Electronic health record and patterns of care for children with cerebral palsy.
Brad G Kurowski, Kelly Greve, Amy F Bailes and 5 others
PMID 33768551WHAT IT FOUND
Most care for children with cerebral palsy happens without the child physically present.
For every in-person visit, there were five care coordination interactions like calls or emails. Therapy and emergency visits were mostly in-person, while neurology and rehab relied heavily on remote coordination.
Key findings
01The ratio of in-person to care coordination visits was 1:5, indicating most interactions occurred outside of in-person visits.
02Therapy specialties had a high ratio of in-person interactions, whereas rehabilitation and neurology had a low ratio with 20% or less of encounters completed in person.
03Seven distinct clusters of care were identified, with the largest cluster involving high-frequency services including therapies, emergency medicine, and administrative support.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was conducted at a single tertiary medical center in the Midwestern United States, so patterns may differ in community settings. Data only captured care received within this specific institution, missing private practices or other centers. Gross Motor Function Classification System (GMFCS) levels were only available for 40% of patients, and documentation varied by specialty. The age recorded was the time of the first code entry at this center, not the actual age of diagnosis.
Declared interests
No specific conflicts of interest or funding sources are declared in the provided text.
The easy way to misread this
Do not assume that low in-person visit ratios for specialties like neurology or rehabilitation mean those services are less important. The study shows these specialties rely heavily on care coordination, such as phone calls and emails, which are not counted as in-person visits.