TY - JOUR
AU - N. J. Glasser
AU - C. Shirkhodaie
AU - Z. C. Newman
AU - J. Wang
AU - M. Zhu
AU - J. W. Mitchell
AU - E. Staab
AU - S. Lichtor
AU - N. Laiteerapong
A1 - 
AB - OBJECTIVE: To examine how depression screening rates changed after implementation of electronic health record (EHR) clinical decision support tools and medical assistant (MA)-led depression screening at an outpatient pediatric practice. METHODS: We assessed changes in depression screening rates at an urban academic pediatric clinic between September 2016 and December 2020 using interrupted time series analysis. During this time, we implemented 1) EHR clinical decision support tools for depression screening and management (November 2017) and 2) training of MAs to screen for depression (July 2019). RESULTS: Over the study period, 3963 patients received care in the pediatric clinic. Their mean age was 14.9 years (standard deviation, 2.6) and about half were female (n = 2011, 51%). The majority were Black/African American (n = 2852, 72%) and had private insurance (n = 2860, 72%). Depression screening rates increased from 3% to >80%. Preintervention, depression screening rates were not increasing (0.9% per month, 95% confidence interval [CI]: -0.3% to 2.1%; P = .15). After implementing EHR clinical decision support tools, there was a 15.6% (95% CI: 2.5%-28.6%, P = .02) increase in the screening rate. Also, MA-led screening was associated with a 24.6% (95% CI: 9.9%-39.2%, P = .002) screening rate increase. CONCLUSION: This study demonstrates that EHR clinical decision support tools and MA-led screening are likely to increase adolescent depression screening and management in pediatric clinics.
AD - Department of Medicine (NJ Glasser, C Shirkhodaie, M Zhu, E Staab, and N Laiteerapong), University of Chicago Medicine, Chicago, Ill. Electronic address: nglasser@uchicago.edu.; Department of Medicine (NJ Glasser, C Shirkhodaie, M Zhu, E Staab, and N Laiteerapong), University of Chicago Medicine, Chicago, Ill.; University of Chicago Pritzker School of Medicine (ZC Newman), Chicago, Ill.; Washington University in St. Louis School of Medicine (J Wang), St. Louis, Mo.; Department of Pediatrics (JW Mitchell), University of Chicago Medicine, Chicago, Ill.; Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital (S Lichtor), Boston, Mass; Harvard Medical School (S Lichtor), Boston, Mass.; Department of Medicine (NJ Glasser, C Shirkhodaie, M Zhu, E Staab, and N Laiteerapong), University of Chicago Medicine, Chicago, Ill; Department of Psychiatry (N Laiteerapong), University of Chicago Medicine, Chicago, Ill.
AN - 40274223
BT - Acad Pediatr
C5 - Healthcare Disparities
CP - 6
DA - Aug
DO - 10.1016/j.acap.2025.102839
DP - NLM
ET - 20250422
IS - 6
JF - Acad Pediatr
LA - eng
N2 - OBJECTIVE: To examine how depression screening rates changed after implementation of electronic health record (EHR) clinical decision support tools and medical assistant (MA)-led depression screening at an outpatient pediatric practice. METHODS: We assessed changes in depression screening rates at an urban academic pediatric clinic between September 2016 and December 2020 using interrupted time series analysis. During this time, we implemented 1) EHR clinical decision support tools for depression screening and management (November 2017) and 2) training of MAs to screen for depression (July 2019). RESULTS: Over the study period, 3963 patients received care in the pediatric clinic. Their mean age was 14.9 years (standard deviation, 2.6) and about half were female (n = 2011, 51%). The majority were Black/African American (n = 2852, 72%) and had private insurance (n = 2860, 72%). Depression screening rates increased from 3% to >80%. Preintervention, depression screening rates were not increasing (0.9% per month, 95% confidence interval [CI]: -0.3% to 2.1%; P = .15). After implementing EHR clinical decision support tools, there was a 15.6% (95% CI: 2.5%-28.6%, P = .02) increase in the screening rate. Also, MA-led screening was associated with a 24.6% (95% CI: 9.9%-39.2%, P = .002) screening rate increase. CONCLUSION: This study demonstrates that EHR clinical decision support tools and MA-led screening are likely to increase adolescent depression screening and management in pediatric clinics.
PY - 2025
SN - 1876-2859 (Print); 1876-2859
SP - 102839
ST - Evaluating Clinical Decision Supports to Improve Adolescent Depression Screening and Management in Pediatric Primary Care
T1 - Evaluating Clinical Decision Supports to Improve Adolescent Depression Screening and Management in Pediatric Primary Care
T2 - Acad Pediatr
TI - Evaluating Clinical Decision Supports to Improve Adolescent Depression Screening and Management in Pediatric Primary Care
U1 - Healthcare Disparities
U3 - 10.1016/j.acap.2025.102839
VL - 25
VO - 1876-2859 (Print); 1876-2859
Y1 - 2025
ER -