Electronic Health Record Monitoring Dashboard and Developmental Screening in Pediatric Patients
An electronic health record monitoring dashboard was linked to higher questionnaire return and faster screening completion for young children referred for developmental and autism screening.
*Retrospective cohort with before-after comparison; Level 2b (OCEBM).
*Retrospective cohort with before-after comparison; Level 2b (OCEBM).
Citation
Davignon MN, Nugent JR, Campbell CI, Mertens JR. Electronic Health Record Monitoring Dashboard and Developmental Screening in Pediatric Patients. JAMA Network Open. 2026;9(5):e2610380. doi:10.1001/jamanetworkopen.2026.10380
Background
Early identification of developmental delay and autism improves outcomes, but screening completion is often low and uneven across patient groups. This study examined factors linked to screening follow-through and whether an electronic tracking tool improved it.
Patients
16,038 children (17,303 referrals), ages 6 to 66 months, referred to a secondary screening program in a large integrated health system; excluded canceled orders, nonmembers, inconclusive demographics, and non-distinct repeat referrals.
Intervention
Electronic health record–embedded monitoring dashboard for tracking outreach and workflow steps.
Control
Usual process before dashboard (manual tracking).
Outcome
Questionnaire return within 45 days; days to return (within 45 days); days to case completion (within 120 days).
Follow-up Period
Up to 45 days (return); up to 120 days (case completion).
Results
| Comparison | Outcome | Significant finding |
|---|---|---|
| After vs before dashboard | Return within 45 days (primary) | 54.7% vs 41.2%; adjusted relative risk 1.34 (95% CI, 1.29 to 1.38); number needed to treat 8 |
| After vs before dashboard | Days to questionnaire return | 6.62 days faster on average (95% CI, 6.07 to 7.18) |
| After vs before dashboard | Days to case completion | 37.07 days faster on average (95% CI, 35.67 to 38.47) |
| Active online portal account vs not active | Return within 45 days | Adjusted relative risk 1.99 (95% CI, 1.75 to 2.26) |
Limitations
Observational design limits causal certainty; staffing and time trends may contribute despite sensitivity checks. Single health system may not generalize. Key family factors (education, household structure) were not available, and child health outcomes after screening were not measured.
Funding
The Permanente Medical Group’s Delivery Science and Applied Research Program.
Clinical Application
Consider adding electronic tracking plus outreach to boost timely developmental screening, especially where return rates are low and delays are common.
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Discussion question (1)
In this retrospective cohort pre/post study, an EHR-embedded monitoring dashboard was associated with higher questionnaire return (41.2% to 54.7%; ARR 1.34) and faster case completion (RMST −37.07 days); what threats to validity (eg, secular trends, staffing changes, documentation effects) most limit causal inference, and would these data justify implementing a similar tool in your clinic?
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