Expediting Nutrition, Safety and Mental Health Assessments in Pediatricians – Physician’s Weekly

Credit Credit: Drazen Zigic

Moving from paper to tablets can improve screening of children for health-related needs such as nutrition and caregiver mental health issues.

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The results are published in Pediatricians highlight the benefits of moving from a paper-based assessment for health-related social needs (HRSN) / caregiver mental health care (CMHC) to a tablet assessment.

Michelle C. Gorecki, MD, MPH, and colleagues found that families were more likely to disclose HRSN/CMHC when using electronic resources, which resulted in more referrals. community and many collaborative services.

Based on the results of the research, the American Academy of Pediatrics and the Academic Pediatric Association both recommend the evaluation and treatment of HRSN and CMHC in the context of pediatric care, emphasizing their importance in promoting health equity, especially among the poor nations.

Past research shows that caregivers are comfortable disclosing sensitive information, such as food insecurity and domestic violence, through non-verbal means such as paper or electronic tablets. However, no previous research has directly compared HRSN/CMHC disclosures between paper and electronic methods.

Dr. Gorecki and colleagues intended to examine the difference in disclosure rates between these methods and to assess whether increased disclosure requirements through electronic screening would lead to higher referral rates. of public and medical-legal relations (MLP).

This study was conducted through a retrospective review of EHR data from 3 primary care pediatric practices, 2 in urban areas (Sites A and B) and the other in a suburban area (Site C). . These practices serve the underserved, with a large share of social insurance and self-identification as Black.

Caregivers of patients 18 years of age or younger completed the HRSN/CMHC questionnaire during well-child visits. The examination was based on paper from January to December 2018, and the transition to electronic tablets began in January 2019 and was extended to December 2019.

Advertising Rates Increase With Electronic Inspection

The analysis included 16,151 patients with paper HRSN / CMHC examinations and 13,019 patients with electronic ones.

Overall, 11% of paper-based assessments indicated one or more requirements compared to a quarter (26%) of electronic assessments (Q<0.001).

Using time series analysis, Dr. Gorecki and colleagues found that two of the three methods significantly increased the odds of disclosing claims electronically (OR, 3.0; 95% CI, 2.5–3.6) versus paper (OR, 1.7; 95% CI , 1.2-2.4) analysis. According to the study results, higher HRSN/CMHC disclosure rates when switching to electronic testing increased referrals to public practice/MLP.

All three systems saw an increase in disclosure rates after moving from paper to electronic devices, although the magnitude was different: Site A had the highest increase in the most (OR, 4.24), followed by Site B (OR, 2.18) and Site C (OR, 1.54).

In addition, many patients revealed many aspects of HRSN/CMHC, especially food insecurity and CMHC, while the declarations of housing concerns and problems of dispensing medicines were reduced, mainly influenced by Site A results.

Dr. Gorecki and colleagues found that an increase in HRSN/CMHC disclosures was associated with an increase in referrals to supportive services. After switching to electronic testing, referrals to public employment rose from 4.1% to 5.1%, and referrals to MLP increased from 1.2% to 1.8%.

Among those who disclosed an HRSN/CMHC, the proportion reporting social work increased from 38% to 57%, and the percentage of MLPs increased from 67% to 83% Mediation analyzes confirmed that higher referral rates were associated with increased disclosure rates resulting from electronic testing.

The indirect effect was statistically significant in all areas, showing that electronic testing led to 1.6 times higher chances of being transferred to a public service and up to 2.2 times higher for transfer MLP. However, the direct effects of electronic testing on referrals were only significant at Center A, suggesting that site-specific factors may have influenced the results.

Improving the Impact of Evaluation on Children’s Travel

According to Dr. Gorecki and colleagues, it is believed that this increased number of disclosures and referrals is related to the feeling of privacy and convenience associated with electronic monitoring. Studies highlight the potential of electronic systems to improve patient outcomes by improving identification of needs and facilitating timely intervention.

“We found that health needs related to mental health care are significantly increased with electronic tablet screening compared to paper screening,” the researchers wrote. “Our research suggests that nurses should consider switching to electronic HRSN/CMHC monitoring, due to its link to increased HRSN/CMHC identification and subsequent coordination of services.”

Important information

• Moving from paper to electronic assessment for social needs and mental health led to more needs being identified: 11% with paper versus 26% with electronic assessment.
• Many patients revealed a wide range of needs related to health care/mental health care providers through the electronic assessment, especially food insecurity.
• Referrals to social support services have also increased through electronic testing, including social work and legal medical relationships.
• The increase in disclosures and referral fees may be due to perceptions of privacy and convenience associated with electronic testing, according to the study’s researchers.