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Arizona’s Approach to Loss to Follow-up. Lylis Olsen Christy Taylor Jan Kerrigan Randi Winston. Before 2006. Voluntary screening (>95%) Voluntary reporting Inpatient Screening Data (~75%) Outpatient Screening Data (~50%) Diagnostics (< 25%) Early Intervention Bilateral (100%)

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arizona s approach to loss to follow up

Arizona’s Approach to Loss to Follow-up

Lylis Olsen

Christy Taylor

Jan Kerrigan

Randi Winston

before 2006
Before 2006
  • Voluntary screening (>95%)
  • Voluntary reporting
    • Inpatient Screening Data (~75%)
    • Outpatient Screening Data (~50%)
    • Diagnostics (< 25%)
    • Early Intervention
      • Bilateral (100%)
      • Unilateral (0%)
slide3

All hospitals screening

  • Centralized reporting
  • Consistent data submission
  • Quality of data
  • Linking Outpatient to Inpatient screens
  • Linked databases
  • Education of medical home
  • Socio-behavioral issues with parents
  • Standardized information
  • Active follow-up process
  • Safety nets
    • Community Health Centers
    • Pediatricians
    • Early Intervention Programs
  • Available outpatient screening
  • Available diagnostic testing
  • Timely notification
  • Expedited referral and pre-authorizations
  • Otitis media management
  • Adequate training and diagnostic tools
slide4

All hospitals screening

  • Centralized reporting
  • Consistent data submission
  • Quality of data
  • Linking Outpatient to Inpatient screens
  • Linked databases
  • Active follow-up process
  • Education of medical home
  • Socio-behavioral issues with parents
  • Standardized information
  • Safety nets
  • Timely notification
  • Available outpatient screening
  • Available diagnostic testing
  • Expedited referral and pre-authorizations
  • Otitis media management
  • Adequate training and diagnostic tools
legislation
Legislation
  • Did not mandate screening (no need)
  • Mandated Reporting
    • Within one week- Electronically or Fax
    • All screening, all diagnostic testing
    • Anyone who screens or tests
  • Active follow-up at state level
  • Ongoing technical assistance to hospitals
  • Education to stakeholders
centralized tracking
Centralized Tracking
  • Electronic merging of data each week from HI*Track
  • Manual data entry for some outpatient screens and diagnostic reports
  • Case management through automated link with Neometrics the newborn screening system
  • Dedicated Staff
    • One program manager
    • One data manager
    • One follow-up coordinator
centralized follow up
Centralized Follow-up
  • Follows 1-3-6
  • Letter to medical home at 6 weeks
  • Verify information through Neometrics and Medicaid databases
  • Letter to medical home and family at 16 weeks
  • Match records with Early Intervention
  • Letter and phone call to medical home and family at 28 weeks
slide8

All hospitals screening

  • Centralized reporting
  • Consistent data submission
  • Quality of data
  • Linking Outpatient to Inpatient screens
  • Linked databases
  • Education of medical home
  • Standardized information
  • Safety nets
  • Active follow-up process
  • Socio-behavioral issues with parents
  • Available outpatient screening
  • Available diagnostic testing
  • Adequate training and diagnostic tools
  • Expedited referral and pre-authorization
  • Otitis media management
  • Timely notification
screening programs
Screening programs
  • Hospitals
    • All provide inpatient screening
    • Most provide outpatient screen
    • Keep refer rates in appropriate range
    • Standardize information to parents and medical home
      • Immunization card
      • Training of the screeners
diagnosis
Diagnosis
  • Education of medical home
    • Expedite the referral and preauthorization process
    • Look for the results of the newborn screen
    • Know available resources
  • Audiology
    • Adequate training and equipment
    • Monitor hand offs
    • Prioritize scheduling of infants
    • Make reporting easy
is it working
Is It Working?

Unknown

  • Electronic reporting errors cleaned up 88 out of 170 “lost” in one hospital
  • Required reporting made immediate change from 60% to less than 40%

Loss

  • One hospital had a 9 month average of 8% loss to follow-up

Delays

  • Medical home is paying attention with a more active role
  • Significant decrease in delays between screening and diagnosis
slide13

All hospitals screening

  • Centralized reporting
  • Consistent data submission
  • Quality of data
  • Linking Outpatient to Inpatient screens
  • Linked databases
  • Socio-behavioral issues with parents
  • Safety nets
  • Education of medical home
  • Standardized information
  • Active follow-up process
  • Otitis media management
  • Adequate training and diagnostic tools
  • Available outpatient screening
  • Available diagnostic testing
  • Timely notification
  • Expedited referral and pre-authorizations
arizona newborn screening
Arizona Newborn Screening

Phone

  • (602) 364-1409
  • (800) 548-8381(outside Maricopa County)

Fax

  • (602) 364-1495

Website

http://www.azdhs.gov/phs/owch/newbrnscrn.htm

[email protected]

[email protected]

[email protected]

[email protected]

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