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Utilization of Children with Special Health Care Needs (CSHCN) Screener© by O'ahu's pediatricians
Mary Guo1, Galen Chock, Leolinda Parlin
1Medical Home Task Force, American Academy of Pediatrics, Hawai'i Chapter, Honolulu, HI, USA. maryguo@hawaii.edu
Insights
Most pediatricians in Hawai'i are not using population health management or the Children with Special Health Care Needs (CSHCN) Screener©, hindering Patient-Centered Medical Home (PCMH) implementation.
Area of Science:
- Health Services Research
- Pediatric Healthcare Quality Improvement
- Health Informatics
Background:
- Physicians in O'ahu are implementing the Patient-Centered Medical Home (PCMH) model.
- The Medical Home Task Force mandates the Children with Special Health Care Needs (CSHCN) Screener© for quality improvement.
- Understanding current practices is crucial for successful PCMH transformation.
Purpose of the Study:
- To assess the adoption of population health management (PHM) among pediatricians in Hawai'i.
- To identify barriers to integrating PHM and care registries into pediatric practices.
- To determine the utilization rate of the CSHCN Screener©.
Main Methods:
- An online survey was administered to 55 pediatricians in Hawai'i.
- Data collection occurred between January 10, 2012, and March 10, 2012.
- The survey assessed knowledge, use of PHM, care registries, and CSHCN Screener© utilization.
Main Results:
- 60% of pediatricians have not incorporated PHM into routine practice.
- 23% lacked knowledge of PHM, and 85% did not use chronic disease registries.
- As of August 2011, 95% had not used the CSHCN Screener©, citing lack of awareness and systematic assessment processes.
Conclusions:
- Significant educational gaps exist for Hawai'i's physicians regarding PCMH transformation.
- Physicians require instructional and financial support to adopt PHM and recommended screeners effectively.
- Addressing these barriers is essential for maximizing the adoption of PCMH recommendations.
Abstract:
O'ahu's primary care physicians are in the process of implementing the Patient-Centered Medical Home (PCMH) model. The Medical Home Task Force recommends the implementation of the Children with Special Health Care Needs (CSHCN) Screener© as one of the two quality improvement programs that must be completed by each participating physician. This study sought to find how many pediatricians practice population health management and to determine barriers for incorporating population health management and care registries into practices. An online survey of 55 pediatricians in Hawai'i was conducted between January 10, 2012 and March 10, 2012. The survey contained questions regarding knowledge and use of population health management and investigated the utilization rate of the Screener©. This survey provides baseline data on the implementation of this recommended screener, and informs the process that will be necessary to ensure maximal adoption of recommendations. Sixty percent of the survey participants have not incorporated population health management into their routine practice. Twenty three percent did not have knowledge of population health management and 85% did not use a chronic disease registry. As of August 2011, 95% had not screened their patients with the Screener©. Reasons included not having heard of the Screener© and never having considered using a systematic process to ask patients to assess their health. Based on results, there are important educational goals that need to be accomplished in order for Hawai'i's physicians to transform their practices into effective PCMHs. Physicians will likely need instructional and monetary support to effectively change their practices into PCMHs.
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