1. CHIPRA Activities to Tackle Barriers Electronic developmental and behavioral screening Electronic referral with ASQ and M-CHAT results Shared script for introducing EI to families 1

2. CHIPRA Electronic Screening Who: All children at 9-, 18-, 24-, and 30-month well-child visits What: ASQ-3 screening at 9, 18, 24, and 30 months M-CHAT screening at 18 and 24 months Where: Screening is initiated at the registration desk Families enter responses in the waiting room or exam room After first screening in office, parents can complete screenings online at home (prompted by age-appropriate email reminders) How: Families use small mobile laptops in the office Answers are submitted through an online web portal Results are scored automatically and pulled into the child’s electronic medical record (EMR) for review at the well-child visit Provider and Family Supports: Electronic letter templates for EI and behavioral health referrals Post-screening family handouts about next steps 2

3. Electronic Screening Successes At point of screening: –Shifted primary responsibility to office staff, opening up more time for discussion with the health care provider –Accurate assignment of questionnaires based on age and prematurity –Accurate and immediate scoring of results –Using the same tool as community service providers At point of referral: –More clarity about referral between provider and family –Clear electronic documentation of the referral decision –Referral letter sent directly from the EMR At point of services: –Improved partnerships with EI 3

4. Electronic Referrals Letter template developed with local EI agencies Most information is pre- populated from the child’s EMR Saved electronically Letters sent directly from the EMR to county EI fax numbers Excerpt from electronic EI referral letter: 4

5. Referral Training 5

6. Ongoing Challenges to Address Needs at point of screening and referral: –Public domain developmental screening tool –Better tools and processes for patients with Limited English Proficiency –Explore the use of shared decision making to improve communication between provider and parent Needs at point of intake: –Better methods for EI to reach families –Electronic feedback through data exchange with community providers Needs at point of eligibility/services: –Quick entry into early childhood programs other than EI 6

7. This document was developed under grant CFDA 93.767 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. However, these contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal Government. Questions? 7