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Acad Pediatr. 2018 Jan - Feb;18(1):111-118. doi: 10.1016/j.acap.2017.04.005. Epub 2017 Apr 18.

Care Coordination and Comprehensive Electronic Health Records are Associated With Increased Transition Planning Activities.

Author information

1
Division of General Medicine, Department of Medicine, Brigham and Women's Hospital, Mass; Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Brigham and Women's Faulkner Hospital, Mass. Electronic address: nsharma@bwh.harvard.edu.
2
Division of General Medicine, Department of Medicine, Brigham and Women's Hospital, Mass; Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Brigham and Women's Faulkner Hospital, Mass.
3
American Academy of Pediatrics, Elk Grove Village, Ill.
4
Division of General Pediatrics, Department of Pediatrics, University of Massachusetts Medical School, Worcester.
5
Division of General Pediatrics, Department of Pediatrics, and Division of General Internal Medicine, Department of Internal Medicine, University of California, San Francisco.

Abstract

OBJECTIVE:

Youth with special health care needs (YSHCN) require assistance from their pediatricians to transition to adult care. There are few data on what transition resources pediatricians have. In this article we discuss whether care coordination and/or comprehensive electronic health record (CEHR) implementation are associated with improved transition processes.

METHODS:

Using the American Academy of Pediatrics Periodic Survey #79, we report whether practices generated written transition plans, assisted in finding adult providers, and discussed confidentiality issues. Descriptive statistics and a logistic regression model were done to evaluate whether CEHR, care coordination, or practice and physician characteristics were associated with improved transition planning.

RESULTS:

Transition planning support in practices is low. Pediatricians with any care coordinator report more written transition plans for YSHCN (23% vs 6%; P < .001), assistance identifying adult providers (59% vs 39%; P < .001), and discussing confidentiality issues (50% vs 33%; P < .001). Pediatricians with a CEHR compared with those without are more likely to report written transition plans for YSHCN (24% vs 12%; P < .05) and discussing confidentiality issues (51% vs 39%; P < .05). In the logistic regression model, having care coordination (adjusted odds ratio, 11.1; 95% confidence interval, 5.9-21.3) and CEHR (adjusted odds ratio, 2.6; 95% confidence interval, 1.5-5.0) were independently associated with higher odds of having a written transition plan.

CONCLUSIONS:

Only 1 in 5 pediatricians have a transition coordinator in their practice and just 15% have a CEHR, even as these resources are associated with improved transition processes for YSHCN. Policy decisions should be made to help practices with supports, such as care coordination and electronic health record implementation, to improve transitions to adulthood.

KEYWORDS:

care coordination; electronic health records; meaningful use; transition; youth with special health care needs

PMID:
28428097
DOI:
10.1016/j.acap.2017.04.005
[Indexed for MEDLINE]

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