A reminder to schedule a follow-up visit related to an infection (e.g., otitis media, pharyngitis, urinary tract infection) or an injury (e.g., fracture, burn or cut requiring stitches) applies as an acute care service.
FAQ Directory: Patient-Centered Medical Home (PCMH)
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6.14.2018 KM 12C (Pediatric Specific) Give examples of pediatric acute care services.
6.14.2018 AC 12 (Pediatric Specific) • AAP practice transformation resources—telephone care:
This applies to the following Programs and Years:
PCMH 20176.14.2018 TC 03 (Pediatric Specific) What are some examples of PCMH-oriented collaborative activities for pediatric practices?
Pediatric practices may want to look into quality improvement projects offered by state AAP chapters and national AAP. The AAP QI Webpage lists a variety of opportunities: https://www.aap.org/en-us/professional-resources/quality-improvement/Pages/ActivityList.aspx
This applies to the following Programs and Years:
PCMH 20176.14.2018 KM 12A (Pediatric Specific) Other than well-child visits, provide some examples of preventative care services that qualify for outreach in a pediatric population
For younger children, practices may also identify patients and provide outreach for services for developmental screenings, autism screening, oral health risk assessment, Hematocrit or Hemoglobin screening, iron supplements for children ages 6 to 12 months at risk for anemia, or tuberculin testing for children at higher risk for tuberculosis
For adolescent patients, other preventive care services could also include (but not limited to) patients in need of specific preventive care-related lab tests, alcohol and drug screening, cervical dysplasia screening for sexually active females, sexually transmitted infection prevention counseling for adolescents at higher risk, obesity screening and counseling, HIV screening for adolescents at higher risk or other required screenings (e.g., chlamydia, depression, dyslipidemia at specific ages).
AAP resources:
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Recommendations for Preventive Pediatric Health Care (PDF): https://brightfutures.aap.org/materials-and-tools/PerfPrevServ/Pages/default.aspx
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Interactive Periodicity Schedule (AAP Pediatric Care Online- Web resource): https://pediatriccare.solutions.aap.org/periodicity-schedule.aspx
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Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition (Web site and links to associated text/materials): http://brightfutures.aap.org/index.html
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This applies to the following Programs and Years:
PCMH 20176.14.2018 KM 02E (Pediatric Specific) Would unhealthy behaviors associated with a parent’s behavior be acceptable for KM 02 E since they are responsible for preventing these behaviors?
Yes, unhealthy behaviors can be the result of parent behavior but ultimately, we're looking for the unhealthy behaviors demonstrated by the patient (child). Secondhand smoke may be a direct example of a parent’s behavior affecting the child’s health and poor oral hygiene may be a child’s unhealthy behavior, but could result from lack of parental oversight or health literacy.
This applies to the following Programs and Years:
PCMH 20176.14.2018 KM 03 (Pediatric Specific) What type of standardized screening tool for depression would meet the requirement for a pediatric population?
NCQA is not prescriptive regarding which depression screening tool is used as long as it’s a standardized tool. Some depression screening tool examples that would be appropriate for adolescents include but are not limited to PHQ2, PHQ9, PHQ-A, PSC, PSC-Y, RAAPS, or HEADSS.
This applies to the following Programs and Years:
PCMH 20176.14.2018 KM 02F (Pediatric Specific) How do clinicians assess the pediatric patient's ability to interact with other kids in a normal fashion? If the child is functioning normally in school would that suffice?
6.14.2018 CM 01D (Pediatric Specific) May practices use “limited or no family/caregiver support” as a social determinant of health?
Yes. For pediatric populations, practices may identify children and youth with special health care needs who are defined by the U.S. Department of Health and Human Services Maternal and Child Health Bureau as children “who have or are at risk for chronic physical, developmental, behavioral or emotional conditions and who require health and related services of a type or amount beyond that required generally.”
This applies to the following Programs and Years:
PCMH 20176.14.2018 KM 02G (Pediatric Specific) What are some examples of social determinants of health for children?
6.14.2018 CM 01A (Pediatric Specific) Would temper tantrums as a behavioral health condition meet the intent of CM 01A?
Practices need to identify behavioral health-related criteria pertinent to their specific patient population such as a behavioral health diagnosis, substance use, a positive screening result from a standardized behavioral health screen, or psychiatric hospitalizations. If the practice feels that patients with temper tantrums is an identifier for patients in need of care management, the practice can use that defining criteria.
This applies to the following Programs and Years:
PCMH 20176.14.2018 KM 12B (Pediatric Specific) Does a list of pediatric patients from two age groups (e.g., 2-year-olds and 6-year-olds) that are “behind” on immunizations meet the requirements of this criterion?
6.14.2018 KM 12D (Pediatric Specific) Why would our practice recall pediatric patients, if not for preventive care, immunizations or acute/chronic care services? Give pediatric-specific examples.
KM 12 categories A-C refer to needed services and are intended for routine, proactive reminders.
Category D addresses patients who miss routine visits, annual exams or follow-up appointments and need to be reminded to visit the practice for services.