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