Implementing Patient Reported Outcome Tablets to Standardize and Increase Pediatric Developmental Screening at a Family Health Center
Authors:
Kevin C. Lee, DO; Ashleigh Peoples, MD; Alyssa Alicea, DO; Scott Brown, DO;
Lori Stiefel, MD; Tiffany Yang, MD
Background:
Around 15% of children in the US have at least one developmental delay, yet < 20% of those children receives early intervention services before 3 years of age. There are multiple screening tools to help identify these children in the primary care setting, with successful models involving a multifaceted approach. The use of electronic devices (ex. iPads) can allow patients and parents to produce patient-reported outcome measurements (PROM) more efficiently for providers to review and address.
Methods:
iPads were given to guardians of children aged 2 months to 5 years during Well-Child Visits(WCV) at the Family Health Center for completion of the Survey of Well-Being of Young Children (SWYC). Using Epic, our inclusion criteria were any child within the age range presenting for a WCV between January 3rd to March 1st, 2023. Each eligible chart was then reviewed for a SWYC score, and intervention for a positive screen. An intervention was done on February 1st encouraging clinical staff to provide tablets to guardians. A survey will be sent to clinical staff and providers to qualitatively assess the effectiveness of this new screening approach.
Results:
Out of 54 included entries, 21 displayed a SWYC score in the note (39%). 11 entries had a positive SWYC screen, and 4 patients were referred (36). After the February 1st intervention, SWYC scores in the note increased from 25% to 54%.
Discussion:
Initial implementation issues prevented higher screening rates in the first half of the data period. Screening rates subsequently doubled after the February 1st intervention, and there was also an increased rate of positive screens.
Conclusion:
Integration of electronic methods of screening into a clinic workflow involves the entire effort of the clinical staff. When integrated appropriately screening rates can increase, allowing clinicians to identify positive screens and treat children appropriately.
