Using Health Information Technology (HIT) to Improve Early Screening and Connect Children to Community Services: The CHIPRA Quality Demonstration Grant in Pennsylvania

Statement of Problem

Despite clinical recommendations supporting screening for developmental and behavioral issues in primary care, there is limited understanding of the best ways to implement these practices using health information technology (HIT). In addition, screening must be supported by strong systems for electronic referral and feedback between primary care clinics and community-level service providers, such as Early Intervention and behavioral health.

Description

From 2010-2015, PolicyLab, Children’s Hospital of Philadelphia’s (CHOP) Department of Biomedical and Health Informatics, and the CHOP Care Network of primary care practices worked with the state of Pennsylvania and the federal Centers for Medicare & Medicaid Services to improve the quality of pediatric care using HIT through a variety of quality improvement projects. PolicyLab provided technical assistance to Pennsylvania projects that implemented electronic screening for developmental and behavioral concerns in primary care and worked to improve referrals to Early Intervention and community behavioral health services.

Due to the success of these pilot integration efforts, which occurred as part of the 2009 Children’s Health Insurance Program Reauthorization Act (CHIPRA) roll out in Pennsylvania, the CHOP Care Network adopted the electronic screening practice into regular operations. CHOP’s 31 primary care offices now electronically screen every child during their well-child visits using a process that ensures all developmental, behavioral and other health-risk screenings are completed according to Medicaid’s Early and Periodic Screening, Diagnostic and Treatment requirements and the American Academy of Pediatrics’ Bright Futures guidelines. Since July 2011, families at CHOP have completed more than 1.1 million standardized screening questionnaires for postpartum depression, developmental delay, autism, adolescent depression and school-age behavioral concerns using tablets during primary care visits or through the online patient portal ahead of their office visit.

Next Steps

This project expanded PolicyLab’s body of work demonstrating the importance of connecting children and families through the continuum of screening to referral for Early Intervention and behavioral health services. We continue to share results of this project locally and nationally, providing guidance to other health systems on how to improve their pathways for identifying and referring children and families to services. The team also focused on identifying mechanisms to finance these enhanced primary care services, working regionally and nationally to determine how to support growth in primary care practices as screening requirements have increased in recent years. Finally, researchers have used the screening results collected from this work in various studies exploring the best ways to identify children at risk for developmental delays, autism and adolescent depression and how to improve the referral pathways to Early Intervention and behavioral health services.

This project page was last updated in December 2019.

Suggested Citation

The Children's Hospital of Philadelphia, Policy Lab. Using Health Information Technology (HIT) to Improve Early Screening and Connect Children to Community Services: The CHIPRA Quality Demonstration Grant in Pennsylvania [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here]. 

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