How an Electronic Medical Record System Facilitates and Demonstrates Effective Psychosocial Screening in Pediatric Primary Care

Arauz-Boudreau, Alexy; Riobueno-Naylor, Alexa; Haile, Haregnesh; Holcomb, Juliana M.; Lucke, Cara; Joseph, Bernard; Jellinek, Michael S.; Murphy, J. Michael

doi:10.1177/0009922819892038

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…Other strategies have focused on integration of psychosocial screening tools into electronic health records and the use of computer-based decision support systems, which can improve workflow and streamline referral processes. 30,39-41 Broader policy-based efforts are also critical for increasing the supply of mental health providers, as well as employing consultation models whereby psychiatrists can guide the management of adolescent mental health problems by primary care providers. 42 Finally, the COVID-19 pandemic has resulted in rapid roll-out of telehealth services, and there is hope that these services can help overcome geographic and financial barriers to care.…”

Section: Discussionmentioning

confidence: 99%

Association of depression screening with diagnostic and treatment-related outcomes among youth

Riehm

Brignone²,

Stuart

et al. 2021

Preprint

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Background and ObjectivesThe goals of depression screening, which is universally recommended in primary care settings in the U.S., are to identify adolescents with depression and connect them to treatment. However, little is known about how depression screening affects the likelihood of being diagnosed with a mental disorder or accessing mental health care over time.MethodsThis longitudinal cohort study used insurance claims data from 57,732 adolescents who had at least one routine well-visit between 2014 and 2017. Using propensity score matching, we compared adolescents who were screened for depression to similar adolescents who were not screened for depression during the well-visit. Diagnostic and treatment-related outcomes were examined over 6-month follow-up and included depression diagnoses, mood-related diagnoses, antidepressant prescriptions, any mental health-related prescriptions, and psychotherapy. We also examined heterogeneity of associations by sex.ResultsCompared to adolescents who were not screened for depression, adolescents screened for depression were 30% more likely to be diagnosed with depression (RR=1.30, 95% CI=1.11-1.52) and 17% more likely to receive a mood-related diagnosis (RR=1.17, 95% CI=1.08-1.27), but were not more likely to be treated with an antidepressant prescription (RR=1.11, 95% CI=0.82-1.51), any mental health prescription (RR=1.15, 95% CI=0.87-1.53), or psychotherapy (RR=1.13, 95% CI=0.98-1.31). In general, associations were stronger among females.ConclusionsAdolescents who were screened for depression during a well-visit were more likely to receive a diagnosis of depression or a mood-related disorder in the six months following screening. Future research should explore methods for increasing access to treatment and treatment uptake following screening.Clinical Trial Registration (if any)N/ATable of Contents SummaryInsurance claims data were used to explore associations between depression screening during routine well-visits and depression diagnoses, psychiatric prescriptions, and psychotherapy among adolescents.What’s Known on This SubjectDepression screening is increasingly viewed as a key strategy for addressing depression among adolescents. To inform clinical guidelines, the United States Preventive Services Task Force has called for research to examine the diagnostic and treatment-related outcomes of depression screening.What This Study AddsIn a sample of 57,732 adolescents, adolescents who were screened for depression during a well-visit were more likely to receive a depression or mood-related diagnosis over 6-month follow-up, but were not more likely to be treated with medication or psychotherapy.

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Section: Discussionmentioning

confidence: 99%

Association of depression screening with diagnostic and treatment-related outcomes among youth

Riehm

Brignone²,

Stuart

et al. 2021

Preprint

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“…Seluruh data disimpan dalam database sehingga baik dokter, pasien, maupun pihak lain yang membutuhkannya dapat mengakses kapanpun dan dimanapun. Data yang disajikanpun lengkap, akurat, dan tepat waktu [12], [13].…”

Section: Electronic Medical Record (Emr)unclassified

Infant Development Monitoring Application

Rahmatya

Wicaksono

2021

IJIS

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Penelitian ini bertujuan untuk merancang model pemantauan pertumbuhan dan perkembangan bayi. Metode pendekatan analisis sistem yang digunakan adalah berbasis objek dengan waterfall model sebagai metode pengembangan sistem. Sistem ini dibangun untuk membantu ibu memantau pertumbuhan bayinya dan vaksin yang telah diperoleh. Ibu seringkali tidak dapat membaca tulisan dokter di buku catatan kesehatan anak. Oleh karena itu, hasil dari perancangan aplikasi ini adalah untuk membantu para ibu dalam memantau pertumbuhan dan perkembangan bayi, seperti tinggi dan berat badan, jenis vaksin yang sudah didapatkan, serta jadwal kontrol dan vaksin selanjutnya. Ibu juga dapat mengetahui kategori berat badan anaknya saat ini dan melakukan konsultasi kesehatan anak melalui aplikasi tanpa harus datang ke dokter anak. Pengujian dilakukan menggunakan metode black box. Pengujian tersebut meliputi aplikasi web dan Android. Hasil pengujian menunjukkan bahwa penelitian ini sudah mencapai tujuannya, dimana data rekam medis yang dimasukkan oleh dokter melalui aplikasi web sudah dapat tersimpan ke database. Selanjutnya, Ibu dari bayi juga sudah dapat mengakses informasi tersebut dan menggunakan fitur-fitur lainnya seperti konsultasi dan pengecekan berat dan tinggi badan bayi melalui aplikasi Android yang dibuat.Kata Kunci: Aplikasi, Tumbuh Kembang Bayi, Rekam Medis, Pemantauan

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“…massgeneral.org/psc) and in electronic health records (EHRs) such as Epic and Comprehensive Health and Decision Information System. These systems are widely used, 27 automate both the administration and the scoring of the PSC, and provide instantaneous access to scores, thereby facilitating their use by clinicians during the WCV. Many electronic systems store scores of electronically administered screens in a way that allows for tracking of scores over time.…”

Section: The Pediatric Symptom Checklistmentioning

confidence: 99%

“…Many electronic systems store scores of electronically administered screens in a way that allows for tracking of scores over time. 27 In addition, in accord with the guidelines, many networks of pediatric providers have now made psychosocial screening with the PSC at each patient's WCV the standard of care 27 as did RHC's system.…”

Section: The Pediatric Symptom Checklistmentioning

confidence: 99%

“…Two final limitations to be considered are the lack of access to EHRs and mental health treatment resources. Although EHRs have replaced paper and pencil screens in many pediatric practices, 27 some thought needs to be given to the place of screening in the remainder of practices that do not. First, there are semi stand-alone systems such as Comprehensive Health and Decisions Information System (https://www.site.chadis.com) that pediatricians who are not a part of EHRs can still use to automate questionnaire administration, scoring, storing, and interpretation.…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

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Beyond Initial Screening: One-Year Follow-up of Adolescents with Internalizing Problems on the Pediatric Symptom Checklist

Holcomb¹,

Boudreau

Riobueno-Naylor³

et al. 2020

J Dev Behav Pediatr

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Objective: Screening for adolescent depression is a quality indicator for pediatric care, and the parent-completed, 17-item Pediatric Symptom Checklist's internalizing (PSC-17P-INT) subscale has been validated for this purpose. The current study assessed the feasibility of PSC-17P-INT screening, the prevalence of risk on 2 consecutive PSC-17P-INTs, and rates of behavioral health (BH) service use before and after screening. Methods: The parent-report PSC-17 was completed on tablet devices before well-child visits (WCVs) with results instantaneously available to clinicians in the electronic health record. Billing data were used to identify adolescents with 2 consecutive WCVs and possible BH service utilization 6 months before and after their first screen. Results: In 2017, 1,068 adolescents (12-17 years old) were seen for a WCV, and 637 (59.6%) of them had one in 2018. Most (93.9%; N 5 604) completed a PSC at both visits. Patients who scored positively on their first PSC-17P-INT were about 9 times more likely to receive subsequent BH services than patients who screened negative (24.3% vs 2.6%, x 2 5 59.65, p < 0.001). However, risk prevalence increased from the first (11.6%) to the second (14.9%) screen, and only 37.1% of at-risk patients remitted. Conclusion:The current study demonstrated that screening adolescents for depression using the PSC-17P-INT was feasible and associated with a significant increase in BH treatment rates. The study also demonstrated that the PSC could be used to track adolescents at risk for depression, found that most youth who screened positive remained at risk 1 year later, and supported recent quality guidelines calling for annual depression screening and follow-up for adolescents with depression.

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How an Electronic Medical Record System Facilitates and Demonstrates Effective Psychosocial Screening in Pediatric Primary Care

Cited by 9 publications

References 26 publications

Association of depression screening with diagnostic and treatment-related outcomes among youth

Association of depression screening with diagnostic and treatment-related outcomes among youth

Infant Development Monitoring Application

Beyond Initial Screening: One-Year Follow-up of Adolescents with Internalizing Problems on the Pediatric Symptom Checklist

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