PHILADELPHIA, Dec. 27, 2019 /PRNewswire/ -- In the largest-ever
study to measure the impact of population health strategies and
tools on hospital outcomes among Medicaid-enrolled children, a team
at Children's Hospital of Philadelphia (CHOP) found targeted
interventions can deliver better patient experience, improved
health outcomes and value to the Medicaid system. The study,
published in JAMA Network Open today, showed that among more
than 93,000 Medicaid-enrolled children, combining technology
solutions with interdisciplinary integrated care teams led to 50
fewer hospital admissions each month and 3,600 fewer bed days for
these youth in a year.
The CHOP intervention, implemented over two years, sought to
identify high-risk, Medicaid-enrolled children with special health
care needs and provide solutions that would keep them out of the
hospital or reduce their stays if they were admitted. A set of
reporting tools in patients' electronic medical record notified
clinicians and staff if their patients visited the emergency
department or were admitted into the hospital. Then, an integrated
care team would connect with these families to help them schedule
and prepare for follow-up appointments, assist with locating needed
services and answer questions they had about their care. These
clinical teams also utilized technological tools to improve
coordination and communication between them.
"As health care systems grow larger, integrated care teams and
technology that supports those teams are going to be critically
important to ensure we're helping families navigate ever more
complex institutions, whether adult or pediatric in nature," said
Dr. David Rubin, director of
Population Health Innovation and PolicyLab at CHOP and lead author
on the study. "Fundamentally, what we are talking about is
identifying those patients who need the most proactive care,
surrounding them with an expert team—from physicians, to nurses, to
social workers, to navigators—and then equipping that team with
supportive technology. In doing that, we saw that we can deliver
the type of care our patients want while providing value and
efficiency throughout the whole health care system."
The researchers designed the integrated care teams to meet the
needs of medically complex youth who frequented the hospital and
might benefit from increased care coordination, as well as
frequently hospitalized children and teens with asthma, one of the
most common chronic pediatric conditions. These teams—composed of
physicians, nurses, social workers and community health workers,
who connected with patients in their homes—were more proactive in
their engagement with families because they were notified promptly
of high-risk events like hospitalizations. For healthy children
included in the study, population health reports through the
electronic health record in their primary care practice helped
ensure timely follow-up from emergency department visits and better
compliance with recommended well-child visits and vaccinations.
Finally, given that children with multiple prior asthma-related
hospitalizations are at highest risk of future asthma-related
hospitalizations and emergency department visits, their
intervention was customized with a bundle of integrated services.
This included personalized bedside education in the hospital,
facilitated filling of discharge medications, connection to
community health workers/asthma navigators who can facilitate
enhanced coordination between inpatient and outpatient care teams,
and expedited follow-up with an allergist or pulmonologist.
"Children's Hospital of Philadelphia is committed to delivering the
highest-quality care to address the pressing health needs of our
most vulnerable children, and this intervention has played a
significant role in that mission," said Madeline Bell, President and CEO of Children's
Hospital of Philadelphia. "In
addition to improving patient care and reducing children's hospital
stays, our population health initiative is delivering the type of
innovation that can improve the value our nation's Medicaid
program, serving as a role model for other health systems that wish
to do the same."
The researchers attributed the success of this population-level
intervention to their ability to deliver services to families
within their existing health care system, investments to develop
strong integrated care teams, alignment of clinical and quality
improvement methods and a wide variety of electronic health record
tools.
"Our evaluation shows that a strong, integrated primary care
network can serve as an effective vehicle for better coordinating
care among large groups of families," said Dr. Lisa Biggs, associate chief medical officer of
the CHOP Care Network and an author on the study. "Having this type
of demonstrable impact is important in continuing to build momentum
for the care management resources needed to deliver targeted
interventions that improve care in all types of medical
settings."
CHOP's Population Health Innovation team—including data
analysts, electronic health record experts and quality improvement
advisors—partners with departments and divisions across the health
system and its specialty and primary care providers to implement
and sustain population health management solutions that improve
patient experience and health outcomes for the populations they
serve. CHOP is one of the largest pediatric health systems in the
U.S., with more than 500,000 children visiting its facilities each
year.
Rubin D, Kenyon C, Strane D, et al. A Population-Based Approach
to Reducing Pediatric Admissions and Bed-Days for Medicaid-Enrolled
Children. JAMA Network Open. 2019.
doi:10.1001/jamanetworkopen.2019.18306. Accessed December 27, 2019.
About Children's Hospital
of Philadelphia: Children's Hospital of
Philadelphia was founded in 1855
as the nation's first pediatric hospital. Through its long-standing
commitment to providing exceptional patient care, training new
generations of pediatric healthcare professionals and pioneering
major research initiatives, Children's Hospital has fostered many
discoveries that have benefited children worldwide. Its pediatric
research program is among the largest in the country. In addition,
its unique family-centered care and public service programs have
brought the 546-bed hospital recognition as a leading advocate for
children and adolescents. For more information,
visit http://www.chop.edu.
About PolicyLab: PolicyLab at Children's
Hospital of Philadelphia (CHOP) is
dedicated to achieving optimal child health and well-being by
informing program and policy changes through interdisciplinary
research. Founded in 2008, PolicyLab is a Center of Emphasis within
the CHOP Research Institute, one of the largest pediatric research
institutes in the country. With more than 30 highly-regarded
faculty and 60 passionate staff who bring expertise from myriad of
fields covering health, research and health policy, our work
focuses on improving public systems, improving health care delivery
and improving child health outcomes. For more information,
visit http://www.policylab.chop.edu.
FOR MORE INFORMATION:
Lauren Walens, Strategic Operations
& Communications Director
PolicyLab at Children's Hospital of Philadelphia
walensl@email.chop.edu or (267) 425-1498
View original content to download
multimedia:http://www.prnewswire.com/news-releases/population-health-strategies-improved-patient-experience--reduced-hospital-stays-for-kids-on-medicaid-300979576.html
SOURCE PolicyLab at Children's Hospital of Philadelphia