Coming Together: Community Partnership Uses Data Registry to Improve Preventive Service Delivery & Child Health Outcomes for Medicaid Children

TARGET POPULATION: THE PEDIATRIC POPULATION OF WASHINGTON DC IS APPROXIMATELY 112,000, OF WHICH APPROXIMATELY ONE THIRD LIVES BELOW POVERTY LEVEL. APPROXIMATELY 80% OF THE CHILDREN ARE ELIGIBLE OR ENROLLED IN MEDICAID, AND APPROXIMATELY 30-40% OF DC'S CHILDREN HAVE EITHER A SPECIAL NEED AND/OR CHRONIC DISEASE. ULTIMATE TARGET POPULATION IS APPROXIMATELY 80,000 CHILDREN. METHODS: OVER THREE YEARS, THE COLLABORATIVE DEVELOPED STANDARDIZED MEDICAL RECORD FORMS (SMRF) TO BE USED AT EVERY EPSDT ENCOUNTER THAT CAPTURES DATA FOR ENTRY INTO AN EPSDT REGISTRY. A PAY-FOR-PERFORMANCE AGREEMENT WAS DEVELOPED WITH MCO'S TO ENCOURAGE & REWARD PROVIDERS FOR EACH COMPLETED SMRF. DURING THE PROCESS, THE DC PARTNERSHIP TO IMPROVE CHILDREN'S HEALTHCARE QUALITY (DC PICHQ) WAS ESTABLISHED TO FORMALIZE THE PARTNERSHIPS. DC PICHQ IS WORKING WITH ALL PARTNERS TO MOVE FROM A DATA COLLECTING EFFORT TO UTILIZATION OF DATA TO DRIVE QI EFFORTS. THIS WILL ENCOURAGE THE TRANSITION FROM PAY-FOR-PARTICIPATION TO PAY-FOR-PERFORMANCE WITH THE EMPHASIS ON IMPROVING CHILDREN'S HEALTH. RESULTS/IMPACT: THE SUCCESSFUL COLLABORATION BETWEEN PUBLIC AND PRIVATE ENTITIES RESULTED IN THE IMPLEMENTATION OF SMRFS AND A DATA REGISTRY. IN THE INITIAL PILOT PHASE, THE SMRFS CAPTURED APPROXIMATELY 90% OF THE REQUIRED DATA ELEMENTS FOR EPSDT VISITS. OVER 15,000 SMRFS HAVE BEEN COLLECTED SINCE THE IMPLEMENTATION IN JANUARY 2006. PRELIMINARY REVIEW OF A SAMPLE DEMONSTRATED >85% COMPLETION OF A FULL EPSDT VISIT COMPARED TO THE 37% SEEN IN THE 2002 AUDIT OF EPSDT VISITS. COMPREHENSIVE DATA ON COMPLETE EPSDT VISITS (INCLUDING BMI DATA) ON ALL CHILDREN OVER 2 YEARS OLD WILL BE AVAILABLE IN MARCH 2007. CONCLUSION: THIS CITYWIDE COLLABORATION OF ALL KEY PARTNERS IS ONE OF THE COUNTRY'S FIRST TO ADDRESS CHILD HEALTH QUALITY IMPROVEMENT BY THE COMMUNITY FOR THE COMMUNITY. THIS PARTNERSHIP ILLUSTRATES THE SUCCESS OF USING EPSDT VISITS TO CREATE A SECURE AND ROBUST CHILD HEALTH DATA REPOSITORY/REGISTRY- MODELED ON THE DC DEPARTMENT OF HEALTH SUCCESSFUL IMMUNIZATION REGISTRY. REAL-TIME CLINICAL DATA WILL GIVE DC'S PROVIDERS A UNIQUE OPPORTUNITY TO IMPROVE THE QUALITY OF CARE THEY DELIVER DURING THE PATIENT VISIT ITSELF. AGGREGATE DATA WILL ALLOW FOR SYSTEM-BASED QUALITY IMPROVEMENT AT THE PROVIDER PRACTICE, MCO, AND CITYWIDE LEVELS. THE DC PICHQ- A REGIONAL IMPROVEMENT PARTNERSHIP- OFFERS A MODEL FOR PROVIDER LEADERSHIP IN IMPROVING CHILD HEALTH OUTCOMES AT THE COMMUNITY LEVEL.