Innovative methods for parents and clinics to create tools for kids' care (IMPACCT Kids' Care) study protocol.
BACKGROUND
Despite expansions in public health insurance, many children remain uninsured or experience gaps in coverage. Community health centers (CHCs) provide primary care to many children at risk for uninsurance and are well-positioned to help families obtain and retain children's coverage. Recent advances in health information technology (HIT) capabilities provide the means to create tools that could enhance CHCs' insurance outreach efforts.


OBJECTIVE
To present the study design, baseline patient characteristics, variables, and statistical methods for the Innovative Methods for Parents And Clinics to Create Tools for Kids' Care (IMPACCT Kids' Care) study.


METHODS
In this mixed methods study, we will design, test and refine health insurance outreach HIT tools through a user-centered process. We will then implement the tools in four CHCs and evaluate their effectiveness and barriers and facilitators to their implementation. To measure effectiveness, we will quantitatively assess health insurance coverage continuity and utilization of healthcare services for pediatric patients in intervention CHCs compared to matched control sites using electronic health record (EHR) and Oregon Medicaid administrative data over 18months pre- and 18months post-implementation (n=34,867 children). We will also qualitatively assess the implementation process to understand how the tools fit into the clinics' workflows and the CHC staff experiences with the tools.


CONCLUSIONS
This study creates, implements, and evaluates health insurance outreach HIT tools. The use of such tools will likely improve care delivery and health outcomes, reduce healthcare disparities for vulnerable populations, and enhance overall healthcare system performance. ClinicalTrials.gov Identifier: NCT02298361.
Oregon Health & Science University, USA. Electronic address: angierh@ohsu.edu.
Heather
H
Angier
Oregon Health & Science University, USA.
Miguel
M
Marino
OCHIN, Inc., USA.
Aleksandra
A
Sumic
Oregon Health & Science University, USA.
Jean
J
O'Malley
Oregon Health & Science University, USA.
Sonja
S
Likumahuwa-Ackman
OCHIN, Inc., USA.
Megan
M
Hoopes
OCHIN, Inc., USA.
Christine
C
Nelson
OCHIN, Inc., USA; Kaiser Permanente Center for Health Research, USA.
Rachel
R
Gold
Oregon Health & Science University, USA.
Deborah
D
Cohen
OCHIN, Inc., USA.
Kristin
K
Dickerson
Oregon Health & Science University, USA; OCHIN, Inc., USA.
Jennifer E
JE
DeVoe
Access to healthcare; Children; Community health centers; Health insurance