Official Title: QUICKSTEPS: Quality Improvement and Care for KidS Through Electronic ProgramS (with the Pennsylvania Department of Public Welfare and Department of Insurance)
Research Leads at CHOP: David M. Rubin, M.D., M.S.C.E. and Marsha Gerdes, Ph.D.
Project Team at CHOP: Elizabeth Brooks, M.P.H., M.S.S.P., Lisa Biggs, M.D., Robert Grundmeier, M.D., Eli Lourie, M.D., James Guevara, M.D., M.P.H.
Supported by: Centers for Medicare and Medicaid Services (CMS)
Dates: February 2010 – February 2015
Background
The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) included $100 million to be awarded to states as ten federal CHIPRA Quality Demonstration Grants. The Pennsylvania Department of Public Welfare and Department of Insurance (DPW/DOI) received one of these grants to improve the quality of health care services for children enrolled in Medicaid and CHIP. Pennsylvania’s objective is to create QUICKSTEPS (QUality Improvement and Care for KidS Through Electronic ProgramS) to improve health outcomes and reduce costs through the use of a pediatric electronic health record that includes pre-visit screening capabilities, a referral linkage system, and continuous evaluation by core pediatric quality measures. CHOP is one of seven health systems across Pennsylvania partnering with DPW/DOI on this effort.
Aims and Methods
- Category A: Testing and reporting on the pediatric core measures of quality
Category A activities include using the electronic health record to extract and report core pediatric quality measures approved by the Agency for Healthcare Research and Quality (AHRQ) and CMS. After collecting data on the core measures, CHOP and the partner health systems will identify gaps in care and use provider feedback reports to improve access and quality of care. - Category B: Promoting the use of HIT in children’s health care delivery
Activities in this grant category seek to innovatively use health information technology (HIT) to improve the early identification of children with developmental delays, behavioral health concerns, and complex medical conditions. Along with maximizing this early identification of need through point-of-care assessment, a major objective of this work is to improve the coordination of children’s care between their primary care medical homes, appropriate medical specialists, and child-serving social agencies. - The piloting of screening tools linked with the pediatric electronic health record (e.g., parental/adolescent questionnaires answered at home or using computers in the office) will explore pre-visit assessment strategies to enhance patient and provider communication during the office visit. Electronic tools including referral and care plan tracking systems will also be implemented to link children with appropriate services within CHOP and in the community.
- Core teams of experts on developmental pediatrics, psychology, children with special health care needs, and clinical informatics are working together to identify screening domains, choose strong and accurate measures for screening, develop partnerships and linkages with community service providers such as Early Intervention and community behavioral health agencies, and design a system to roll out screening to primary care practices. The lessons learned will be shared with the other partner health systems as they work to implement similar activities in the later years of the project.
Progress
Reporting and analysis of the pediatric core quality measures is ongoing. The electronic screening and referral linkage components are gradually being implemented in 12 pilot CHOP primary care practices, which will be followed by data collection and evaluation phases. The entire project runs through 2015.
Policy Focus
- Given the recent American Academy of Pediatrics and U.S. Preventive Services Task Force recommendations for standardized screening at pediatric primary care visits, this project will evaluate barriers to the use of standardized screening tools and electronic screening methods for families with children enrolled in Medicaid and CHIP.
- The CHIPRA work will also identify barriers to the collection and analysis of the pediatric core quality measures to inform future quality measurement reporting initiatives in pediatric health care.
This document was developed under grant CFDA 93.767 from the U.S Department of Health & Human Services, Centers for Medicare and Medicaid Services. The contents, however, do not necessarily represent the policy of the U.S. Department of Health & Human Services, and you should not assume endorsement by the Federal Government.
