Educating Practices In Community Integrated Care (EPIC IC) for Children with Special Health Care Needs

EPIC IC is a three-year grant for development of a statewide medical home training project. The mission of the program is to enhance the quality of life for children with special health care needs through three interacting strands: recognition and support of families as the central caregivers for their child, effective community-based coordination and communication, and improved primary health care. The UCLID Center at the University of Pittsburgh and the Leadership Education in Neurodevelopmental Disabilities at Children’s Seashore House/Children’s Hospital of Philadelphia are serving as consultants to this Title V effort.

EPIC IC has developed curriculum around the five Medical Home components: 1) Overview, 2) Family Centered Care, 3) Care Coordination, 4) Practice Design and Policies, and 5) Transition. The Overview component was completed in April 2002 and slides are available for EPIC IC teams to use for educational sessions. The EPIC IC program delivery model will combine the Educating Physicians In their Communities (EPIC) statewide format with the National Initiative for Child Healthcare Quality (NICHQ) and the Institute for Healthcare Improvement “learning collaborative” model.

Nineteen practice teams have been recruited for the ongoing quality improvement project. Clinicians, practice staff and a family representative from each of these nineteen practices will work as a team. The EPIC IC practice teams:

1. Participate in monthly conference calls. To date five calls have taken place. Topics have included choosing a parent partner, identification of children with SHCN, coding for CSHCN, and incorporating a care coordinator into a primary care practice.
2. Engage in a process of quality improvement in the care of their patients with special health care needs. Tools have been provided to help in the identification of CSHCN, recruitment of parent partners, templates to improve coding, documentation, and scheduling. Templates have been provided to develop care plan and patient summary information for the practice and families. To promote the awareness of community based services, a Care Coordination and Community Resources notebook was developed for each of the practices. Practice teams will begin presentations to other physicians and office staff in Spring 2002.
3. Work with the rest of the practice clinical and office staff in the quality improvement initiative. Practice teams have presented the EPIC IC curriculum to their own practice staff to help them understand Medical Home concepts and principles. A Problem Based Learning scenario was developed to help initiate discussion around how individual practices can improve the way that care is delivered to CSHCN. Teams have been encouraged to meet regularly with practice staff to provide an update on the progress made.
4. Experience ongoing assessment, follow-up and mentoring over a 1-2 year period to maintain the improvements in care for children with special health care needs. Using the Medical Home Index, a tool from the Center for Medical Home Improvement, each practice team completed a self assessment to determine areas of strength and areas to improve. The project coordinator has ongoing communication with the EPIC IC teams, including site visits to the practices, to provide ongoing support and address individual practice needs.

EPIC IC program has also been awarded a contract from the PA Department of Health Title V program. This funding will support the federal Medical Home funding to include specific training and projects to insure appropriate transition of adolescents to adulthood and to adult care. EPIC IC also received DOH Title V funds to develop a statewide CSHCN child (day) care initiative to promote inclusion of CSHCN in child (day) care. EPIC IC will work with statewide agencies such as LEND, UCLID, UCP to develop a “Train the Trainer” model for training child care providers about inclusion of children with special needs in child care. Funds are available to support demonstration projects for care coordination in select medical practices and within the community. UCLID and LEND at Seashore House are members of the EPIC IC Advisory committee who will determine those practices who will receive care coordination funding.