1. Minnesota Newborn Screening Program Amy Gaviglio, MS, CGC
Timeliness and Point-of-Care Newborn Screening:
Statewide Implementation of Electronic Demographics and Result Reporting
15 minutes
Minnesota Newborn Screening Program
Amy Gaviglio, MS, CGC

2. Newborn Hearing Screening
Occurs hours after birth
Results reported to the Dept of Health
Typically reported via the newborn screening bloodspot card
Manually entered onto the card and manually transcribed into LIS
Left Ear/Right Ear; Pass/Refer

3. Newborn CCHD Screening
Occurs >24 hours after birth
Results reported to the Dept of Health
Pass/Fail at individual level
Raw O2 sat values and Pass/Fail at individual level
Aggregate data at facility level

4. Earlier detection = earlier intervention = better outcomes
Timeliness
Earlier detection = earlier intervention = better outcomes

5. Why Electronic Reporting?
Experience with Hearing Screening
Process involved a number of manual steps
>3500 unreported results/year
Inaccurate results
High programmatic costs ($45,000+ annually)
Unnecessary follow-up or missed follow-up

6. Hearing Screening Process

7. Why Electronic Reporting?
Experience with CCHD Pilot
Misinterpretation of algorithm
Babies discharged home who failed the screen, vice versa
Likelihood of algorithm to change
Unreported results

8. Algorithm

9. Project Scope Obtain newborn demographics directly from the EMR
Obtain EHDI results directly from the screening device
Obtain raw and individual-level CCHD results directly from the device or at the time of screening to allow for clinical decision support
FUNDED THROUGH FEE INCREASE

10. Integrated Newborn Record
OZ Systems
Step 1
Step 2
Step 3
Integrated Newborn Record
NANI™
(ADT Feed)
Telepathy EHDI™
Telepathy CCHD™
(HL7 Messages)

11. Current Project Approach
Training Scheduled and Completed
ADT Feeds Built, Tested, and Devices Connected
Go Live Date Selected
Post-Go Live Monitoring
Kick Off Webinar
GO LIVE
MDH
OZ Systems
IT Staff
Nursing Staff
MDH
OZ Systems
Interface Team
Biomed Team
Nursing Staff
MDH
Nursing Staff
MDH
MDH
OZ Systems
Interface Team
Biomed Team
Nursing Staff

12. Estimated Birth Coverage* By Status
Production/Ongoing Submission: %
Active Engagement: %

13. Outcomes: Hearing Screening
Better quality results are available days earlier

14. Outcomes: CCHD Screening
Pilot study showed that 29% of retests or Echocardiograms were due to inaccurate interpretation of the algorithm.
Preliminary 2016 data indicate that only 7% of retests were due to mis-interpretation. No unnecessary Echos have been ordered.

15. Observations
Post-production monitoring necessary when project involves workflow changes
Electronic reporting does not solve all timeliness and data problems
Serial screening, mis-entry into EMR, etc.

16. Next Phase(s) Continue implementation
Current goal is all hospitals live by 11/01/2016
Sending EHDI/CCHD results back to EMR
Audiology electronic reporting into MNScreen
Further interoperability

17. Why does it matter? Increased data integrity Increased efficiency
Increased timeliness
Improved QI/QA abilities
BETTER OUTCOMES

18. Thank You! MNScreen Team: Kaitlin Houlihan Kirsten Coverstone
Amy Gaviglio
OZ Systems
Rebecca Johnson