Implementing an Electronic Health Record-Integrated Pediatric Primary Care Sleep Screener

Area of Science:

• Pediatric primary care
• Sleep medicine
• Health informatics

Background:

• Sleep is vital for child development, academic success, and mental health.
• Pediatric primary care settings often overlook consistent sleep assessments.
• Implementing effective sleep screening tools is crucial for early intervention.

Purpose of the Study:

• To develop and evaluate an electronic sleep screener for well-child visits.
• To assess the reach, adoption, implementation, effectiveness, and maintenance of this tool in a large primary care network.
• To improve the identification and management of sleep problems in children.

Main Methods:

• A case-control study using retrospective electronic health records from a primary care network.
• Development and implementation of an age-based electronic sleep screener.
• Analysis of data from preimplementation, scaling, implementation, and maintenance periods.
• Multivariate logistic regression to compare sleep disorder diagnosis, polysomnogram orders, and referrals before and after implementation.

Main Results:

• The electronic sleep screener was adopted in 89.5% of well-child visits during implementation and maintained at 92.5%.
• Patients completing the screener showed significantly higher rates of sleep disorder diagnosis (OR, 1.64), polysomnogram orders (OR, 2.67), and referrals (OR, 6.48).
• Commonly reported issues included frequent snoring (9.7%), sleep problems (12.2%), insufficient sleep (34.4%), infant bed sharing (6.5%), and adolescent daytime sleepiness (14.7%).

Conclusions:

• A brief, electronic well-child visit sleep screener is highly adoptable and sustainable in diverse primary care settings.
• The screener significantly increases the recognition and management of pediatric sleep issues.
• This tool offers a practical solution for integrating sleep health into routine pediatric care.