PC2061: FHIR Challenge 1.0: Innovative Approach to Accelerating Adoption of the Forthcoming Pediatric Obesity Clinical Practice Guideline Through Partnership with Health IT Vendors

Background: The AAP Institute for Healthy Childhood Weight sought to support the implementation of the forthcoming Clinical Practice Guideline (CPG) on Pediatric Obesity through the development of shareable resources and clinical decision support (CDS) tools that are electronic health record (EHR) vendor agnostic. The tools and/or resources are meant to facilitate adoption of the CPG’s recommendations by leveraging the Fast Healthcare Interoperability Resources (FHIR) standard to facilitate integration within existing EHR workflows and accelerate dissemination and implementation across multiple EHR platforms.
This experience is meant to serve a test case for how the Academy can productively partner with health information technology (HIT) entities to promote widespread use and adoption of critical AAP clinical guidance at the point of care. Ideally, this effort will lead to more collaborative and ongoing interactions with HIT innovators as we develop critical pediatric guidance and create a cadre of HIT entities, experts, and/or vendors for the Academy to partner with moving forward.

Methods: Using an open request for applications (RFA) process, candidate awardees were selected (see image 1) in late July/early August 2021. Each candidate vendor was awarded a nominal amount and given 4 months to develop a plan for a Pediatric Obesity CPG implementation package, prototype (proof of concept), and a mutually beneficial business and sustainability plan that includes potential long-term partnership with the AAP. Awardees then presented their prototypes and business plans to a review committee comprised of practicing clinicians, clinical informaticists, subject matter experts, and representatives from CPG subcommittee. Upon the completion of presentations, 1 awardee was selected (see image 2) to partner with the Academy and fully develop the related tools and execute their business plan in parallel with the publication of the CPG.

Results: Of the five applicants, representing a breadth of experience and expertise in the development and implementation of FHIR tools, the review committee selected three vendors to complete Phase 1. After Phase 1 presentations, one vendor was selected to partner with AAP to launch vendor-agnostic, shareable CDS tools at the time of the CPG publication. Major factors driving the ultimate vendor selection included past experience and feasibility of business models.

Conclusion: The review process revealed that there are not a large number of vendors focused on pediatric content and the development of low-cost resources that would be sustainable for pediatric primary care contexts. As the field continues to develop, there will need to be a concerted effort from vendors, healthcare systems, payors, and policy makers to promote pediatric focused shareable CDS resources. Our concurrent development of a pilot shareable CDS tool alongside the CPG, can inform future strategies and investments.