Abstract
Objective The study aimed to evaluate an integrated electronic questionnaire system implementation
in outpatient community pediatric practices on workflow, completion rates, and recorded
scores.
Methods We evaluated the implementation and outcomes of an integrated electronic questionnaire
system at 45 community pediatric practices that used standardized questionnaires to
screen for autism, depression, and substance use and to measure asthma control. Electronic
health record (EHR) data for all well child visits were extracted for the 3 months
before and after implementation. We used statistical process control charts to evaluate
questionnaire completion rates and Chi-square tests to evaluate screening completion
and positive screening rates. The collection and entry of questionnaire information
was observed and timed.
Results EHR data included 107,120 encounters across 45 practices that showed significant
and sustained improvement in completion rates for all questionnaires. The rate of
recorded concerning questionnaires decreased for asthma control (19.3 vs. 12.8%, p < 0.001), stayed the same for autism (96.6 vs. 96.2%, p = 0.38), decreased for depression (9.5 vs. 6.7%, p ≤ 0.001), and increased for any substance use (9.8 vs. 12.8%, p < 0.001). Twelve practices were observed, and patient time and staff time managing
questionnaires were decreased after implementation.
Discussion Electronic questionnaire administration saved staff time and patient time. We report
overall improvement in questionnaire completion rates, with notable variation in improvement
in completion across practices and in change in concerning recorded result rates across
measures.
Conclusion Conversion of four standard paper questionnaires to an integrated electronic system
reduces patient and staff time while increasing completion rates when well integrated
into routine care.
Keywords
asthma - autism spectrum disorder - depressive disorder - surveys and questionnaires
- electronic health records
