Improving Quality Care for Children with Special Needs (Tennessee)

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Summary:

This project developed a secure Web-based electronic health record (EHR) for children with special health care needs (CSHCN) called the Tennessee Child Health Profile (TN-CHP). TN-CHP provides comprehensive information by linking data on newborn screening (NBS) and newborn hearing screening (NHS) from the public health database of the Tennessee Department of Health with diagnostic, treatment, and followup data from programs providing CSHCN services. The goal of this EHR is to improve primary diagnosis efficiency by making it easier for primary care providers, parents, and legal guardians to access and manage CSHCN information.

The primary objectives of this project were to:

    • Give health care providers secure web access to a comprehensive electronic health record of CSHCN (with parental permission) to ensure currency of information and continuity of care.
    • Use health information technology to improve coordination and quality of care provided to CSHCN in ambulatory settings.
    • Provide accurate, comprehensive health care information for developmental tracking of children from birth to adulthood.

Partners in the project were the Genetic Centers at the University of Tennessee (UT) Knoxville, UT Memphis and Vanderbilt, the Child Development Center at Vanderbilt, the UT Boling Center for Developmental Disabilities in Memphis, and the University Health Systems/UT Medical Center.

The project completed the development of TN-CHP. The team successfully collaborated with major stakeholders representing State departments, academic centers, and consumer agencies. Measured outcomes included the rates of CSHCN identification from NBS and NHS, tracking of diagnosis, and delivery of CSHCN services. The project also investigated the effect of birth weight on the lag time between date of birth and diagnosis.

Improving Quality Care for Children with Special Needs - 2010

Summary Highlights

  • Principal Investigator: 
  • Funding Mechanism: 
    RFA: HS05-013: Limited Competition for AHRQ Transforming Health Care Quality Through Information Technology (THQIT)
  • Contract Number: 
    UC1 HS 016133
  • Grant Number: 
    UC1 HS 016133
  • Project Period: 
    September 2005 – September 2010, Including No-Cost Extension
  • AHRQ Funding Amount: 
    $1,096,491
  • PDF Version: 
    (PDF, 324.12 KB)

Target Population: Children with Special Health Care Needs, Pediatric*

Summary: This project developed a secure, Web-based electronic health record (EHR) called the Tennessee Child Health Profile (TN-CHP) to provide comprehensive information on children with special health care needs (CSHCN). The goal of the TN-CHP is to expedite primary diagnosis by making it easier for primary care providers, parents, and legal guardians to access and manage CSHCN information. The TN-CHP links data on newborn screening (NBS) and newborn hearing screening (NHS) from the public health database of the Tennessee Department of Health with data on diagnosis, treatment, and followup from programs providing CSHCN services. Outcome measures included rates of CSHCN identification from NBS and NHS, tracking of diagnosis, and delivery of CSHCN services. The project also investigated the effect of birth weight on the lag time between date of birth and diagnosis.

Specific Aims:

  • Make available to health care providers secure Web access to a comprehensive EHR of CSHCN to ensure current information and continuity of care. (Achieved)
  • Improve the coordination and quality of care provided to CSHCN in ambulatory settings by the use of health information technology. (Achieved)
  • Provide accurate, comprehensive health care information for developmental tracking of children. (Achieved)

2010 Activities: The project team conducted statistical analysis of outcome measures for followup of NBS and NHS and developed the final report.

Grantee’s Most Recent Self-Reported Quarterly Status (as of January 2010): This project is complete with all major milestones achieved. The allocated funds were underspent in the first three years but were expended during the no-cost extension period of the project.

Impact and Findings: The major successes include: 1) the development of a comprehensive, Web-based EHR for CSHCN; 2) the participation of major stakeholders representing State departments, academic centers, and consumer agencies; and 3) data analysis of outcomes, including followup of NBS and NHS that was conducted and showed the lag times between birth and dates of screening tests and diagnosis and numbers of confirmed cases.

Specifically, the team found that there is a statistically significant difference in mean lag time of 1.65 days from date of birth to first collect between the low birth-weight babies (<1,500 grams) and those weighing 2,500 grams or more, and a statistically significant difference in mean lag time of 1.35 days from date of birth to first collect between the low birth-weight babies and those weighing between 1,500 and 2,500 grams. They also found that low birth-weight babies experience a mean lag time from date of birth to first report that is nearly five days longer than babies with weights from 1,500-2,500 grams, and more than 9.0 days longer than babies with weights greater or equal to 2,500 grams. Finally, low birth-weight babies experience a mean lag time from first collect to first report that is nearly five days longer than babies with weights from 1,500-2,500 grams, and 7.3 days longer than babies with weights greater than or equal to 2,500 grams.

Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to support patient-centered care, the coordination of care across transitions in care settings, and the use of electronic exchange of health information to improve quality of care.

Business Goal: Knowledge Creation

*AHRQ Priority Population.

Improving Quality Care for Children with Special Needs - Final Report

Citation:
Lozzio C. Improving Quality Care for Children with Special Needs - Final Report. (Prepared by University of Tennessee, Knoxville under Grant No. UC1 HS016133). Rockville, MD: Agency for Healthcare Research and Quality, 2010. (PDF, 965.03 KB)

The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
Principal Investigator: 
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