Part of Connecticut Children’s Office for Community Child Health

www.helpmegrownational .org

Early Learning Integration Webinar #3:

Utilizing Technology and Web-based Solutions to

Enhance Screening, Referral, and Linkage

February 13th, 2019 |2pm EST

AGENDA

Introduction Jacquelyn Rose, AKIP

Leveraging ASQ online, API, and efaxto support screening, linkage, and referralRebecca Hernandez, HMG Orange County

Creation and utilization of developmental screening registriesRebecca Hernandez, HMG Orange CountyJanet Kilburn & Lauren Smith, HMG Vermont

Emerging technologies to support screening, linkage, referral, and cross-sector sharingGarth Harries, SparklerAbby Alter, HMG Connecticut

National Center UpdatesStephanie Luczak, HMG National

Innovation Model

• Core Components• System Building• Capacity Building• Technology

• Structural Requirements • Operational Help Me Grow

System• Partnership between Help Me

Grow and Early Learning

• Technology • Linking results of

developmental screening with HMG CAP

• Promoting family access to and early learning utilization of tools such as ASQ online

• Engaging with existing developmental screening registries or exploring opportunities to develop developmental screening registries with communities

Utilizing Technology and Web-based Solutions to Enhance Screening, Referral and Linkage

February 13, 2019

Rebecca Hernandez, M.S.Ed.Program ManagerHelp Me Grow, Orange County

• Review streamlined process of using the ASQ Online

• Understand benefit to creating multiple entry points

• Learn how Orange County uses customized fields to import data

• Understand the Application Programming Interface (API) between System for Tracking Access to Referrals (STAR) and ASQ Online

• Share methods of communication on referrals and results

• Learn about STAR availability and agreement with Brookes Publishing

• Learn about the OC Children’s Screening Registry

Let’s discuss…

Printed copy of each interval

Calculate interval and mail to caregiver

HMG must score and enter in data

system

Can send ASQ Family Access link via email

or text

Parent can access using a smart phone,

laptop, desktop

Parents submits completed tool via

ASQ Online

Can be sent from call center and used at other HMG locations

Correct interval is automatically generated at the time parent completes the tool

Tool is scored automatically decreasing errors

Child already connected to Help Me Grow OC for referrals to programs and services

Streamlining the Screening ProcessHardcopy versus ASQ Online

HMG conveys results to parents and

physicians

Parent completes and mails back

ISSUE: if delayed interval may be

incorrect

Hardcopy ASQ Online Added Benefits

ASQ Family Access allows for parent completion of the tools in a variety of locations and multiple public URLs/links can be utilized.

Why does this help?

• Separate links can be created and distributed to differentiate users

• Links can be used for ASQ-3 and ASQ:SE-2 / Spanish and English

• Each unique link can be tracked separately using distinct entry points in a data system

• Allows for accurate reporting of separate screening activities or events

Where does Orange County use these unique links?

• Sent by Care Coordinators from call center in referral letters and emails

• Used by partners with agreements such as QRIS family child care

• Used at community events - examples include Mexican Consulate, School Readiness Fairs

• Available on our website

Multiple Links - Multiple Entry Points

An automated way to import data from ASQ Online to your data management system

What is needed?

• Web-based data management system (STAR)

• Subscription to ASQ Enterprise/ASQ Pro and subscription to ASQ Family Access to send links to parents

• Purchase of the API add-on subscription (waived if a STAR user)

• Your own developer or IT staff to program data to create the bridge

What data gets transferred?

• Child profile data and caregiver profile data

• Customized fields if placeholder exists in your data system

• Screening data including parent comments, scores, and questionnaire cutoff scores

API: A Bridge between STAR and ASQ Online

Customized Fields in ASQ Online

L i n k e d T e c h n o l o g y

ASQ Online • Brookes Publishing• API Subscription

Family Access Links

• Used on smart phones, laptops, desktops

STAR Data Management

System

STAR Developmental

Screening ModuleAPI*Entered Enable

d

Activities- Parent completes

tool & submits

Activities- Automatically scored

- HMG staff accepts

ActivitiesResults are imported

ActivitiesTracks referrals and

outcomes

* Application Programing Interface (API) allows data to be transferred between database management systems

** System for Tracking Access to Referrals (STAR) is a web-based data management system utilized by the Help Me Grow team

Child’s healthcare provider receives communication related to screening, referrals and outcomes.

How does this happen?

• Parents give child heath care provider information

• STAR contains a list of child health care providers including fax numbers

• Letters are generated for parents with screening results and referrals

• Providers receive copy by eFAX, function automated in STAR

• Care coordinators obtain outcomes on referrals (examples are service provided, received evaluation, parent declined, appointment scheduled, etc.)

• Outcome letter generated and sent only to provider via eFax

Communicating Results

• Currently ten HMG Systems utilize STAR for data collection and analysis

• STAR includes data collection for all HMG components including CAP, Family and Community Outreach and Child Health Provider Outreach

• Optional module offered for API illustrated in this webinar

• Agreement with Brookes Publishing which waives Brookes API add-on fee for all STAR users

• Annual subscription and one time set-up and training fees

• Installation and customization by KJMB Solutions and training by Help Me Orange County team

STAR Available to HMG Affiliates

Questions?

• An online database for primary health care and community-based providers to view and enter developmental and behavioral screening data

• The intent is to communicate screening results between organizations and health care providers

• Includes four screening tools:

Ages & Stages Questionnaires – Third Edition (ASQ-3)

ASQ: Social Emotional, Second Edition

Parents Evaluation of Developmental Status (PEDS)

Modified Checklist for Autism in Toddlers - Revised

• Administered by Help Me Grow Orange County/CHOC Children's

• Developed with funding from the HRSA Healthy Tomorrows award

There are two levels of access:

1. The data collected and entered by each service provider can viewed by that provider in its entirety.

2. The data collected by another service provider, but common to both parties, can be viewed depending on participant type. Participant types are:

• Treating Provider: Has a treatment relationship with the Child that would warrant a benefit to the child if screening results were shared. Needs to attest that he/she has a treatment relationship with the Child before viewing results.

• Non-Treating Provider: Has obtained a written, valid HIPAA Authorization from the child’s parent to allow access to view screenings results entered from another provider and Service Provider has a relationship with the Child that warrants a benefit to the child if screening results are shared.

• Data Entry Only: May use the data they collect and enter into the registry for internal purposes only and will not view records from other service providers.

L i n k e d T e c h n o l o g y

ASQ Online Family Access Links

STAR Data Management

System (HMG)

API*

Entered

* Application Programing Interface (API) allows data to be transferred between database management systems

** System for Tracking Access to Referrals (STAR) is a web-based data management system utilized by the Help Me Grow team

OC Children's Screening Registry

Electronic Health

Records

Electronic Health Records(Cerner/CHOC)

Developmental screening results pushed daily to Registry

Referrals sent to HMG from Registry for linkage to services

Referrals made by HMG and their outcomes populate Registry

Questions?

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Janet Kilburn

Help Me Grow State Coordinator

Act Early Ambassador

Vermont Department of Public

Health

Utilizing Technology and Web-based Solutions to Enhance Screening,

Linkage, and Referral

Lauren Smith

UDS Registry Manager

Certified ASQ® Trainer

Vermont Department of Public Health

History of Developmental Screening Efforts in Vermont

2006: AAP Policy Statement

2009 – 2011: 1st Vermont Child Health Improvement Program leads

UDS improvement project

2013: Project LAUNCH Stakeholder engagement to develop shared

vision, common definitions, framework and process map

2014: VCHIP began working with early care education programs to

implement Vermont’s System for Universal Developmental Screening

2014 – 2016: Accountable Care Organization (ACO) adoption of

developmental screening as quality measure

2015: Help Me Grow Vermont implemented

2016 – 2017: Pilot test the UDS Registry; Provide TA; gather feedback

2018: Enhancing equity and accessibility of high quality PD opportunities for

Early Care and Education Professionals

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UDS Registry

VERMONT’S SYSTEM FOR UNIVERSAL DEVELOPMENTAL SCREENING (BIRTH – 8 YEARS)Vermont’s system for universal developmental screening is a collaborative process to understand every child’s developmental

progression and respond appropriately to meet each child’s developmental needs

Child and Family

• Surveillance

• Screening• Self Referral (CIS,

medical home, or other intervention services)

• Care Coordination

2013, Developed by the Vermont Child Health Improvement Program (VCHIP) in collaboration with: American Academy of Pediatrics- VT Chapter, Building Bright Futures, Child Care Resource, Children’s Integrated Services, Early Care and Education Professionals, Families, Howard Center, LUND, Northern Lights Career Development Center, Vermont Academy of Family Physicians, Vermont Association for the Education of Young Children, Vermont Agency of Human Services, Vermont Family Network, and Visiting Nurses Association

School• Parenting Education• Surveillance• Screening (risk-based)• Evaluation • Referral (CIS, medical home, or

other intervention services)• Care Coordination

Early Care & Education• Parenting Education & Anticipatory

Guidance• Surveillance• Screening • Referral (CIS, medical home, or

other intervention services)

Community Agencies & Organizations

• Family Support• Home Visiting Services• Screening • Evaluation

• Parenting Education• Care Coordination • Consultation • Intervention Services

Medical Home• Anticipatory Guidance • Surveillance • Screening• Referral for Evaluation • Care Coordination

Building Bright Futures Regional Councils

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Registry Realized

Developmental Screening Page

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Note: Only lists program areas to which user has permission.

Registry Overview

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Pilot ASQ Enterprise at HMG Contact Center

Regional and tailored Quality Improvement Projects

Electronic Health Record Import Project

Onward!

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36

Questions?

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- PRESENTS -

In partnership with

Par

tner

s

Pilot Partners:

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OEC Sparkler Initiative

A pilot with early care and other providers to

help improve child developmental screening,

communication, and promotion with families

through interactive app-based technology

Go

als

Overall Goals:● Reduce existing barriers to family participation in

developmental screening and monitoring.● Increase alignment of existing healthcare and learning

services around each child’s specific developmental needs as well as developmental promotion.

● Strengthen the process for family referral and linkage to needed services, including the process for follow-up monitoring.

● Build family engagement in early surveillance, screening, and activities to promote healthy child development among all children.

Pilot Scope 2 Years

Up to 2000 Children in 2 Communities

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Sparkler helps organizations partner with parents to get

young children ready for learning and life by answering 3

questions

2. How is this child doing?

3. Who else canhelp?

1. What can I do to help this child thrive?

Technology isn’t an

independent solution..

…but technology

DOES create the

possibility of

integration and

continuity, for families

and for organizations

Sparkler powers a mobile platform that does three related things:

1. Content deliveryLibrary of research-informed, off-screen experiences, including the ASQ Intervention activities.

Personalized playbook based on child’s profile and progress.

Parenting tips and resources, including video and, soon, checks for understanding

Sparkler powers a mobile platform that does three related things:

2. Screening

Assessment of a child’s well-being via the ASQ (SE and 3, English and Spanish…

And ongoing observation from parents about play activity in 4 domains mapped to Head Start Early Learning Standards.

System integration with ASQ Online and API interoperability to other systems.

Joint ASQ administration tools to support conferencing

Dashboard summary intended for front line program use

Sparkler powers a mobile platform that does three related things:

3. Connection

Shared accounts

Chat-based coaching

Child-centered communication tools, including shared accounts and peer-to-peer networks

We look forward to partnering with organizations to focusgrown-ups on igniting the minds of young children

... we are constantly developing and innovating with new partners and new components.

For more information, please reach out.

Garth Harries: garth@playsparkler.com

Co

nn

ecti

cut

Pilo

t

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CT OEC PilotTarget: 2,000 children

Early Learning Sites:

Center Based

Family Home Care

Target Communities:

Large population of children in early learning sites

Chose communities with established OEC/State relationships

Existing umbrella organizations like All Our Kin (AOK)

Status of OEC Pilot

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ECE Category Bridgeport Hartford

Family Home Providers January launch with All our Kin Coaches • Met with AOK and Hartford’s

Early Childhood Collaborative

• Launch in May

• AOK Coaches to help enroll

providers> then enroll parents

Center Based Bridgeport Early Head Start

Other Centers TBD

• Worked with Hartford Mayor’s

Office

• 10 Centers with multiple sites

interested

• Feb. 21st orientation

Other Group Day Care Homes- potential

Co

nn

ecti

on

To

HM

G Strengthening Connection to Help Me Grow and

Child Development Infoline

All Sparkler ASQ results are sent electronically to CT’s Child Development Infoline

Sparkler/CDI systems coordinated to accept electronic file from Sparkler with ASQ data to drop into CDI ASQ system

When concerns are identified by ASQ, children will be connected to appropriate services:

Birth to Three

Children and Youth with Special Needs

Early Childhood Special Education

Help Me Grow

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Opportunity for Early Care ProvidersO

pp

ort

un

ity

Closing Loop on screening

Linkage to support: Child Development Infoline, HMG and Sparkler Coaching

Gift Card Incentives for Providers and Parents in Pilot

Parent and child play activities age specific

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Less

on

s

Providers and parents need to be knowledgeable about strengths and importance of ASQ

Privacy issues are complex

Support of coaches is important to success

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Eva

luat

ion

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Process Evaluation

Outcome Evaluation

OEC looking into feasibility of random control trial or other designs

Ou

tco

me

Met

rics

Outcomes and Metrics

Family Engagement – via app enrollment numbers and ASQ completions, and post survey with families and providers

Increased awareness, knowledge and service utilization – via app data, provider utilization of ASQ reports and communications with families

Expanded outreach to and engagement with the early learning setting in fostering children’s healthy development –via post surveys with early learning providers, app data

Enable linkages among families, early learning settings, child healthcare practices, and CDI – via data from CDI and Help Me Grow on referrals and linkages to services, survey with parents

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Questions?

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Discussion

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PROJECT NEXT STEPS

Webinar #4• Ensuring cross-system collaboration • March 13 | 2:00pm ET

Data Reporting• Reporting period: December-March• Due: April 5, 2019

SLACK• Continuously throughout project

Learning Collaborative 1• In-person - 2019 HMG National

Forum• Virtual attendance available• May 7th | 12:45-1:45pm ET• RVSP directly to

sluczak@connecticutchildrens.org

QRIS Annual MeetingJune 25 – 27, 2019

New Orleans, Louisiana #QRIS2019

PARTNER UPDATE

Registration is OPEN!