Electronic health records are concentrated in larger and networked pediatric practices. Smaller and independent pediatric practices, the most common types of practice, are unlikely to adopt electronic health records until the cost of implementing and maintaining the systems decreases, developing standards for interoperability are adopted, and electronic health records are widely perceived to improve quality of care by practicing general pediatricians. The lack of decision support in current electronic health records may limit the ability of these tools to improve care delivery.
Many primary care physicians are not prepared to manage the follow-up care of children with a positive newborn screen, including initial counseling, diagnosis, and subspecialty referral. New strategies are needed to ensure appropriate and equitable health care delivery.
A well differentiated assessment of importance and satisfaction has implications for the evaluation of the quality of psychiatric care, for specific methods of treatment, and for the improvement of in-patient psychiatric care.
These results raise issues regarding the manner in which board certification is used or not used by hospitals in their efforts to ensure the practice of high-quality care within their institutions. The premise for recertification is the need to assure the public of continued competence of physicians over the course of their professional careers. Increased attention by the public and regulatory agencies regarding patient safety and quality of care will likely have an impact on hospital privileging processes.
Timely follow-up after an abnormal preschool vision screening test is necessary for the prevention of amblyopia. A previous large community-based preschool vision screening program found that only approximately half of those children who were referred were documented to have received follow-up care. 1 No similar data are available regarding follow-up from the primary care setting. We present findings from a pilot study designed to identify barriers to follow-up care faced by families screened by pediatricians and family physicians. These data will be used in larger studies to measure rates of follow-up and to develop interventions to improve the detection of amblyopia and conditions associated with the development of amblyopia.
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