Medical Home

Closing The Follow-Up Gap: Medical Home

Role of the Medical Home

According to the Joint Principles of the Patient-Centered Medical Home, March 2007, "The Patient-Centered Medical Home (PC-MH) is an approach to providing comprehensive primary care for children, youth and adults. The PC-MH is a health care setting that facilitates partnerships between individual patients and their personal physicians, and when appropriate, the patient's family."

"The medical home concept includes these characteristics: accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective care."

The role of the primary care provider in EHDI: "The primary care physician must assume responsibility to ensure that audiological assessment is conducted on infants who do not pass screening and must initiate referrals for medical specialty evaluations necessary to determine the etiology of the hearing loss." Joint Committee on Infant Hearing, 2007

Tips for Improvement

Misconception: Parents can tell if their child has a hearing loss by the time their child is 2-3 months old.

Clinical Fact: Before newborn hearing screening, most children were not found to have a hearing loss until 2-3 years of age. Children with milder hearing loss were not found until 4 years of age.

Misconception: Hearing loss risk factor assessments will identify all children with hearing loss.

Clinical Fact: As many as 50% of infants born with hearing loss have no known risk factors.

Misconception: If infants pass the newborn hearing screening, they do not require ongoing hearing surveillance.

Clinical Fact: It is estimated that by school age, new cases of permanent hearing loss occur in approximately 6 per 1000 children in addition to the 3 per 1000 likely to be detected at birth. American Speech-Language-Hearing Association. Guidelines for audiology services in the schools. ASHA. 1993: 35(suppl 10); 24-32.

Misconception: There is no rush to identify hearing loss.

Clinical Fact: Children identified with hearing loss after 6 months of age are more likely to have speech, language, and cognitive delays than children identified before 6 months. Children identified early can avoid these delays through evidence-based early intervention programs.

Myths vs. Clinical Facts of Newborn Hearing Screening and Early Diagnosis

Resources

National

2019 Joint Committee on Infant Hearing Position Statement

Supplement to the JCIH 2007 Position Statement: Principles and Guidelines for Early Intervention After Confirmation That a Child Is Deaf or Hard of Hearing

AAP Early Hearing Detection and Intervention (EHDI) State Chapter Champions

Clinical Practice Guideline: Otitis Media with Effusion (Update) 2016

Hearing Assessment in Infants and Children: Recommendations Beyond Neonatal Screening, 2009

Early Hearing Detection and Intervention (EHDI) Guidelines for Pediatric Medical Home Providers

Clinical Practice Guideline: Tympanostomy Tubes in Children, American Academy of Otolaryngology, 2013

Minnesota

MN EHDI Patient Checklist for Primary Care Providers

Hearing Screening Follow-up Process

Guidelines for Hearing Screening After the Newborn Period to Kindergarten Age

Guidelines for Primary Care and Medical Home Providers

Screening Resources For After The Newborn Period:

Hearing Screening Training Manual for use in Child and Teen Checkups (C&TC), Early Childhood Screening, Head Start, and school-based programs

Otoscopy and Tympanometry Manual for use in Child and Teen Checkups (C&TC), Early Childhood Screening, Head Start, and school-based programs

Training Opportunities

Meeting The Needs Of Physicians In Support Of EHDI (Non-CEU) (NCHAM)

Resources for Improvement

Strengthen Care Coordination

Newborn Hearing Screening Fact Sheet

EHDI Patient Checklist for Primary Care Providers

Enhancing Collaboration Between Primary and Subspecialty Care Providers for Children and Youth with Special Health Care Needs

Early Hearing Detection and Intervention Coding Fact Sheet for Primary Care Pediatricians (AAP)

Bright Futures Coding for Preventive Care (AAP)

The Journey Through Diagnosis: A guide for families of children with a genetic condition- Midwest Genetics Network

Minnesota Department of Health, Health Care Homes

Clinic Quality Assurance Checklist

Sharing Child Information to Coordinate Early Childhood Special Education (ECSE) Referrals Guide

Engage Families as Partners

EHDI Parent Resource Binder features the Parent Roadmap and offers more in depth information about hearing loss. Any child living in Minnesota that is newly identified with a hearing loss will receive a printed copy of this resource binder.

Does My Child Have a Hearing Loss? Emergency & Community Health Outreach (English) (Hmong) (Somali) (Spanish)

Partnering with your Doctor The Medical Home Approach: A guide for families of children with special health care needs - Region 4 Midwest Genetics Network (English) (Spanish) (Arabic)

Connect to Community Resources

Minnesota Department of Human Services: Deaf and Hard of Hearing Services

Local Public Health - County Agencies

Minnesota Hands and Voices

Minnesota Hands and Voices: Resource Directory

Help Me Grow

Training Opportunities

"Although most pediatricians believe that they have primary responsibility for follow-up planning for children who do not pass their hearing screens, they frequently do not have the access they need to screening-test results or to the results of any subsequent diagnostic evaluations."

Improving Follow-up to Newborn Hearing Screening: A Learning-Collaborative Experience

Giving Your Baby a Sound Beginning

Giving Your Baby a Sound Beginning (video is captioned) - 06:24