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Care Coordination and Comprehensive Electronic Health Records are Associated With Increased Transition Planning
Niraj Sharma1, Kitty O'Hare1, Karen G O'Connor2
1Division of General Medicine, Department of Medicine, Brigham and Women's Hospital, Mass; Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Brigham and Women's Faulkner Hospital, Mass.
Academic Pediatrics
|April 22, 2017
Summary
Pediatricians with care coordinators or comprehensive electronic health records (CEHR) are more likely to provide better transition planning for youth with special health care needs (YSHCN). These resources significantly improve written transition plans, adult provider identification, and confidentiality discussions.
Area of Science:
- Pediatric Health
- Healthcare Management
- Transition of Care
Background:
- Youth with special health care needs (YSHCN) require structured support for transitioning from pediatric to adult healthcare services.
- Pediatrician preparedness and available resources for this transition are not well-documented.
- Effective transition planning is crucial for continuity of care and long-term health outcomes for YSHCN.
Purpose of the Study:
- To investigate the association between care coordination and comprehensive electronic health record (CEHR) implementation and the quality of transition processes for YSHCN.
- To identify the extent to which pediatric practices offer resources to support the transition of YSHCN to adult care.
- To evaluate the impact of specific practice characteristics on improved transition planning.
Main Methods:
- Utilized data from the American Academy of Pediatrics Periodic Survey #79.
- Assessed the prevalence of written transition plans, assistance with adult provider identification, and discussion of confidentiality issues.
- Employed descriptive statistics and logistic regression to analyze the relationship between CEHR, care coordination, and transition planning outcomes.
Main Results:
- Pediatricians with care coordinators reported significantly higher rates of written transition plans (23% vs. 6%), adult provider assistance (59% vs. 39%), and confidentiality discussions (50% vs. 33%).
- Pediatricians utilizing a CEHR were more likely to provide written transition plans (24% vs. 12%) and discuss confidentiality (51% vs. 39%).
- Logistic regression confirmed that both care coordination (aOR=11.1) and CEHR (aOR=2.6) were independently associated with increased odds of having a written transition plan.
Conclusions:
- Transition planning support within pediatric practices remains limited, with only 20% having a transition coordinator and 15% a CEHR.
- Care coordination and CEHR implementation are significantly associated with improved transition processes for YSHCN.
- Policy interventions supporting care coordination and CEHR adoption are recommended to enhance healthcare transitions for YSHCN into adulthood.
Keywords:
care coordinationelectronic health recordsmeaningful usetransitionyouth with special health care needsMore Related Videos
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