Using Public Health Informatics to Improve the Low Rate of Early Identification and Referral of Children with Developmental, Psycho-Social and Behavioral Delays in Oregon

The project seeks to improve the low rate of early identification, evaluation for service eligibility, and referral to early intervention (EI) of children identified at risk for physical, developmental, psycho-social and behavioral delays.  Surveys with providers, parents and EI staff indicate that many of the factors impacting this low rate are problems resulting from poor information management, care coordination and communication. These are problems that can be addressed by an informatics solution.
We will improve the low rate by providing a web-based Child Health Record (CHR) system with functionality to support screening, referral for eligibility assessment, referral to EI services, feedback of results and eligibility status, and other communication and coordination needs between the providers, parents and EI.  The CHR will use link data across the healthcare landscape to present a comprehensive view of the child’s needs and services so that duplication of screening and other services is addressed.  It will use nationally-recognized standards to exchange information between database silos such as electronic health record and practice management systems, state registries and EI program databases.  The CHR will be web-based, open source, extensible, scalable and easy to use.
Table 1 displays the low and high estimated annual cost for Oregon children whose disabilities are not identified in time for Early Intervention.  This is the Public Health problem the project will address.
Table 1:  Comparison of Expected Costs for Oregon Children Whose Disabilities Are Identified in Time for Early Intervention Versus Children Who Are Not Identified Before Entering School (5)

Number of children	Cost of Early Intervention ($Low – $High)	Cost of intervention after entering school ($Low – $High)
Per unidentified disabled child	$2,860 – 11,700	$30,000 – 100,000
6,400 children	$18 million – 75 million	$192 million – 640 million
7,200 children	$21 million – 84 million	$216 million – 720 million