261808 Getting the patient voice into the electronic medical record: Using parent-completed pre-visit tools to customize and improve well child care

Tuesday, October 30, 2012 : 2:50 PM - 3:10 PM

Christina Bethell, PhD, MBA, MPH , Department of Pediatrics, School of Medicine, The Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, OR
Kasey McCracken, MPH , Dept. of Pediatrics, Oregon Health & Science University, Child and Adolescent Health Measurement Initiative, Portland, OR
Colleen Reuland, MPH , Dept. of Pediatrics, Oregon Health & Science University, Oregon Pediatric Improvement Partnership, Portland, OR
John Kilty, MD , The Children's Clinic, Tualatin, OR
Judy Shaw, EdD, MPH, RN , University of Vermont, College of Medicine, Vermont Child Health Improvement Program, Burlington, VT
     
Background: A pre-visit, online tool can educate parents prior to a visit, elicit priorities for care and enable linkage of parent reported information in the EMR for use before a well child visit.

Objective: To design and assess the acceptability and feasibility of an online, parent-completed tool, inserted into the EMR, to promote adherence to Bright Futures (BF) recommendations and customizes care to meet patient/family needs.

Methods: A pre-visit tool (PlanYourChild'sWellVisit tool-PCW) was developed reflecting BF recommendations for well-child care. The tool focuses on child/family health screening, identifying parent's anticipatory guidance priorities, parental education and provision of a "Visit Guide" for use during visits. Results are automatically inserted into the provider's EMR forms and used to customize the visit. Results derive from a 12 pediatrician private practice and represent 2,076 PCW completions by parents. Baseline and follow-up well child care quality, experience surveys and focus groups were conducted.

Results: 43.2% of parents invited completed PCW. Median completion time was 9 minutes; 91.2% indicated comfort with length. Results were reliably transferred into EMR. Nearly 90% of parents picked priority topics to discuss. 57.7% had concerns about their child's development or behavior to discuss. Over 90% of parents reported they would recommend the PCW to other parents. 85.2% reported PCW helped prioritize topics to discuss, especially regarding their child's development. Access to online educational materials embedded in the tool was reported useful by 83.2% of parents. Each participating pediatrician reported an intention to continue use of PCW and that it improved ability to provide recommended well-child care. Providers also noted positive impact on quality of care for children whose parents did not complete the online, pre-visit tool due to the improvements made in EMR forms.

Conclusions: Pre-visit patient engagement tools are feasible, effective in improving the experience of well child care visits.

Learning Areas:
Advocacy for health and health education
Clinical medicine applied in public health
Communication and informatics

Learning Objectives:
Participants will be able to compare parent-completed tools for well child care delivery and discuss improving care by engaging parents.

Keywords: Family Involvement, Quality of Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present this data because I have 20 years experience in health services research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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