BACKGROUND: Newborn Screening is as state-mandated program that screens all Minnesota newborns soon after birth to determine if they are at risk for congenital conditions, including hearing loss and critical congenital heart disease (CCHD). Screening for both hearing loss and CCHD occurs at the birth facility with results reported to the Minnesota Department of Health (MDH) for further oversight and case management. Success of the program depends upon accurate and timely reporting of both the infant’s demographic information and the subsequent screening results. Previously, demographics and hearing screening results were submitted to MDH utilizing the newborn screening specimen card. This manual process required hospital staff to hand write the information on the specimen card, then courier the specimen card to MDH where it is again hand-entered by MDH staff into a database. This process resulted in numerous challenges including missing demographic information, unreported or incorrectly reported screening results, and delays in case management for infants who did not pass their screening tests.
METHODS: To address the current gaps in reporting and case management, in late 2014, MDH became the first public health agency in the country to implement real-time reporting of infant demographic information directly from all Minnesota birth hospitals’ electronic health records and screening results directly from the screening devices or at the time of screening. The project was completed in early 2017 with all Minnesota birth hospitals reporting results electronically using this new model.
RESULTS: Stakeholder identification and engagement, business analysis and risk assessment were completed for each birth hospital or healthcare system due to differences in electronic health records, screening devices and staff organization. Development of an end-user training curriculum with multiple training modalities, and an established long-term training plan was required. Troubleshooting and help desk protocols were developed for each birth hospital. Providing incentives such as Meaningful Use specialized registry status and grant funding became necessary in order to implement with all birth hospitals. Implementation of electronic reporting has also offered additional opportunities for ongoing quality improvement efforts.
CONCLUSIONS: The addition and implementation of new reporting modalities can follow different paths in local, statewide and national Newborn Screening programs. Because each program and birth facility may face different challenges or enjoy different opportunities, sharing experiences in implementation of electronic data systems is critical to improving Newborn Screening programs and population health.