O2079: From Burden to Balance: Transforming Pediatric Screenings for Savings and Success

Background: A standard pediatric well visit encompasses age based developmental and mental health screenings. We demonstrate how automation of validated patient screenings with autoscoring and embedded clinical decision support (CDS) helps improve screening rates, eliminates manual scoring, decreases cognitive burden, promotes health equity, helps with adolescent privacy in answering questionnaires, and provides institutional cost savings.

Methods: Patients from 0-18 years seen for a well child check at our Primary Care Network (PCN) over the past 12 months were included. Validated developmental and mental health screenings in English were deployed on tablets at the initial go live. Developmental screenings integrate into our Electronic Health Record through rule-based assignments. Adolescent mental health screening was manually assigned and handed to the patient when separated from the caregiver to ensure privacy. These data then populate into discrete fields, auto-calculate scores, which are visible within provider notes, and provide necessary clinical decision support for interpretation and recommended interventions. High risk mental health screens also include interruptive alerts for the entire care team. Initially for non-English speaking patients, interpreters were used to assist with screening completion. In 2025 we deployed questionnaires in Spanish electronically eliminating the need for interpreters for this purpose.

Results: For a 12-month period ending March 2025, our PCN saw 128,239 well visits and administered 115,075 screenings (57,702 Survey of Well-being of Young Children, SWYC, 6,061 Modified Checklist for Autism in Toddlers, M-CHAT, 24,708 Patient Health Questionnaire, PHQ-8, and 24,604 Ask Suicide-Screening Questions, ASQ). Rates of all screenings increased after electronic deployment (Figure 1). The total time saved by autoscoring for these screenings was estimated at 480 hours annually.

There were 12,435 interruptive alerts for severe depression and acute suicidality across 3128 encounters, with a median of 3 [2, 5] alerts per encounter.

14% of our PCN patient population has Spanish as their primary language requiring interpreters during their visit. After deployment of electronic questionnaires in Spanish, there was rapid adoption at all sites ( Figure 2) decreasing the use of interpreters for this purpose, with an estimated cost savings of up to $7,000 per week.

Conclusion: Developing methods of automation is an invaluable investment in improving provider workflow in busy clinic settings, increasing health equity and providing a return on investment for resources for healthcare institutions. In addition, it decreases staff burden and errors by having to remember which screening to give out at what age.

Our findings underscore the effectiveness of automation in standard well-child screenings demonstrating its potential to improve patient screening rates, care team burden and optimize healthcare delivery.

Investing in programs like these allows for nuanced program-specific optimizations irrespective of the size of the practice and patient volume.