you know following what we heard at the awards. Wouldn’t it be a good thing if health care providers and public health officials had complete information about an individual child so that they can support the processes that lead to coordinated care referrals and follow up and non-duplications of services and that’s what this is all about.

I want to talk about CHARM. This is a project in Utah that has been worked on for a number of years, several years I guess sounds more accurate. CHARM is going to be the information resource for providers as well as for public health programs to coordinate services, improve child safety and improve health outcomes. CHARM stands for Child Health Advance Records Management. It is a part of creating a child health profile which includes demographic information, health information, contacts, referral follow up and diagnosis and treatment. The components of CHARM at this point are: vital records, immunization registry and the newborn hearing screening. Jill was talking earlier about the territorial issues around unique identifiers and several years ago Utah embarked on a project that was called N CHARM which was called Newborn CHARM and the work group that was working on N CHARM decided to agree upon a unique identifier for children and that identifier is the newborn hearing screening record number. So what has been developed in Utah is that in the screening kit in hospitals, the metabolic screening kit there is a barcode number that is attached to the metabolic screening of the blood spot screening attached to the child’s hearing screening records and then also attached to the birth certificate records and so that is how we were able to create a unique identifier for every child.

Additional programs that will be added to CHARM as time goes on you can see. Then we also have plans for adding future programs into the whole system including WIC, which can be challenging and data from Children with Special Health Care Needs Clinics. So this is how CHARM works or this is how is started, is pulling together or connecting I should say, program data. CHARM is not about separate data systems. It’s about programs maintaining their own data sets and connecting them so that a provider in the medical home or public health officials can access information about a child without the need to integrate all the data systems so it is connecting data systems. So every program continues to maintain their own individual data set.

I just wanted to mention that I’m not with the University of Utah ; I’m with the Utah Department of Health just so everybody is clear. Just wanted to clarify that. So CHARM has been developed by the Utah Department of Health in conjunction with other partners. Partners are very important, as we all know. When CHARM is up and running which I believe; Holly at the end of this year it will be first put out? November okay. It will provide access to information from several program databases that will allow providers and public health officials to track, monitor child health status, check on screening results. Make sure kids have been followed up after a screening that requires follow up and treatment. Making sure that kids have all their immunizations. Making sure that referrals that have been made have actually occurred in the medical home on those referrals and the information obtained from the referrals and then outcomes for children and their families.

The goal eventually is to make sure that all children from birth to 21 years of age are included in this data integration project. Again to re-enforce it, CHARM is designed not to replace any databases. It is basically going to be the brain of an integrated data system that will broker integration of data across programs. What will happen is that an individual program, for example newborn screening can hit a CHARM button on their computer and get into other data sets for that child. For example, to make sure that if that child had a poor newborn screening result that that was followed up by the child’s medical home. I have to say that this is my soapbox. When I think of medical home, I don’t think of medical home for just children with special health care needs. Obviously children with special health care needs are unique in that they truly need to make sure that the care delivered is coordinated and family oriented etc. All children need medical homes and that’s what this is all about. Promoting that information being available in a child’s medical home.

CHARM is taking a modular approach to adding programs starting with a core set of programs and then building the capacity for that over time. So, some of the immediate benefits of CHARM are finding infants that are missed in screening. Jill had mentioned earlier about knowing that there are infants out there but not having screening results. Identifying infants lost to follow up and more important making sure we are not contacting families whose babies have died. Additional benefits of CHARM include access to information that’s timely so that children’s health care can be tracked. Health care providers can be alerted to the need for care such as updated immunizations, those kinds of things and obviously will save time for health care providers because they won’t need to track down some child’s health record from multiple sources. It should improve coordination of services, timely sharing of critical data and reducing fragmentation of data and health care services and actually increases accountability for the child’s health care. It also will help advance health care providers knowledge about children who have health, developmental and genetic conditions and enables us in public health to make better policy decisions. The project also or the program also ensures the security and confidentially of the medical information. Built into the system is that only authorized and authenticated public health and health care providers will be able to access a child’s information.

I want to talk a little bit about funding. Much of the efforts that have occurred to this point have been funded through cooperative agreements and the Public Health Informatics Institute was also a funder. Title V funding has gone into supporting CHARM and the department is looking for additional funding opportunities. Some possible new opportunities, I think it is important to make sure we are working with our LEND grant participants to make sure they’re aware of CHARM and it’s possibilities and linking using birth certificate orders. Parents come into the health department; they place an order for a birth certificate. At that time parents are asked to provide current information and this provides CHARM with an opportunity to continually update the information on a child. So it’s a wonderful opportunity there to have more up to date information. Then eventually it will create an alert system for children who do need follow up whether it is immunizations or other services. I’ve listed the information for the CHARM contact. It’s not me it’s Richard Howard and Richard is the manager of the CHARM project and is wonderful to work with. I know he has talked with folks from other states so I encourage you to contact him if you have questions about how this works or how this will work in your states. His information is also on your handout. Thank you.