AAP Board update: Work continues on policymaking improvements, data registry
AnneHegland, Editor in Chief
The Academy is making progress in advancing two major child health initiatives — strengthening
the policy process and establishing a clinical data registry. Developments pertaining
to both projects, which are goals of the AAP five-year Strategic Plan, were detailed
at the Board of Directors meeting Jan. 24-25.
Policy: accomplishments, looking ahead
The Board Committee on Policy (BCOP), established in January 2017, is charged with
ensuring that AAP policies are developed with integrity; remain a trusted resource
for pediatricians, families, other clinicians, health care systems and policymakers;
and are consistent with all other AAP policy.
“Our policy is often cited as the Academy’s No. 1 member value. It helps define our
reputation and our brand,” BCOP Chair Jane Foy, M.D., FAAP, told board members.
To maintain the high level of integrity, the BCOP meets monthly to critically review
intents for policy. The AAP Task Force on Policy has been working in parallel with
BCOP to make the following improvements to this process:
adding authors with additional perspectives (primary care, subspecialists, family
ensuring broad perspectives and expertise in peer reviews;
confirming the absence of overlap with other statements;
flagging policies for controversy and requiring early draft submission;
flagging policies for fast-track priority; and
requiring authors to indicate if, when and how policy impacts payment.
Enhancements to the policy writing phase include:
author copyright release to protect AAP intellectual property before writing can commence;
early review of controversial statements;
BCOP involvement in mitigating conflict between authors and reviewers;
collection of data to determine where/when policy development is stagnant; and
monitoring policies that have been in development for over two years.
In related business, the board approved $50,000 in Friends of Children funding for
two pilots for multi-stakeholder child health policy development. The funding will
be used to bring together stakeholders with different evidence and points of view
to build consensus on difficult topics.
“There are specific policies that we think would benefit from a consensus-building
approach,” said Dr. Foy. “This would include an independent literature review and
evaluation of that literature, a facilitated face-to-face conversation with the authors
and convening any stakeholders that might have a strong opinion or expertise that
would affect the outcome.”
A diverse group of pediatricians with expertise in health information technology,
called the incubator group, continues to lay the groundwork on the Child Health Improvement
through Longitudinal Data (CHILD) registry. This first-of-its-kind data registry would
collect, store and analyze health data on all U.S. children. Most recently, the group
has defined the registry’s priorities as follows:
Improve the health of children.
Provide value to members.
Position the AAP to assist members with value-based payment.
Registry specifications are being developed, including defining a minimal viable data
set; specifying quality measures to collect and provider views of the quality data
and measures for payment; and developing patient-reported outcome measures.
Feedback solicited from pediatricians is helping to improve the registry.
“There needs to be a minimal burden to the practicing pediatrician,” said Christoph
U. Lehmann, M.D., FAAP, medical director of the AAP Child Health Informatics Center.
“Data has to flow automatically without any extra effort, duplicate data entry or
any cost to the practice. This is essential.”
Representatives from the FamilY Partnership Network also weighed in, advising that
families be asked for permission to use data and about family/patient experience of
care as well as outcomes of care.
Next steps include developing a request for proposal and a plan for sustainability,
both of which will be presented for the board to review at its May meeting.