The use of internet-based technology to tailor well-child care encounters.
OBJECTIVE
The goal was to evaluate the feasibility and acceptance of a new model for well-child care (WCC) in a large health maintenance organization.


METHODS
We designed a new model of WCC that engages families in Internet-based developmental and behavioral screening, allows for review of the results before the visit, and allows for selection of the appropriate visit type (e-visit, e-visit with brief provider visit, or extended encounter). The new model was pilot-tested in 2 practices within a large health maintenance organization. Seven providers and 70 parents participated in the study. Parents and providers were surveyed regarding their experience and satisfaction with the encounter.


RESULTS
Seventy-five percent of parents thought that the online previsit assessment improved or very much improved the WCC visit. However, 12% of parents found the online assessment somewhat or very difficult to use. All of the parents found the e-visit or the e-visit with brief provider visit acceptable or very acceptable, compared with a standard WCC visit. All 7 providers thought that use of the new model helped focus the visit and that they would continue or definitely continue to use the model.


CONCLUSIONS
We demonstrated the feasibility of a new model of WCC that engaged parents in previsit assessment and used alternative visit types to tailor care to the needs of the family. Future research will be needed to examine the impact of this model on important WCC outcomes.
Bergman
David Aaron
DA
Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94304, USA. david.bergman@stanford.edu
Beck
Arne
A
Rahm
Alanna Kulchak
AK
D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D003120:Colorado; D005240:Feasibility Studies; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006801:Humans; D020407:Internet; D017146:Models, Organizational; D009819:Office Visits / Q000639:trends; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D011314:Preventive Health Services / Q000458:organization & administration