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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Newborn Screening Long Term Follow-Up in the Medical Home
Deborah Badawi1, Katharine Bisordi2, Marilyn J Timmel1
1Maryland Department of Health, Baltimore, MD 21201, USA.
Insights
Pediatric primary care data is not sufficient for evaluating long-term outcomes in children with newborn screening (NBS) disorders. Challenges in data sharing and care coordination limit its current use as a sole evaluation source.
Area of Science:
- Pediatric Health
- Public Health
- Health Informatics
Background:
- Newborn screening (NBS) identifies infants with serious genetic, metabolic, and functional disorders.
- Effective long-term outcome evaluation is crucial for children with NBS disorders.
- Current data sources for outcome assessment may be fragmented.
Purpose of the Study:
- To explore the feasibility of using pediatric primary care data for evaluating long-term outcomes of children with NBS disorders.
- To assess compliance with care guidelines and morbidity in this population.
- To examine the accuracy of primary care data compared to other sources.
Main Methods:
- Recruited primary care practices and enrolled patients with sickle cell disease or hearing loss.
- Collected data on medical home quality via practice records and family surveys.
- Assessed clinical outcomes through medical record review and patient surveys.
- Explored electronic data sharing using Clinical Document Architecture (CDA) files.
Main Results:
- Care coordination proved challenging, even in accredited medical homes.
- Providers lacked complete clinical outcome information.
- Children did not consistently receive recommended preventive care.
- Electronic data sharing faced interface challenges.
Conclusions:
- Pediatric primary care providers in the USA are not currently a suitable sole source for evaluating long-term outcomes of children with NBS disorders.
- Improvements in data sharing and care coordination are necessary.
- Further research is needed to optimize outcome evaluation strategies.
Abstract:
This demonstration project explored the feasibility of utilizing data from pediatric primary care providers to evaluate the long-term outcomes of children with disorders identified by newborn screening (NBS). Compliance with national guidelines for care and the morbidity for this population was also examined. Primary care practices were recruited and patients with sickle cell disease or who were deaf/hard of hearing were given the opportunity to enroll in the study. Data were collected on the quality of the medical home with practice data compared to family responses. Clinical outcomes for each patient were assessed by review of medical records and patient surveys. These data sources were compared to determine accuracy of primary care data, morbidity, and receipt of preventive care. Electronic data sharing was explored through transmission of Clinical Document Architecture (CDA) files. Care coordination was a challenge, even in highly accredited medical homes. Providers did not have complete information regarding clinical outcomes and children were not consistently receiving recommended preventive care. Electronic data sharing with public health departments encountered interface challenges. Primary care providers in the USA should not currently be used as a sole source to evaluate long-term outcomes of children with disorders identified by NBS.
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