Practices saw greater disclosure rates after switching from paper to electronic screenings

Key takeaways:

• Disclosure rates increased from 11% with paper forms to 26% with electronic screenings.
• More patients were referred to social workers or medical-legal partnerships after switching to electronic questionnaires.

Caregivers were more likely to disclose social needs and mental health concerns at well-child visits after practices transitioned from paper-based screenings to electronic questionnaires, according to a study published in Pediatrics.

“In this study, we sought to 1) assess whether health-related social needs (HRSN)/ caregiver mental health concerns (CMHC) disclosure rates differ when questions are administered on paper vs. electronic tablet; and 2) evaluate whether changes in need identification alter referral rates to social work and our medical-legal partnership.” Michelle C. Gorecki, MD, MPH, FAAP, clinical fellow in the division of general and community pediatrics at Cincinnati Children’s Hospital Medical Center, and colleagues wrote.

The researchers analyzed HRSN/CMHC questionnaires for well-child visits at three primary care practices in Cincinnati. Gorecki and colleagues compared 16,151 paper-based screens completed from February to December 2018 with 13,019 electronic questionnaires from February to December 2019.

Around half of patients (54%) who filled out electronic forms had also completed paper forms the year before. More patients disclosed concerns through electronic means than paper (26% vs. 11%), the researchers found.

They also conducted an interrupted time series analysis, which found that the odds for disclosure after switching to electronic screening were significantly higher at two of three practices (OR = 2.97; 95% CI, 2.46-3.59; and OR = 1.72; 95% CI, 1.22-2.42). The third site saw an increase in disclosure odds that was not statistically significant.

After switching to electronic forms, practices referred a larger proportion of patients to social workers (4.1% vs. 5.1%; P < .001) or medical-legal partnerships (1.2% vs. 1.8%; P < .001)

“Our study suggests that clinicians consider a transition to electronic HRSN/CMHC screening, given its link to increased identification of HRSN/CMHC and subsequent connection to services,” the researchers wrote.