Improve Well-Child Schedule Adherence with Patient Engagement

The medical system has long adhered to the tenets of value-based care in the establishment of the periodicity schedule for well-child visits. The American Academy for Pediatrics (AAP) recommends formal screening for infants through adolescence to chart growth and development and to provide early interventions for illnesses and injuries, which provides benefit to both children and the healthcare system as a whole.

“While the end goal of health transformation should be achieving the triple aim of improved health quality, improved population health, and reduced per capita health care costs, this requires investing more, rather than less, in primary, preventive, and developmental care. At no age is this truer than for children, whose health trajectories have health cost implications over decades and lifetimes.” – Charles Bruner, Ph. D., et al¹

Unfortunately, adherence the well-child schedule is suboptimal, with rates diminishing over time – as low as 41% by the time the child is 15 months old.² For children over age 6, well-child visits help ensure continued health, including assessments on growth, weight, sleep, or signs of physical or mental health issues.³ For children with chronic conditions such as asthma, evidence suggests that low well-child visit adherence rates are associated with an increased risk of hospitalizations.⁴

The reasons behind low adherence rates are complex. Modern families face multiple time constraints, may not know about ongoing well-child visit needs, or may face social or economic challenges that impact their ability to adhere to the periodicity schedule. Pediatric professionals focusing on improving adherence to well-child visits can take a multi-pronged approach:

• Well-Child Visit Reminders: encourage adherence to well-child schedule with automated reminders or suggested appointment timeslots
• Social Determinants of Health: focus health promotion materials on family, community, and social factors, including links to community resources, transportation coupons, etc.
• Pre-Appointment: send appointment reminders and preparation instructions, helping reduce no-show rates
• Lower Readmissions: follow up with children recently released from hospital after injury or illness with automated assessment questionnaires and care plan reminders
• Wellness Education: provide pro-active wellness information and links to appropriate community resources or educational material on your patient portal.
• Chronic Condition Management: identify and track children with special health care needs, sending care plan reminders, ongoing encouragement, and periodic assessment questionnaires to parents to expedite intervention

PerfectServe can provide you pre-scheduled communications as well as two-way messaging to help engage patients and their families in positive health outcomes. PerfectServe’s Patient & Family Communication tool leverages SMS text messages, social determinants of health, and pre-populated workflows to identify patients and families who could benefit from well-child visit reminders, educational materials, or SDOH support. Unlike emails or phone calls, text message communications benefit from high response rates, allowing you to reach out to parents when and where it matters most. Parents can schedule an upcoming well-child visit, answer a wellness survey, or ask a question, with automatic alerts sent to the care team if a patient may need preventative support or outreach.

Working with one of the nation’s largest healthcare systems, we sought to improve well-child schedule adherence rates for children age 0-3 years old. Prior to the program, many well-child visits occurred up to a month after they should have, impacting immunization schedules and early prevention programs. PerfectServe’s Patient & Family Communication tool sent parents a reminder about well-child appointments, leading to 13% more pediatric well-child visits, a tighter adherence to the recommended schedule, and more participation in visits beyond infancy. The program had the benefit of also raising postpartum depression screening rates from 30% to 70%.

Contact us to learn how we can help improve your well-child initiatives.

¹https://www.mentalhealthamerica.net/sites/default/files/Commentary%20on%20Value%20Based%20Care%20final%20Nov%202017%20pdf%20%28002%29.pdf

² https://www.ncbi.nlm.nih.gov/pubmed/30305388

³ https://health.usnews.com/health-news/patient-advice/articles/2016-02-23/why-older-kids-need-well-child-checkups-too

⁴ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551592/ ; https://www.sciencedaily.com/releases/2013/05/130524104642.htm