KIDSCARE: a network for children with special health care needs

Area of Science:

• Health Services Research
• Pediatric Healthcare
• Clinical Informatics

Background:

• Arkansas Medicaid, Title V, and Children's Medical Services (CMS) initiated guidelines for therapy preauthorization for Children with Special Health Care Needs (CSHCN) in December 1997.
• The University of Arkansas for Medical Sciences (UAMS) partnered with Arkansas Medicaid (MCD) and CMS to develop clinical practice guidelines for physical therapy (PT), occupational therapy (OT), and speech/language therapy (SLP).

Purpose of the Study:

• To describe KIDSCARE, a clinical information support network designed for determining medical necessity and allocating therapy services for CSHCN.
• To outline the development of evidence-based clinical practice guidelines for PT, OT, and SLP services for CSHCN, considering primary diagnosis and age appropriateness.

Main Methods:

• Implementation of a statewide, internet-based clinical information support network.
• Development of clinical practice guidelines based on primary diagnosis and age appropriateness for therapy services.
• Collaboration between Arkansas Medicaid, UAMS, and CMS.

Main Results:

• Guidelines for preauthorization of therapy services for CSHCN were implemented.
• A statewide, internet-based clinical information support network (KIDSCARE) was developed.
• The network facilitates the determination of medical necessity and allocation of therapy services.

Conclusions:

• The KIDSCARE network supports evidence-based decision-making for therapy services for CSHCN.
• This initiative aims to improve the allocation and medical necessity determination of therapy services for children with special healthcare needs.
• The project highlights the integration of clinical informatics in managing healthcare services for a specific pediatric population.