St. Joseph’s University Medical Center

Emerging practice

St. Joseph's Children's Hospital

Size

Large (>7 Physicians)

Geographic area

Urban

Practice type

Hospital Affiliated Practice

Insurance status

• Over half of patients have Medicaid/Care Management
• A small portion of patients have private insurance
• A small portion of patients have self pay
• Almost half of patients were uninsured

Race/ethnicity of patients served

• American Indian or Alaska Native: unknown
• Asian:3%
• Black or African American: 17%
• Hispanic/Latinx: 52%
• White: 25%
• Not listed: 3%

Practice Modification due to COVID-19 Pandemic

• Adopted strategies for telehealth and hybrid visits (hybrid visits consisted of telehealth for any discussion and any concerns, in-person visit for height/weight and vaccines).
• Developed a sign-on process with telehealth system that allowed access to interpreters for multilingual families/caregivers.
• Restructured clinic hours to perform well visits for children under 3 years old in the morning and conduct sick visits in the afternoons
• Call Center gave portal access instructions to families/caregivers when making virtual appointments including the use of a YouTube video that was created in English and Spanish to help families’ better access the portal
• Collaborated with call centers to inform patients of office modifications made due to the COVID-19 pandemic.
• Collaborated with call centers to solicit reasons of family/caregiver hesitancy to attend in person visits. Based on feedback, practice staff developed a plan for pediatricians to address hesitancy with families/caregivers, including additional telehealth or hybrid options.

Developmental Surveillance, Screening and Referral Modifications

• Identified and individually contacted at risk families/caregivers and patients 0-2 years old that fell behind in immunizations or screenings to reduce lapse in care
• Integrated developmental screening questions into developmental history questions during telehealth visits
• Utilized electronic health record (EHR) to improve patient interaction by following up with patients in a specific time period for concerns, documenting if patients attended the recommended services, and if not identifying and addressing the barriers and providing anticipatory guidance
• Collaborated with front desk staff and medical assistants to develop workflows for age-specific developmental screenings and EHR follow-up reminders
• Focused on education of families/caregivers for available services for behavioral and developmental evaluation by providing documentation of referral options through mail and hard-copy resources