AAP delegation works to strengthen AMA focus on child health issues
- Copyright © 2009 by the American Academy of Pediatrics
The Academy submitted three resolutions to the American Medical Association (AMA) House of Delegates (HOD) Interim Meeting addressing important next steps in immunization administration, health information technology and tobacco cessation efforts.
AAP delegates also continued to focus this “House of Medicine” on health insurance coverage for all children and advocating for the medical home.
The AAP delegation is relatively small (five voting members in the HOD) but very effective because of support from AAP leadership, other primary care organizations and the entire Pediatric Section Council. In addition, the Medical Student, Resident/Fellow and Young Physician sections of the HOD are strong supporters of pediatric issues.
AAP delegates Carol D. Berkowitz, M.D., FAAP, Stuart Cohen, M.D., M.P.H., FAAP, Melissa Garretson, M.D., FAAP, and Richard J. Pan, M.D., M.P.H., FAAP, were joined at the meeting by AAP President David T. Tayloe Jr., M.D., FAAP, and AAP Executive Director Errol R. Alden, M.D., FAAP.
Health insurance for all children
The Resident and Fellow Section submitted Resolution 610 asking the AMA to support, as a strategic priority, requiring all children to have health insurance. AAP attendees testified that strong AMA policy was critical as the national legislative agenda focuses on this issue.
An overwhelming majority of HOD members approved the resolution. This action more closely aligns AMA policy with AAP policy as the nation embarks on this crucial debate.
Health information technology
AAP-sponsored Resolution 801, adopting language similar to a 2008 Annual Leadership Forum resolution, asked the AMA to advocate for payer incentives for physician investment in health information technology. AAP delegates testified that this technology needs to be available for practicing physicians to assure participation in quality improvement, maintenance of best practices and reporting activities in this evolving age of transparency and accountability. This item was reaffirmed as AMA policy.
Tricare health plans
Council on Medical Service Report 2 was the product of a 2007 HOD directive related to concerns over the Department of Defense (DOD)-sponsored Tricare health plans. The report calls for adequate provider rates, educating physicians regarding the contract process with these plans, enhancement of mental health benefits, and improved coordination between civilian and government treatment facilities. The AAP Executive Committee and delegation explained that the report did not adequately address inadequate payments and procedures related to vaccines and other products.
Dr. Cohen offered an additional recommendation, which the HOD passed, to address these issues. Subsequently, a meeting has been scheduled with a top DOD official and the AAP Executive Committee to discuss these concerns.
A number of resolutions addressed various aspects of the medical home, care coordination and physician-directed care teams.
Dr. Tayloe gave convincing testimony regarding the principles and practical aspects of conducting care in medical home environments. The HOD subsequently approved, by a substantial majority, the principles of a medical home as developed/adopted by the Academy, the American Academy of Family Physicians (AAFP) and the American College of Physicians. The American College of Obstetricians and Gynecologists offered an amendment relating to medical home full-funding, access, patient choice and physician unity. These recommendations were referred to the AMA Board of Trustees for further study.
Joint AAP/AAFP Resolution 901 urged the AMA to advocate that all electronic health records should include templates asking physicians to collect information about tobacco use, secondhand smoke exposure, cessation interest and past quit attempts. The templates also should prompt clinicians to encourage quitting, give advice about maintaining smoke-free environments and connect patients/families to cessation resources.
Testimony supported adoption of this resolution, but concern was expressed for technical details and other specifics. The HOD voted to refer this item to the AMA Board of Trustees for a report back at a future meeting. The AAP delegates will seek passage of this resolution when it returns to the HOD floor.
Vaccine bar codes
AAP Resolution 902 asked the AMA to work with vaccine manufacturers, medical specialty societies, electronic medical record vendors and immunization information systems to apply uniform bar-coding on vaccines based on standards promulgated by the medical community. There was abundant testimony in favor of this recommendation, but the details and complexity necessitated referral to the AMA Board of Trustees for further action.
Dr. Burton is chair of the AAP delegation to the AMA House of Delegates and the AMA Section Council on Pediatrics.