Post on 20-Jan-2018
description
Statewide developmental screening in Rhode Island accomplished through partnershipPamela High MD 1
Pei Chi Wu MD 1
Stacey Aguiar MPH 2
Blythe Berger PhD 2
Autism CARES MeetingBethesda, MDJuly 16, 2015
EPSDT in RI
The Rhode Island EPSDT Schedule aligns with AAP Bright Futures Guidelines recommending formal standardized developmental
screening at 9, 18 & 30 months autism screening at 18 & 24 months.
Partnership
The RI Department of Education (RIDE) Race to the Top Early Learning Challenge Grant
The RI Department of Health (HEALTH) Community partners including RI AAP Supporting primary care practices with technical
assistance and funding to implement a system of electronic, standardized developmental screening aligning with EPSDT standards.
Participating Practices Receive1. Technical Assistance to implement standardized
screening using the SWYC (Survey of Wellness in Young Children)
2. A one year user license for CHADIS (Child Health and Development Interactive System) to conduct electronic screening. Parents can complete screens at home or in the office online using computers, smart phone and tablets. The system scores screens and providers can view results in real time.
3. Tablets to access and use CHADIS in the office4. Bonuses and TA to increase developmental screening
rates5. Support to link families to available, accessible
services
Practice Identification & Goals
Practices were identified that had a patient population of either 1. >25% on Medicaid & >25 Medicaid kids ages 0-3
yrs….. OR2. <25% on Medicaid & >50 Medicaid kids ages 0-3
yrs 79 practices were thus identified with
about 375 primary care providers serving 13,174 Medicaid children birth to 3 years old
(of 27,679 total children birth to 3 in RI), with a target of reaching 90% of these children
screened by October of 2016.
HEALTH’s Resource and Referral Specialist Receives referrals electronically from
practices Calls family to follow-up & gather
information Refers family to resources Follows up to make sure family has
engaged in services The resource communicates with
referring provider
HEALTH is building an interface between CHADIS and KIDSNET
KIDSNET is RI's confidential, computerized child health information system
KIDSNET collects data for every child born in RI including birth records, immunization, newborn bloodspot screening, WIC, lead poisoning, Early Intervention, Newborn Developmental Risk Assessment, hearing, Family Visiting and birth defects
What is KIDSNET?
A Public Health Program – not an electronic medical record Integrated Child Health Information System for maternal and child health programsFacilitates the collection and appropriate sharing of health data by authorized users for the provision of timely and appropriate preventive health services and follow up
KIDSNET Partner Programs
7 Universal:Newborn Developmental Risk Newborn Bloodspot ScreeningNewborn Hearing AssessmentImmunizationChildhood Lead PoisoningVital RecordsChild Outreach
10 Targeted:WICEarly InterventionFamily VisitingBirth DefectsCEDARR**
(information and referral about services and supports for children enrolled in Medicaid who have disabilities and special needs)
Healthy WeightAsthmaEarly Childhood Developmental ScreeningFoster Care*Head Start **
*No Web access **in development
Birth to Three
Data SourcesFamily Visiting Electronic Web-based
Screening (Child Health and Development Interactive System-CHADIS, Patient Tools)
Electronic Web-based Screening
Primary Care provider subscribes to service
Parent completed tools (Survey of Well-Being in Young Children-SWYC, Ages and Stages Questionnaire – ASQ, M-CHAT)
Recommendations for Physicians NEXT DUE Developmental Screening: Recommended at 9 ,18, 30 months
DUE NOW
Autism Screening: Recommended 18 and 24 months
DUE FUTURE at 18 months
Click here for EPSDT schedule
Three to Five
Data SourcesElectronic Web-based ScreeningChild Outreach (Child Find)
Future
Developmental screening data will be available soon in KIDSNET.
Ultimately, we will link KIDSNET to the RIDE's database to be able to track long term outcomes
Progress to date
16 practices at 16 sites are fully using electronic screening
HEALTH has begun conversations with several other pediatric practices around participating in the project
Progress to date: Referral to R & R Specialist at DOH January 2015 – 28 referrals from 6 practices February 2015 - 23 referrals from 7 practices March 2015- 59 referrals from 7 practices April 2015 - 53 referrals from 10 practices May 2015 – 61 referrals from 11 practices June 2015 – 62 referrals from 7 practices