Center for Child & Adolescent Health Research and Policy

Innovations in Health Care Delivery

Medical Home Transformation in Pediatric Primary Care — What Drives Change

The Medical Home Transformation in Pediatric Primary Care project examines drivers of change in the process of transformation of primary care to the medical home model. The project collects qualitative data from multiple individuals (providers and family members) at 12 exemplary pediatric practices across the nation. It further captures data from a family survey and a chart review at a subset of six practices. The project seeks to identify key factors influencing the transformation of the practices and to describe the business models that support the transformation to a medical home. This project is conducted in collaboration with the Center for Medical Home Improvement and is funded by the Agency for Healthcare Research and Quality.

Adoption of Innovations for Mental Health Care in Pediatric Primary Care

As pediatric mental health care grows more complex and the shortage of child mental health specialists worsens, achieving widespread adoption of innovative delivery models to promote high-quality mental health care in general pediatric settings becomes very important. We aim to understand how and why general pediatricians adopt new tools for mental health care, and reasons new tools are not adopted.

We are conducting a mixed-methods study around adoption of two innovations in child mental health. One innovation is the Massachusetts Child Psychiatry Access Program, a state-funded telephone consult program whereby pediatricians obtain phone consults from child mental health specialists while the patient is in the pediatrician's office. The second innovation is an ADHD electronic medical record template with clinical decision support, which prompts physicians to deliver guideline-adherent care during office visits. We will apply these findings to improve implementation programs for current and future mental health tools in primary care pediatrics. With this work, we hope to expand the capacity of pediatricians to care for mental health conditions, thus improving access for many children and youth who need but do not receive high quality mental health care.

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