Implementation

How Can Your Clinic Implement PEDS Online?

#	Question	Answers	Solution
1.	Do you have an appointment reminder system in which you could alert parents to complete screens prior to the appointment?	Yes	Call, email, or send families home with a post-card alerting them to them to take screens before their next appointment
1.		No	Go to Question 2
2.	Do you have a kiosk in your waiting room or a desk-top in every exam room?	Yes	Have families complete screens while they wait through our parental portal (they will not see results)*
2.		No	Go to Question 3
3.	Is there a computer parents could use at the med tech's or nursing station to complete screens?	Yes	Have parents complete screens at the med tech or nursing station using the parent portal*
3.		No	Go to Question 4
4.	Do receptionists have time to provide print copies of screens so that families can complete them in waiting rooms?	Yes	Provide print copies for parents to complete in waiting rooms then go to Question 6
4.		No	Go to Question 5
5.	Could the med tech provide print copies of screens for parents to complete?	Yes	Have med tech give out print copies then go to Question 6
5.		No	Go to Question 7
6.	Could your med tech enter parents' answers on print forms onto their computer?	Yes	Have med tech enter parents answers onto our site and submit results.*
6.		No	Go to Question 7
7.	Is there a nursing station between the med tech and the exam room where families could complete screens in writing or be interviewed?	Yes	Have nurse help families complete print copies (or interview them) while on our site and submit results.*
7.		No	Go to Question 8
8.	Does a nurse or physician extender enter the exam room before the doc and have a few minutes to interview families while also entering their answers onto our site?	Yes	Have nurse or physician extender interview families and enter their answers onto our site and submit results.*
8.		No	Go to Question 9
9.	Do docs tend to begin their encounter by interviewing parents about their concerns and checking on children's milestones?	Yes	Have docs complete at least one screen by interview while entering answers on our site, and then deciding whether additional screens are needed (see also #10)
9.		No	Go to Question 10
10.	Have staff send families home with print copies of screens (or additional screens) to complete and bring back to a follow-up or subsequent well visit	Staff will need to decide who will enter results onto our site when the family returns*
* Docs, either before or during the encounter, would then open our site's administrative panel on their own computer to review results (and to decide whether additional screens (e.g., M-CHAT-R) should be added.

Still have implementation questions?

Staff resistant to change?	See Harvard's site www.developmentalscreening.org and its video showing staff and providers grousing away about 'one more thing to do' but then concluding that our tools were enormously beneficial. The site also has guidance for how to help staff and providers overcome resistance, generate enthusiasm, and collaborate on implementation.
Need an example of how one clinic solved things?	Please review our case example showing how one clinic debated options and came up with a workable solution! See Case Example for "Matty"
Need information on billing and coding for optimal reimbursement?	Please see "Billing/Coding/Reimbursement" containing current information from the American Academy of Pediatrics.
Need a rationale for why PEDS Online is beneficial?	Saves time: no need to hand-score, dictate reports, rummage for billing information and ICD-10 codes. These are automatically generated by PEDS Online. no need to elicit milestones informally (which are known to miss most children with problems). Parents can self- administer PEDS:Developmental Milestones to ensure accurate early detection. no need to fumble for questions to elicit parents' concerns. PEDS provides validated questions and accurate decision support. shortens visits and eliminates "oh by the way concerns" when using PEDS before or at the beginning of the encounter. Ensures audit documentation: ensures compliance with Medicaid mandates provides proof that validated, standardized screens were used Increases clinic revenues: provides needed codes for optimal reimbursement helps ensure that clinics receive ~ $10.00 - $13.00 per screen, even while PEDS Online costs less than $2.76 for all 3 screens we offer. Improves quality of care: increases parent and provider satisfaction ensures accurate decision-making about children and families' needs ensures that screens are correctly administered (e.g., if answers are circled on PEDS but no words are written on the forms). provides support for Quality Improvement and Maintenance of Certification efforts, via a searchable database, and abundant content on www.pedstest.com offering background information, current research updates, etc. Provides training support: slide shows, videos, case examples, Frequently Asked Questions, and other guidance helpful for training staff and providers email and telephone support from PEDS Online staff

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