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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Medical Home: Referrals.

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Strategy. Electronic Templates

Approach. Develop and adopt standardized screening and follow-up protocols in order to reduce wait times and increase access to follow-up care

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Overview. Electronic templates that standardize screening and follow-up protocols can lead to reduce wait times and increase access to follow-up care among patients of all ages. Examples include a multidisciplinary technology-enhanced care pathway that has been shown to improve communication among healthcare providers and facilitates timely referrals for specialty services in concussion management.[1] Integration of the Smart Early Screening for Autism and Communication Disorders. (ESAC) tool in primary care shows significant reduction in the average age of referral for autism spectrum disorder. (ASD) evaluation.[2]

Evidence. Emerging Evidence. Strategies based on emerging evidence show promise but have not undergone extensive testing. While these approaches demonstrate potential, their effectiveness remains unconfirmed. Prioritize rigorous monitoring to ensure they achieve desired outcomes for all MCH populations.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Screening and follow-up completion rates
  • Patient and family satisfaction surveys
  • Wait time data

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Provider Experience of Care. This strategy improves healthcare professionals' perceptions, feelings, and satisfaction with the work environment and systems they use.
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Screening (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of healthcare organizations adopting standardized electronic screening and follow-up templates. (Measures uptake of electronic templates)
  • Number of patients screened using electronic templates for various health conditions and social needs. (Assesses reach of screening activities)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of electronic templates aligned with clinical guidelines and best practices. (Measures quality of template content)
  • Percent of patient encounters where templates are consistently utilized by providers. (Assesses fidelity of template implementation)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of patients reporting satisfaction with efficiency of screening and follow-up experiences. (Measures patient-reported outcomes of template-driven care)
  • Number of research studies evaluating effectiveness of electronic templates across all populations. (Shows evidence generation for templates)
  • Number of healthcare systems reporting improvements in population health outcomes associated with template use. (Measures system-level impact of templates)
  • Number of communities experiencing reductions in health outcome differences through tailored use of screening templates. (Assesses population health impact)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of patients reporting satisfaction with efficiency of screening and follow-up experiences. (Measures patient-reported outcomes of template-driven care)
  • Percent of research studies evaluating effectiveness of electronic templates across all populations. (Shows evidence generation for templates)
  • Percent of healthcare systems reporting improvements in population health outcomes associated with template use. (Measures system-level impact of templates)
  • Percent of communities experiencing reductions in health outcome differences through tailored use of screening templates. (Assesses population health impact)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Alberts, J. L., Modic, M. T., Udeh, B., Dey, T., Cherian, K., Lu, X., Figler, R., Russman, A., & Linder, S. M. (2019). Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion. Journal of visualized experiments : JoVE, (143), 10.3791/58962. https://doi.org/10.3791/58962

[2] Schrader, E., Delehanty, A. D., Casler, A., Petrie, E., Rivera, A., Harrison, K., Paterniti, T., Sebastiany, L., Nottke, C., Sohl, K., Levy, S. E., & Wetherby, A. M. (2020). Integrating a New Online Autism Screening Tool in Primary Care to Lower the Age of Referral. Clinical pediatrics, 59(3), 305–309. https://doi.org/10.1177/0009922819900947

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.