AAP Involvement

 

State Chapters: Currently Sue is a member of the Florida Chapter (where she lives in Sanibel, FL), the New Jersey Chapter (where she has a summer vacation home), and the Pennsylvania Chapter (the home for her practice and clinical career). 

 

Sue’s early involvement in the PA Chapter was as the Chair of the Pediatric Council (2006-2013). She came up through Chapter Leadership (2008-2018) and served as President of the PA Chapter. Other PA leadership includes: PA Governor’s Health Innovation In PA Workgroup; Worked with PA Department of Public Welfare to define Medicaid Meaningful Use for pediatrics in Pennsylvania; Pediatric Representative to Pennsylvania Value Based Care Summit, Harrisburg, May 2018; Testimony to Pennsylvania House Professional Licensure Committee (on proposed independent scope of licensure bill), October 2015; Advisor for CHIPRA Demonstration Grant (Quicksteps), May 2010-2012;  PA REACH SVS Project Team July 2010-October 2010.

 

National AAP Involvement

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Section on Administration and Practice Management, Chairperson 11/1/2022-present. SOAPM member since 2007. Former SOAPM representative to the Private Payer Advocacy Advisory Committee; former co-chair communications committee, 2010-2013.

Recipient of Charles “Buzzy” Vanchiere Award, 2019. 
Faculty presentations:

• NCE October 2014: Boutique Practices: More than Just a Cute Name;

• October 2012: Creating Exceptional Employee Relations.

• NCE October 2019: Taking Back Our Practices: Keep Your Sanity and Joy by Having Control (or at least influence!) on Your Daily Work Life;
  Section H: What’s the Problem You're Trying to Solve?

• October 2022; Several AAP News Articles and SOAPM webinars on Practice Management, ICD-10 readiness, Quality Improvement and Practice Transformation. 

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Alliance Advisory Panel Workgroup, March 2023-present,  restructuring Sections/Councils/Committees

 

Payer Advocacy Advisory Committee (PAAC), immediate past Chair, 2018-2022. PAAC member 2016-2022.. Advancing the Conversation for adequate payment and moving to Value-Based Payment models for Pediatrics.

 

Mentorship Program, 2021-present. Currently mentoring a third-year medical student with aspirations to enter the field of Pediatric Rehabilitation Medicine as well as 2 mid-career general pediatricians.

 

Partnership for Policy Implementation (PPI), January 2023-present. Clinical informaticists working with policy and clinical guidelines authors to incorporate implementable language into recommendations so they are actionable, decidable, and executable.

 

Data Registry Incubator Workgroup, April 2018-December 2020.

 

Task Force on Pediatric Change, June 2015-2017.

 

Child Health Informatics Center Pediatric Advisory Council, September 2015-present.

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Council on Clinical Information Technology, Member 2008-present. Nominations Committee 2012-2014.
Recipient of Byron Oberst Award 2017.

Faculty presentations:

• 2015 NCE: EMR Use and Minimizing Disruption at the Point of Care

• 2014 NCE: Switching EMRs

• 2012 NCE: Integrating Bright Futures into Clinical Practice.

• AAP News Articles on EMR use, clinical decision support, Immunization Information Systems, etc.

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Immunization Task Force (forecasting/decision support and IIS workgroup), September 2007-2018.
 

Presenter AAP/AIRA stakeholders meeting on increasing provider use of immunization information systems, September 2007.

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Presenter/AAP representative to CDC/NVAC conference on enhancing provider participation in IIS, February 2008.

May 2010: AAP stakeholders meeting on immunization decision support

November 2010: AAP focus group which led to FDA approval of immunization barcoding, now focused on strategies for adoption/incorporation of barcoding in vaccine inventory and delivery systems

 

ePROS/QuIIN/COQIPS, involved in various quality improvement projects including integrating Bright Futures into practice and the EMR, using ePROS to improve well care. Member Council on Quality Improvement and Patient Safety (COQIPS).

 

Section on Telehealthcare, 2014-present, author ALF resolution for the Academy to address Telehealthcare, involved in collaborative work with SOTC and SOAPM regarding the use of telemedicine in the pediatric office.

Faculty presentations:

• 2020 Presentations on incorporating Telehealth to meet patient/family needs during the COVID-19 public health emergency.

• 2021 NCE presentation: Achieving High Quality Health Supervision Visits Using Telemedicine.

Active member of  SPROUT’s (Supporting Pediatric Research on Outcomes and Utilization of Telehealth) Telehealth Working Group on the Patient-Centered Medical Home (October 2019-present.)

 

AAP additional membership: Section on Advances in Therapeutics and Technology, Council on School Health, Section on Senior Members.

 

Co-author on two AAP policy statements: “Guiding Principles for Team-Based Pediatric Care,” Pediatrics, August 2017, Volume 140, Issue 2; and “Nonemergency Acute Care: When It’s Not the Medical Home,” Pediatrics, May 2017, Volume 139, Issue 5.

 

AAP National Conference and Exhibition Presentations including: 

• October 2022: 21st Century Cures Act Rules and Information Sharing in Pediatrics;

• October 2021: Lessons Learned from COVID-19 Public Health Emergency and Implications to Practices, 21st Century Cures Act and Information Blocking;

• October 2020: Crossroads in Crisis: Your Practice During COVID-19, Rejected! Advice on Avoiding Claim Denials, How to Optimize Screening and Get Paid for It; 

Other presentations: Pediatrics in a Value Based Payment System, Telehealth for Pediatrics During COVID and Beyond, Patient Care: Right Place, Right Care, Right Time.

 

American Academy of Pediatrics, Provided Testimony on behalf of the Academy before the US House of Representatives Subcommittee on Small Business regarding Health IT Adoption and Challenges Faced by Solo and Small Group Health Care Practices, June 2009

 

CDC/AAP Enhance Support for the Delivery of Essential Health Services to Young Children Stakeholder Group, 10/20-Present, Faculty contributor to PediaLink course Innovative Strategies for Improving Developmental and Surveillance and Screening.

 

Child Neurology Foundation, Telehealth for the Child Neurology Community Key Opinion Leader Workgroup, December 2020-November 2021.

 

PA AAP Healthy Teeth Healthy Children: Integrating Oral Health in Telehealth Project, January 2021-present.

 

AAP Influenza Preparedness ECHO, Faculty 2020-2021.

 

AAP COVID-19 Interim Guidance contributor, Providing Acute Care in the Ambulatory Setting During the COVID-19 Pandemic, Post-COVID-19 Conditions in Children and Adolescents.

 

PA AAP Lead Testing ECHO Program, Faculty and Quality Improvement Advisor, January-December 2021.

 

Pediatric Health Information Technology Involvement

 

Shift co-founder: July 2019-present. (formerly known as Protecting Privacy to Promote Interoperability). Shift is a national multidisciplinary interest group of over 300 expert stakeholders across the industry assembled to address the problem of how to granularly segment sensitive data to protect patient privacy and promote interoperability and care equity. 

 

Office of the National Coordinator for Health IT (ONC) Presenter/Facilitator, Discovery Workshop on eConsent: From Birth to End of Life, August 2022; Health IT for the Care Continuum Task Force, March 2019-May 2019

 

Health IT for the Care Continuum Task Force (subcommittee for HITAC),  Provided recommendations on ONC’s approach, recommendations, and identified 2015 Edition certification criteria to support pediatric care and practice settings; related criteria to support multiple care and practice settings; and a request for information on how health IT can support the treatment and prevention of opioid use disorder.

 

Drummond Pediatric and Patient Safety Advisory Panel, October 2019-present; Developing a Voluntary Certification of the Pediatric EHR.

 

Electronic Health Record Association (EHRA) co-chair Public Health Task Force, Clinician Experience Workgroup, Privacy & Security Workgroup, January 2019-December 2021.

 

Immunization Integration Program, Technical Advisory Panel and Executive Committee, July 2017-present.

 

Healthcare Information and Management Systems Society (HIMSS), member 2015-present

2023 HIMSS Changemaker Award Finalist 

​Kressly Pediatrics, recipient of Davies Award, 2018.     

Presentations:

• HIMSS annual meeting, February 2019 “Patient Portals: Critical for Consumer Driven Care”

• HIMSS annual meeting, March 2018 “Adolescent Privacy.”

Planning committee for the HIMSS19 AMDIS/HIMSS Physician Executive Symposium, July2018-current. 

HIMSS 2023 presentation, April 2023, “Prioritizing Maternal Health as a Core Paradigm Across Specialties to Advance Interoperability”

 

Certification Commission for Health Information Technology (CCHIT), July 2008-2010. Member of Child Health workgroup dedicated to improving pediatric functionality in current EHRs.

  

The Patient, The Practitioner and the Computer, Brown University, The Big Picture: Healthcare Stakeholder Panel, March 2017; Drowning in Too Much Useless Information: How Do We Find What We Need? October 2020. 

 

PA-eHealth Initiative (PA-eHI), Board Member/Physician Representative, January 2011-2013. Providing physician representation to initiatives dedicated to the connectivity of health information technology across PA.

 

Other Leadership Experience:

 

 PROTECT Initiative (CDC/OID/NCEZID), 2012-present. AAP News Article on use PROTECT initiatives include mL based liquid dosing to improve safety.

 

Leadership Pittsburgh Faculty

Presentations:

• Health Care Payment Models for their Equity in Healthcare summit, January 2022;

• Total Cost of Care for their Healthcare Delivery summit, February 2021.

 

25 by 5: Symposium to Reduce Documentation Burden on US Clinicians by 75% by 2025, Panel presenter, February 2021. 

 

Care Transformation Collaborative of Rhode Island, Capitation Care Panel Presentation, May 2021.

 

Institute for Medicaid Innovation, Presenter Promoting Well Child Healthcare Access and Vaccination Adherence During COVID-19

 

Honors and Awards

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2023 HIMSS Changemaker Award Finalist 

 

2019 Charles “Buzzy” Vanchiere Award, awarded by the AAP Section on Administration and Practice Management to recognize outstanding contributions to the education of pediatricians in administrative pediatrics, practice management, and payment. Recipients are practicing or administrative pediatricians who enhance the quality of care of the patients by providing educational services to all pediatricians at the local and national levels.

 

2018 HIMSS Davies Award of Excellence

The HIMSS Davies Award of Excellence showcases healthcare organizations that demonstrate globally innovative, thoughtful applications of information and technology to drive and redefine evidence-based best practices so that others can learn, adapt and improve population health and patient outcomes. Kressly Pediatrics was awarded this honor for work on Improving Well Visit Rates and Improving HPV Immunization Rates.

 

2017 Byron Oberst Award, awarded by the AAP Council on Clinical Information Technology to a pediatrician who has made a significant contribution to the field in one or more of the following areas:

• Improving pediatric clinical information systems

• Educating child health professionals in the use of clinical information technology

• Creating health policies that promote better use of pediatric clinical information systems

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Providing Pediatric Testimony to Government

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2009 House Committee on Small Business, Washington, DC. Provided testimony on the impact of Health IT funding as part of the American Recovery and Reinvestment Act. Full testimony transcript is available here and included “The Academy greatly appreciates the funding included in ARRA for pediatricians to purchase health IT. Unfortunately, the statute creates disparities between practices that are paid by Medicaid versus Medicare. First, ARRA funds flow differently for the two programs. ARRA requires practices to maintain a minimum percentage of Medicaid patients in order to qualify for incentives under that program. This requirement is not imposed 

on practices receiving Medicare payments. The Academy believes that this requirement should be repealed so that the Medicaid and Medicare incentives are comparable.”

 

2015 Pennsylvania State Legislature, Testimony on CRNP Independent Scope of Licensure proposed legislation HB765 .

 

Proud Pediatrician Advocacy Wins

 

Payment for Well Visits via Telehealth: 2 weeks into the Public Health Emergency, Sue had a very real fear that the profession of pediatrics was doomed unless someone acted quickly. Watching her practice and colleagues and friends start to panic about having no visits and no income, her dominant advocacy gene kicked in. She said to herself, we have to get Telehealth up and running at full speed and we have to find a way to get virtual well visits paid. This was first and foremost about the care of patients: What if this lasts a long time? These kids are vulnerable and invisible to us. They need us now more than ever. We have no choice but to meet them where they are…in their homes. And, if there is no margin, there is no mission! If we have no income, we can’t pay our practice teams and there will be no community pediatricians on the other side of the PHE. 

 

Sue began with the folks at the Committee on Coding and Nomenclature. Let’s figure out a way to make this happen. The coding team was skeptical, but the more Sue made her case, the more they saw the need. Once we had the COCN folks on board, then it had to be pushed up to the AAP leadership. And then started the daunting task of getting payers on board. Eventually, the majority of payers were convinced, the AAP COVID interim guidance on Well Visits was born and practices got creative on how to do as much as we could via Telehealth and then do “close the gap” visits in person when safe or in the parking lot in many cases. This was the perfect example of seeing a real need and thinking outside the box to do what was right for children and pediatricians. Thankfully we no longer have the need, but we did our best to serve our patients in creative ways. 

 

Payment for COVID testing: It became clear when point-of-care COVID testing was available for in-office use, the SOAPM community started reporting that they were getting paid under cost for performing the tests. Not acceptable. Pushing as many levers as possible, Sue worked with the AAP and spoke with journalists about the problem, eventually getting most payers to increase payment and reprocess claims. 

 

PA Pre-Participation Sports Forms: Frustrated with the rules that Preparticipation Physical Exams had to be done after May 1st for every student athlete, Sue set out to fix the problem at its root cause. In leadership at the PA AAP at the time, she made connections with the PIAA board and got the chapter leadership invited to a meeting where they made their case for certifying the athlete after May 1st but it could be based on an up-to-date physical according to Bright Futures and a complete review of the medical record. A win for all pediatricians in PA! Sue has helped several other chapters accomplish similar changes in their states.

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Proud Pediatric Health IT Advancements

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Shift: For more than a decade, informatics leaders at the Academy had been concerned about protecting adolescent privacy of data in EHRs as the move toward data sharing and interoperability was rapidly advancing. Others kept lamenting that something had to be done. Not shying away from a big challenge, Sue co-founded Shift along with colleague Dr. Hannah Galvin. 

Understanding that this would remain a “kids' problem” at the “kids' table” without much visibility. Sue and Hannah set out to change the conversation to include any patient. At any point in our lives, we may have sensitive data that we want to protect from being shared with others in the healthcare system. Advancing the conversation with connections in the industry, Shift was born and now includes a board of directors and over 300 stakeholders with multiple viewpoints. 

 

Shift is advancing health equity in the interoperability world by pointing out that our current system allows sharing of “everything” or not sharing at all. This means that people with sensitive data are getting materially different care in our health systems because if they want to protect their information, they make the hard choice to not share anything. 

 

Voluntary Pediatric Certification of the EHR: The AAP has been pushing the conversation with the Office of the National Coordinator for Health IT (ONC) for many years, making the case that pediatric needs are unique and not met by many current EHRs. This lead to the Child Health EHR Format and eventually to the 21st Century Cures incorporation of a Voluntary Certification program into the rule.  Sue was instrumental in adding a practical voice to the HITEC work that shaped the recommendations as part of the Health IT for the Care Continuum Task Force. She remains an advisor for the  Drummond Pediatric and Patient Safety Advisory Panel.
 

Community Collaboration

 

Opioid Use Task Force: While Sue was serving as the Medical Director for the third largest School District in PA, she was hearing from school nurses that kids were showing up having taken narcotics for “pain relief” and were falling asleep in class and driving home while impaired. In addition, patients were telling stories about “pill parties” and people selling leftover narcotics they had for oral surgery, orthopedic injuries, or trips to the ER for an injury. Always willing to dive in and look for solutions, Sue engaged a multi-disciplinary working group in her community that included physicians from multiple specialties to discuss the extent of the problem and come up with some actionable solutions. Some of the outcomes included changing defaults in EHRs for the number of pills dispensed, creating a campaign to educate parents, and making it easier to dispose of unused narcotics at police stations. 

 

AAP Advocacy in Action

 

Leadership Resolutions: When pediatricians say, “The AAP should do x,” Sue’s response is often, “Have you considered writing a resolution for the leadership forum?” Always willing to help others get their ideas on paper and champion the ideas of colleagues, Sue has a history of submitting quite a few of her own including the following adopted resolutions::

2020: Supporting AAP Research on Payment in Order to Support Pediatricians

Developing a Pediatric Model for Value Based Payment 

2017: Advocate for Epinephrine Supply in Schools to Serve Entire 4 School Population 

 

Resolutions submitted for 2023:

• Strengthening Vaccine Confidence in Clinical Trials by Standardizing Trial Vaccine Data Exchange

• Supporting Pediatric Payment Advocacy

• Sustainability for Pediatric Preventive Care Recommendations

 

Volunteering at Home and Abroad

 

ISSA Trust Foundation: Improving Pediatric Healthcare in Jamaica. 2010-present. 

Sue has been involved in pediatric medical missions in Jamaica and in data collection and analysis on how to improve the well-being of Jamaica’s children. She initiated the fluoride varnish program and was able to identify some root causes of anemia and promote innovative ways to address the problem. Currently, she serves as an advisor to the foundation's efforts to build the first pediatric ambulatory clinic in Jamaica. The foundation is committed to strengthening the existing pediatric healthcare workforce and creating sustainable delivery models. 

 

Clinic for the Rehabilitation of Wildlife: Since moving to the sanctuary island of Sanibel, Sue has been volunteering at CROW as an intake coordinator. She fields triage calls from community members who find injured animals, facilitates intake into the hospital, and records key information into the wildlife electronic medical record. Her pediatric on-call experience positions her to succeed when dealing with distraught community members who find an injured animal who can’t verbalize what’s wrong. In addition, every day she learns something new about the wildlife who share the island. Did you know when rescuing a pelican you should never close their mouths? Pelicans are obligate mouth breathers and they will suffocate if you hold their bill closed. 

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Career

 

After completing her chief residency year, Sue joined a group private practice in Bucks County, PA as the fourth physician, and only woman pediatrician, in the group. With a continuous learning and improvement mindset, she set out to learn as much as she could about practicing community based pediatrics and the business of medicine by asking difficult questions. The healthcare environment was challenging in the greater Philadelphia area as the competitive market led to capitation payment models and consolidation. Learning first hand that in a capitation model, “seeing more patients doesn’t make you more money” her drive to question the status quo and yearn for innovative ways to deliver patient-centered care. In those early years of practice, where the physicians took their own call, attended c/sections in the middle of the night, balanced office visits with inpatient care being compassionate and efficient underscored the need to be intentional about everything.

 

For seven of those years Sue was a single mom learning the real value of creating a family out of friends and community support as her own parents died before her son was born. It was then that Sue realized that there is no such thing as work/life balance. It is micro-decisions about prioritization and being mindfully present to make each moment count.

 

After 15 years in the group practice setting and with her practice preparing to sell to a larger health system, Sue struck out on her own in 2004. It was then that she took her 15 years of experience and longing to transform care delivery, that she “disassembled the lego bricks” of practice design and set out in a different direction. Kressly Pediatrics was born out of a need to create an environment where compassionate care fostered enormous satisfaction for both the practice team and for families. Her Vision Statement “Traditional care, using modern technology in partnership with families” shaped practice design.

 

It’s here where Sue started pushing the Health IT envelope. She wanted to use technology to improve access and convenience for families, and use people where they added caring and the most value. It’s at that point where she envisioned the first iteration of a patient portal in 2004 and had her husband build her the technology to support her vision. Buying a license for use of Office Practicum pediatric EHR, she set out knowing that EHRs had a long way to go, but she wanted to be part of that journey. Advocating for improvements in the EHR, Sue became the medical director for OP, a position which she held for over a decade. At OP and in the larger HIT community Sue added the pediatric voice to many conversations advocating for functionality that is key to improving the care of children.

 

It’s also in opening up her own practice that she started asking hard business questions. Always with a desire to provide the best care possible, she challenged payers to provide needed resources. As Pay for Performance (P4P) models expanded in the region, she challenged their methods for panel attribution, quality metrics, capitation payment calculations with her own data which was almost uniformly more accurate than theirs.

 

The practice Sue founded in 2004 eventually grew to 4 doctors and 5 staff (how’s that for efficiency!) and created her “three legged stool” of expertise: clinical care, practice management and health IT all underscored with a dominant advocacy gene. That experience has led to her unique broad perspective being sought after as a subject matter expert by multiple organizations. Having lost her parents when they were in their 50’s, Sue promised herself that if she could make it happen, she would step away from clinical practice when she was 60 and look for other ways to advocate for children, pediatricians and a better world. To that end, Sue retired from clinical practice in 2020. The practice she founded has since joined a larger independent pediatric system in the area.

 

Currently Sue is an independent consultant, providing insight and value to pediatric practices on quality improvement, practice transformation, coding and payment (including Value Based Payment models), efficient use of Health Information Technology, as well as offering subject matter expertise to Health IT organizations. In addition, she serves on multiple committees and holds multiple volunteer leadership roles where she advocates for children and pediatricians, making the case to anyone who will listen.

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