Family Planning v2

The Family Planning Profile (FPP) provides a means to capture and communicate family planning data needed for managing and monitoring family planning care in a variety of settings from primary care to specialty family planning clinics that seek to conduct quality improvement initiatives in sexual and reproductive health. Volume 4 of the profile describes constraints specific to the US DHHS Office of Population Affairs' (OPA) Title X Family Planning Annual Report (FPAR).

Family Planning Profile Recording

Summary

Data about family planning clinical services plays a critical role in identifying trends and opportunities for improvement in the provision of quality family planning care, and is an integral element of determining future policies and programs. This IHE profile supports quality improvement in family planning by specifying the content and transactions needed to capture family planning data from EHR systems to a centralized data repository. Future iterations of the profile will describe how to calculate and return clinical performance measures.

Benefits

Family Planning Profile: Family planning measures, contraceptive counseling and provision, infertility counseling and referrals, clinical surveillance

• Introduces critical family planning data elements to the health IT community
• Lessens burden of data collection for clinical sites that must report information about services
• Enables more efficient collection of cleaner, more accurate data about family planning services
• Supports collection of performance measures to be used for quality improvement purposes
• Outlines the requirements for electronic medical record and health systems to submit information necessary to support sexual and reproductive health performance measures, including the data elements, value sets, and the format for a clinical visit summary. In the US, this profile will be needed by over 4,000 family planning clinical settings.

Details

Contraception is a major preventive health service that is not fully integrated nor consistently captured within many electronic medical record (EMR) systems. Pregnancy intention and contraceptive method are essential health indicators for women and men and for primary and specialty care clinicians, healthcare administrators, academic researchers, non-profit advocacy organizations, and local, state, and federal public health authorities. A variety of gaps currently exist in the healthcare setting if pregnancy intention and contraceptive method fields do not exist in the EMR system and are not explicitly addressed in the clinical setting or captured for practice- and clinician-level performance metrics. The absence of standardized data capture, reporting, monitoring, and evaluation of family planning services to public health authorities is often a burden to already stretched practices with multiple, diverse reporting obligations. This lack of integration requires substantial back-end work to extract and export meaningful data. Additionally, many data elements important to family planning providers are critical to other clinical domains (e.g., blood pressure) while others are currently used primarily in family planning settings (e.g., client's pregnancy intention), and need to be better captured in primary care to improve preconception health screenings. Standardized capture and recording of these variables across multiple clinical settings and diverse medical record documentation would facilitate more efficient reporting and adherence to clinical guidelines.

Clear specification on data elements, aligned with industry, clinical, US and international standards, is an important goal for advancement of high-quality health information technology. Contraceptive prevalence, chlamydia screening, unmet need for family planning rates are examples of measures used for national statistics that would contribute to health service delivery assessment at local or institutional levels if data were available in electronic health records. The usefulness of these kinds of measures is dependent on the existence of quality data. Pregnancy intention and contraceptive use data are currently sporadically collected, if at all, especially among male clients. It is not possible to collect this data adequately through the use of billing or diagnostic codes because not all methods are dispensed or prescribed (e.g., abstinence or withdrawal). Further, it is not possible to collect visit-level data with these codes because a method may be dispensed at one visit and still be in use at a subsequent visit but would not require entry of such codes at the later visit. The only way to address these challenges in data collection is through standardized clinical decision support and data capture.

This profile was successfully tested at the 2015 IHE North American Connectathon by the following organizations:

Form Filler:

• ithIcoserve
• GE Centricity
• Mitchell & McCormick
• Netsmart Insight Technologies
• Patagonia Health

Form Manager:

• Utah Department of Health

Form Receiver and Form Processor:

• AEGIS.net

Systems Affected

• Electronic Health Record systems, Practice Management systems, etc.
• Public Health Surveillance systems
• Personal Health Records systems
• Infrastructure (Forms Manager)
• Current FPAR reporting system
• Additional state reporting systems

Specifications

Trial Implementation

Documents: IHE QRPH Family Planning supplement [1]

Underlying Standards:

• HL7 Clinical Document Architecture
• IHE ITI Retrieve Form for Data Capture (RFD)

See Also

US DHHS Office of Population Affairs clinical and programmatic guidelines for the Title X Family Planning network. [2]

Gavin L, Moskosky S, Carter M, Curtis K, Glass E, Godfrey E, Marcell A, Mautone-Smith N, Pazol K, Tepper N, Zapata L. Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recomm Rep. 2014 Apr 25;63(RR-04):1-54. PMID: 24759690. [3]

American College of Obstetricians and Gynecologists. Guidelines for Women’s Health Care: A Resource Manual. Washington, DC: American College of Obstetricians and Gynecologists; 2007. [4]

Bellanca HK, Hunter MS. ONE KEY QUESTION®: preventive reproductive health is part of high quality primary care. Contraception. 2013 Jul;88(1):3-6. PubMed PMID: 23773527. [5]

Institute of Medicine (U.S.). Clinical preventive services for women: closing the gaps. Washington, D.C: National Academies Press; 2011. [6]

World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2011 update). Baltimore and Geneva: CCP and WHO, 2011. [7]