An eHealth solution for posttraumatic stress and pain screening integrated in pediatric injury care

ABSTRACT Pediatric injury is the leading cause of child mortality and acquired disability in the United Statesaffectingmillion children annuallyAmong school age children alonemore thanmillion are treated in Emergency Department or admitted to the hospital annually for injuryincurring billions in medical and work loss costs each yearAfter hospital dischargemany injured children experience pain that is not well controlledand approximatelyindevelops persistent posttraumatic stress symptomsPTSSBoth pain and PTSS have been shown to be associated with health and functional outcomes following injuryHealth systems face increasing economic accountability for shortand long term patient outcomesbut few have the ability to routinely screen for indicators of modifiable factors for poor recovery in injured pediatric patients after discharge from the hospital or emergency departmenthampering follow up care and impairing optimal outcomesThere is currently no practicalvalidated means to screen childrenpost dischargefor painPTSS and functional recovery in a timely fashion and to make these data actionable to healthcare system stakeholders or to beneficiaries such as parentsWe propose a novelvalidated child self report screening system that is delivered to pediatric trauma patients in a child friendly modalityscored in real timeand integrated with external healthcare IT systemsThe system addresses an urgent unmet needand will transform pediatric trauma care by connecting screening results to follow up care and predictive analytics to improve injury outcomesBuilding on Phase I efforts that demonstrated the system s feasibilityusabilitysubjective appeal and commercial potentialand learned from key stakeholdersthis Phase II project continues system development and commercializationwith the active involvement of a potential customerThe integrated digital screening system takes advantage of advances in e Health and developmentally appropriate user engagement strategiesas well as a shifting economic landscape that provides health systems with incentives for optimizing shortand long term patient outcomes and achieving meaningful use of health information technologyThe proposed technology transfer and commercialization effort is supported by a decade long strong industry academic technology transfer partnership that is ideally suited for pediatric trauma care transformation PROJECT NARRATIVE Each yearmillion US children are injuredwith more thanmillion treated in the ED or admitted to the hospitalafter discharge many experience pain that is not well managedand approximatelyinof them will develop posttraumatic stress symptomsPTSSthat persist for months and interfere with recoveryThere is currently no practical validated means to screen children for painPTSSand functional recovery in a timely fashion and connect screening results to follow up careThe proposed project will extend and enhance an ongoing collaborative project between Radiant and Children s Hospital of PhiladelphiaCHOPto develop a robustintegrated online pediatric PTSS screening and intervention program