0738 Efficacy of an Automated System to Screen for Snoring in Pediatric Primary Care

Abstract

Introduction: Despite guidelines for evidence-based diagnosis of pediatric obstructive sleep apnea (OSA) recommending that all children are screened for snoring, studies have found low rates of screening for snoring in primary care. The aim of the current study is to evaluate the efficacy of a computer decision support tool on primary care provider (PCP) documentation of snoring. Methods: In 2015 we introduced a computer decision support module (Child Health Improvement through Computer Automation for Snoring; CHICA-Snore) in five urban pediatric primary care clinics. In CHICA-Snore, parents receive a screening item asking if their child snores, delivered via an electronic tablet in the waiting room. PCPs receive an automated prompt in the electronic health record for snoring children, encouraging them to evaluate the child for OSA. We extracted data from the charts of a random sample of 194 children whose parents reported snoring between August 2015 and February 2016. All primary care visits for each child were reviewed during two time periods: 1) one year prior to the visit in which the parent reported snoring (baseline); and 2) the visit at which the parent reported snoring (CHICA Snore). Chi-square analysis was conducted to compare rates of snoring documentation between the two time points. Results: Participants were 194 snoring children between the ages of 3 and 12 years seen by 27 PCPs. Children had a mean age of 8.1 years (SD=2.5), were 55.7% male, and the majority (93.8%) had Medicaid insurance. The most common race/ethnicity was black non-hispanic (58.2%), followed by white hispanic (24.2%) and white non-hispanic (10.3%). PCP documentation of snoring increased significantly with CHICA-Snore, (18.8% at baseline and 64.0% with CHICA-Snore; p