Study: Automating pediatric screening decreases ID burden

Researchers from Children’s Health Services Research at Indiana University School of Medicine, Indianapolis, found automating the process of screening and alerting the physician to those who screened positive significantly decreased the burden of identifying relevant guidelines and screening of patient families in our clinics, according to an article published online April 16 in Pediatrics.

“Clinical decision support system integrated with EMRs offer a good strategy for implementing screening in waiting rooms,” Vibha Anand, PhD, an assistant professor of pediatrics at the Indiana University School of Medicine, and colleagues wrote. The researchers’ objective was to determine rates of positive risk screens during typical well-care visits among children and adolescents in a primary care setting.

Using the internally built Child Health Improvement through Computer Automation (CHICA), a pediatric clinical decision support system, clinical guidelines are encoded as medical logic modules to generate scanable paper forms: the patient screening form to collect structured data from patient families in the waiting room and the physician worksheet to provide physician assessments at each visit.

“By using visit as a unit of analysis from CHICA’s database, we have determined positive risk screen rates in our population,” the authors wrote.

Data for all patients who had a visit between June 2, 2009, and June 16, 2011, to one or more of the clinics served by CHICA were extracted for analysis. These data were response to questionnaires and the authors computed the response rate and rate of self-reported risk for each screening question.

From a cohort of 16,963 patients, 408,601 questions were asked in 31,843 visits. Of the questions asked, 89 percent had a response. Of those, 11 percent of the identified positive risk screens in both the younger children and the adolescent age groups, the authors found.

“By automating the process of screening and alerting the physician to those who screened positive with our decision support system, we have significantly decreased the burden of identifying relevant guidelines and screening of patient families in our clinics,” the authors concluded. “Moreover, we have been able to provide estimates as to the prevalence of various risk factors present in the pediatric primary care clinical setting that should be addressed in well-child visits.”