Background: In 2016, the Naval Medical Center San Diego General Pediatrics Clinic was not compliant ( < 75th percentile benchmark) with national a HEDIS goal for well child visits, which specifies a minimum of 6 well child encounters in the first 15 months of life. Goal: Our specific process improvement aim was to improve patient compliance with scheduled well child visits such that we would achieve the HEDIS 90th percentile benchmark within the first 12 months of project implementation. Methodology: Using a PDSA model, we teamed with our hospital informatics department to design a web-based text messaging system. Parents who voluntarily enrolled received text message reminders to schedule well visit exams for their infants. Beginning January 1st 2017, text messages were sent 30 days before infants were due for their well visit; these messages were triggered by patient date of birth. HEDIS data was tracked monthly to assess for change. Discussion: Our text messaging initiative resulted in significant improvement in compliance with a national HEDIS goal for well child visits in the first 15 months of life. Within 8 months of project implementation, our clinic had exceeded the HEDIS 90th percentile benchmark for this metric. We’ve observed minimal fluctuation in patient compliance over time, and have not dropped below the 75th percentile HEDIS benchmark since this project initiated. Notably, while the percentage of compliant patients has remained relatively consistent over time, the 90th percentile benchmark did increase slightly in January 2018. The unique aspect of our system is that it sends reminders to schedule before patients become non-compliant with their visit, which is not only better for meeting HEDIS goals, but more importantly for patient care. Next steps: In addition to well child reminders, the General Pediatrics Clinic utilized our text messaging innovation to send reminders for flu vaccination in early fall 2018. We tripled the number of beneficiaries receiving flu vaccination: 950 patients in the 2017 season and 2,790 patients to date in the 2018 season. Text messaging is a preferred method of communication for many of our patients and improves patient compliance with recommended preventive health visits.

Well Child HEDIS Measures 2017-2018

Well Child HEDIS Measures 2017-2018

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