Department of Pediatrics
Health and Medical Administration | Pediatrics
OBJECTIVE: Youth with Special Health Care Needs (YSHCN) require assistance from their pediatricians to transition to adult care. There is little data on what transition resources pediatricians have. This paper studies if care coordination and/or comprehensive electronic health record (CEHR) implementation are associated with improved transition processes. METHODS: Using AAP 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 improve 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<0.001), assistance identifying adult providers (59% vs. 39%, p<0.001), and discussing confidentiality issues (50% vs. 33%, p<0.001). Pediatricians with a CEHR compared to those without are more likely to report written transition plans for YSHCN (24% vs. 12 % p<0.05) and discussing confidentiality issues (51% vs. 39%, p<0.05). In the logistic regression model, having care coordination (AOR 11.1, 95% CI 5.9-21.3) and CEHR (AOR 2.6, 95% CI 1.5-5.0) are 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 EHR implementation, in order to improve transitions to adulthood.
Rights and Permissions
This is a PDF file of an accepted manuscript that has been accepted for publication and posted with a 12 month embargo as allowed by the publisher's author rights policy at https://www.elsevier.com/about/company-information/policies/sharing. Citation: Acad Pediatr. 2017 Apr 18. pii: S1876-2859(17)30161-4. doi: 10.1016/j.acap.2017.04.005. [Epub ahead of print] Link to article on publisher's site
Transition, Youth with Special Health Care Needs, Electronic Health Records, Meaningful Use, Care Coordination
Sharma, Niraj; O'Hare, Kitty; O'Connor, Karen G.; Nehal, Umbereen; and Okumura, Megumi J., "Care Coordination and Comprehensive Electronic Health Records are Associated with Increased Transition Planning Activities" (2017). Pediatric Publications and Presentations. 123.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Available for download on Wednesday, April 18, 2018