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Electronic Health Record Tools to Identify Child Maltreatment: Scoping Literature Review and Key Informant Interviews.

Publication ,  Journal Article
Stilwell, L; Golonka, M; Ankoma-Sey, K; Yancy, M; Kaplan, S; Terrell, L; Gifford, EJ
Published in: Acad Pediatr
July 2022

OBJECTIVE: To prevent missed cases and standardize care, health systems are beginning to implement EHR-based screens (EHR-CA-S) and clinical decision supports systems (EHR-CA-CDSS) for the identification and management of child maltreatment. This study aimed to 1) document the existing research evidence on the performance of EHR-CA-S and EHR-CA-CDSS and 2) examine clinical perspectives regarding the use of such tools and factors that affect uptake. METHODS: We searched MEDLINE, Embase, EBSCO, Scopus, and CINAHL databases for English language articles published prior to November 2021 that describe and/or evaluated an EHR-CA-S and/or EHR-CA-CDSS involving 0 to 18-year olds. We performed semistructured interviews with 20 individuals who have experience in identifying, evaluating, and/or treating child maltreatment and/or conducting research on these topics. RESULTS: Our search identified 574 articles; 16 met inclusion criteria. Studies examined screening, alerts and triggers, and quality improvement. None evaluated long-term clinical outcomes. Sensitivity ranged from 0.14 to 1.00, specificity from 0.865 to 1.00, positive predictive value from 0.03 to 1.00 and negative predictive value from 0.55 to 1.00. A variety of EHR-CA-S and/or EHR-CA-CDSS have been implemented at institutions in our sample. Interviewees cited missed cases, policy requirements, and the lack of standardization of care as impetuses for adopting these tools, yet expressed concerns regarding insufficient evidence, bias, and time-intensiveness of implementation. CONCLUSIONS: Interviewees and the literature agree that current evidence does not support adoption of a particular CA-S or CA-CDSS. Further refinement and research on EHR-CA-S and EHR-CA-CDSS is necessary for these tools to be feasibly implemented and sustained, reliable for clinical practice, and not cause any unintentional harms.

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Published In

Acad Pediatr

DOI

EISSN

1876-2867

Publication Date

July 2022

Volume

22

Issue

5

Start / End Page

718 / 728

Location

United States

Related Subject Headings

  • Quality Improvement
  • Pediatrics
  • Mass Screening
  • Humans
  • Electronic Health Records
  • Decision Support Systems, Clinical
  • Child
  • 3213 Paediatrics
  • 1114 Paediatrics and Reproductive Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Stilwell, L., Golonka, M., Ankoma-Sey, K., Yancy, M., Kaplan, S., Terrell, L., & Gifford, E. J. (2022). Electronic Health Record Tools to Identify Child Maltreatment: Scoping Literature Review and Key Informant Interviews. Acad Pediatr, 22(5), 718–728. https://doi.org/10.1016/j.acap.2022.01.017
Stilwell, Laura, Megan Golonka, Kristin Ankoma-Sey, Madeleine Yancy, Samantha Kaplan, Lindsay Terrell, and Elizabeth J. Gifford. “Electronic Health Record Tools to Identify Child Maltreatment: Scoping Literature Review and Key Informant Interviews.Acad Pediatr 22, no. 5 (July 2022): 718–28. https://doi.org/10.1016/j.acap.2022.01.017.
Stilwell L, Golonka M, Ankoma-Sey K, Yancy M, Kaplan S, Terrell L, et al. Electronic Health Record Tools to Identify Child Maltreatment: Scoping Literature Review and Key Informant Interviews. Acad Pediatr. 2022 Jul;22(5):718–28.
Stilwell, Laura, et al. “Electronic Health Record Tools to Identify Child Maltreatment: Scoping Literature Review and Key Informant Interviews.Acad Pediatr, vol. 22, no. 5, July 2022, pp. 718–28. Pubmed, doi:10.1016/j.acap.2022.01.017.
Stilwell L, Golonka M, Ankoma-Sey K, Yancy M, Kaplan S, Terrell L, Gifford EJ. Electronic Health Record Tools to Identify Child Maltreatment: Scoping Literature Review and Key Informant Interviews. Acad Pediatr. 2022 Jul;22(5):718–728.
Journal cover image

Published In

Acad Pediatr

DOI

EISSN

1876-2867

Publication Date

July 2022

Volume

22

Issue

5

Start / End Page

718 / 728

Location

United States

Related Subject Headings

  • Quality Improvement
  • Pediatrics
  • Mass Screening
  • Humans
  • Electronic Health Records
  • Decision Support Systems, Clinical
  • Child
  • 3213 Paediatrics
  • 1114 Paediatrics and Reproductive Medicine