Abstract
Purpose
A high-quality primary care clinic should provide clear action points and important care coordination for a child receiving a new diagnosis of autism spectrum disorder (ASD). Unfortunately, a substantial proportion of caregivers report little-to-no post-diagnosis support from their home clinics and primary care providers often report lack of training and resources in providing these supports.
Methods
We implemented an intervention package to investigate the impact on the frequency and quality of follow-up care for children with ASD in a busy, high-volume resident continuity clinic. The package consisted of a care coordination scheduling pathway and a standardized clinical template—embedded in the electronic health record (EHR)—that guided providers through best-practice recommendations and patient resources.
Results
As a result of these interventions, 74% of patients had ASD-specific follow-up, a more than threefold increase from baseline with a majority of providers using the EHR-embedded template to guide their visit. Providers also indicated a high degree of usability for the system and that it aided them in following best-practice guidelines for ASD care.
Conclusion
Through explicit scheduling pathways and a novel EHR template, we saw a significant increase in ASD-specific follow-up visits and implementation of best practices for ASD care, demonstrating a new process for training and engaging primary care providers in clear action steps for post-diagnostic care without having to rely on tertiary referrals.
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Funding
This initiative was funded in part through a faculty award from the Katherine Dodd Faculty Scholars program (Bahrami). This project also received support from UL1 TR000445 (from NCATS/NIH).
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Laleh Bahrami, Cara Miller, Holly Miller, Tori Foster, Abhinaya Ganesh, and Jeffrey Hine. The first draft of the manuscript was written by Laleh Bahrami and Jeffrey Hine and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Bahrami, L., Miller, C.T., Miller, H. et al. Enhancing Diagnostic Follow-up and Care Coordination for Children with Autism in a Busy Resident Continuity Clinic: Leveraging the Electronic Health Record. J Autism Dev Disord (2024). https://doi.org/10.1007/s10803-024-06253-1
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DOI: https://doi.org/10.1007/s10803-024-06253-1