Pediatricians are trained to detect and handle developmental issues, as well as social, emotional & psychological problems, and for the most part are getting the job done.
However, studies show that these problems are generally under-diagnosed, particularly in the under-served population.
So where is the disconnect? The answer, the prevalence of these problems in a typical patient population may range from 8 to 15% and it is relatively easy for 1% or 2% of the children to go undetected (maybe one child every couple weeks).
Unfortunately with 70,000 pediatricians in the US, missing on average 1% or 2% of their patient panel, this
equates to a huge number and a huge associated cost.
The advantage of using standard screening measures, combined with a comprehensive screening protocol, is that the Pediatrician's diligence is augmented by consistent screening measures that on average reduce the under-diagnosis error.
In addition, automating this screening process, keeps the brunt of the workload off of the staff.
While augmenting the detection process with automation is
cost-effective, there is considerable evidence showing that
providing Pediatricians with integrated support services is
cost-effective as well.
Care Coordinator Model
Once referred, determining the appropriate referral resources
and helping parents/children with logistic hurdles, are tasks
that are handled effectively by a dedicated Care Coordinator.
Whether formally organized into a registry/program or on a
case-by-case basis, Care Coordinators improve the percentage
of detected problems that receive the appropriate treatment.
Diagnosis, Assessment, Referral and Treatment (DART) therapists,
perform a range of services to streamline treatment. Typically
additional in-depth assessment is performed to better understand
the issues. If a simple intervention is needed, it is performed
immediately. Alternately, the child may be referred to other
professionals (psychiatry, psychology, etc) or back to the
Behavioral Health Consultants (BHCs) become an integral part of the medical team, collaborating with Pediatricians and even performing brief interventions during the normal office visit.
This model of care is efficient because: intervening as early as possible limits the progression of problems;
BHCs cover a wide range of issues, not just diagnosing a specific
referral; and performing interventions as part of a normal visit removes
stigma, helping bypass the fallout of patients not showing for referrals.
Level of Integration
As you can see, progressively higher levels of integration & collaboration
are being used for detection and treatment of developmental, social,
emotional & psychological problems. Determining the level
of integration that works best given your setting (FQHC/CHC,
large practice, etc) may take some time, but starting with automated screening is an
obvious first step. Automated
screening is low cost, augments detection and enables online
aggregate views with no additional work. Aggregate views demonstrate
population prevalence of problems and validate effectiveness
of more advanced care models.
Please Contact Us to learn
more or discuss how automated screening and one of these Integrated
Models will work in your setting.