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The effect of EHR implementation on provider perspectives of developmental surveillance, screening, and referrals for early intervention services
Thesis

The effect of EHR implementation on provider perspectives of developmental surveillance, screening, and referrals for early intervention services

Blair A. Brown
Master of Public Health (M.P.H.), Drexel University
May 2012
DOI:
https://doi.org/10.17918/etd-3927
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Brown_Blair_2012407.69 kB
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Brown_Blair_2012_Suppl1591.48 kB
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Abstract

Developmental Surveillance Early Intervention Services Electronic Health Records Public Health
Objectives: Electronic health records (EHR) are becoming more widespread in the healthcare community. Research suggests that EHR is more efficient, cost-effective, and provides higher quality patient care than paper-based records. There is limited data available on how the transition to EHR affects developmental care in pediatrics, specifically from the provider's perspective. Methods:A mixed-methods survey for providers was designed asking about their perceptions on the ease of completing developmental surveillance, use of validated screening tools, and the overall effectiveness of the referral process for early intervention services. Providers were given surveys one week prior to EHR implementation and three months post-implementation. Surveys were done on paper and using Qualtrics online survey software. The data were collected and pre and post responses were analyzed in SPSS for significant differences using the Wilcoxon Signed Rank Test. Qualitative responses were summarized into themes and compared pre and post. Results: All 16 providers completed both the pre and post-survey. Overall both pre and post-implementation, more than 60% of providers regularly assess child development. Prior to EHR providers were somewhat more likely to use validated screening tools and believed EHR would improve their assessments. Post-implementation surveys show that providers feel their assessments of development are worse. Based upon qualitative responses, providers believe access to screening tools and time are the largest barriers to completing effective developmental assessments. Conclusions: Long term, EHR has the potential to improve the quality of care, specifically pediatric developmental care. After only three months of EHR providers are most likely still becoming familiar with the system. The lack of availability of screening tools and referral forms stream-lined into EHR may be a limiting factor in the current efficiency of EHR. As providers gain confidence using the system and the necessary screening tools and forms are added, EHR has the potential to improve developmental surveillance, screening, and referrals.

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