Archive for the ‘Public Health News’ Category

Role of the Primary Care Physician and Medical Home in the Early Hearing Detection and Intervention Program

Congenital hearing loss occurs in 1-3 out of 1000 infants in the United States and often found in babies whose parents have normal hearing.  There is well-established evidence that early identification of hearing loss and appropriate early intervention can mitigate the potential for poor language acquisition. The Joint Committee on Infant Hearing’s Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs, and their statement entitled, “Newborn and Infant Hearing Loss: Detection and Intervention” supports universal newborn hearing screening and outlines best practices in the timing and methods for follow up hearing screening and participation in early intervention. Early detection of hearing loss facilitates language acquisition and future opportunities for educational success.

Pediatricians and others in pediatric primary care providers play a vital role in mitigating developmental delays in infants and young children who are deaf and hard of hearing.   Those providing a medical home for children can ensure appropriate and timely referrals to providers that can perform evaluations and are knowledgeable about congenital hearing loss.  DPH provides an Early Hearing, Detection, and Intervention (EHDI) coordinator for each county to assist in follow-up services for families of infants who do not pass the initial hearing screening.  You can find your local EHDI Coordinator online at https://sendss.state.ga.us/sendss/!mch.coord_search.

Since its release, the EHDI program adopted the AAP Guidelines for Pediatric Medical Home Providers, available online at https://pediatrics.aappublications.org/content/120/4/898/tab-figures-data. This algorithm maps the 1 – 3 – 6 follow-up guidelines for newborn hearing screening as shown in Figure 1.   Outlined below are the key components of the physicians’ role in this process:

  1. For all newborns, obtain written results of newborn hearing screening from the birthing facility. Results are available via a web portal through the Georgia Department of Public Health’s State Electronic Notifiable Disease Surveillance System (SendSS) or eReports. Physicians can register for SendSS and eReports by following these links  https://sendss.state.ga.us/sendss/login.screen; https://ereports.ga.gov/dph/eReports/weblogin.aspx?MsgNum=0&Locale=1033
  2. By one month of age, ensure that all newborns receive a hearing screening. Infants who “refer” on their initial screening, in one or both ears, must receive a follow-up hearing screen.  Infants that pass their initial screening do not need additional testing unless concerns arise.  If the initial hearing screen uses an automated auditory brainstem response (a-ABR) screener, then the same test must be performed during the outpatient, follow-up hearing screen.
  3. By three months of age, infants that refer on their outpatient follow-up screen, send for a diagnostic evaluation. Complete only one outpatient screening, as repeated screenings do not provide enough information to determine appropriate follow-up recommendations.  Repeated screenings delay the identification of hearing loss.  After three months of age, sedation may be required for testing, which can be a deterrent for parents.  EHDI coordinators can assist in locating appropriate providers, as needed.
  4. By six months of age, support referrals to early intervention, otolaryngology, ophthalmology, and genetics, after diagnosis of permanent hearing loss. A suspected or confirmed case of hearing loss in children from birth to age 5 is a notifiable disease and requires a report to the Georgia Department of Public Health.  Therefore, it is important to notify the EHDI program upon confirmation of permanent childhood hearing loss.  Send a copy of the diagnostic report to the EHDI Program or a surveillance form for reporting hearing loss for children five and under, located on the GA Chapter of the American Academy of Pediatrics website.  EHDI Coordinators will work with the child’s physician and family to assist in linking infants with early intervention services.
  5. Otitis media with effusion can lead to permanent hearing loss. Infants and children must be referred to an otolaryngologist and audiologist.
  6. Hearing loss may develop at any age; therefore, it is important to monitor all infants for progressive or late-onset hearing loss. Referral for audiological evaluation is recommended at least once before age 30 months for infants who have risk indicators for late-onset hearing loss, such as family history of permanent childhood hearing loss, neonatal intensive care unit stay of more than five days duration, and parental concern. Included is a list of risk indicators in the attached algorithm.

For more information on the Georgia EHDI Program, please visit https://dph.georgia.gov/EHDI

or call 404-651-5482

 

 

DPH Webinar “Healthcare Transition for Adolescents and Young Adults with Autism”

DPH Webinar

“Healthcare Transition for Adolescents and Young Adults with Autism”

Thursday, January 9, 2020

Time: 12:00 pm – 1:00 pm

Click Here to Register link

The Georgia Academy of Family Physicians, in cooperation with the Department of Public Health invites you to participate in an interactive live webinar on Transition of Care: Autism.

The webinar will focus on providing guidance on how to plan and execute better health care transitions for patients with Autism and will cover the following objectives:

  • Identify key skills and contexts that make healthcare transition challenging for transition-age youth with autism.
  • List features of a healthcare transition process and general timelines for transition planning
  • Identify resources and information related to best practices in transition planning for youth with autism.

Presenter:

Matthew Joel Segall, Ph.D.

Educational Consultant & Licensed Psychologist

Program Director, Education and Transition Services

Assistant Professor of Psychiatry and Behavioral Sciences Emory Autism Center

 

CME Information:

AMA Credit: The Georgia Academy of Family Physicians is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.  The GAFP designates this live educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity

Kathleen E. Toomey, M.D., M.P.H.

Commissioner, Georgia Department of Public Health

November 19, 2019

The Georgia Department of Public Health (DPH) has confirmed 11 cases of measles in the past 10 days. That brings the total number of confirmed measles cases in Georgia to 18 so far this year – more than in the previous decade combined.

As physicians and health care providers, we must be ever vigilant for patients presenting with febrile rash illness and clinically compatible measles symptoms. If you suspect measles in a patient, notify Public Health immediately at 404-657-2588 (during business hours), or 1-866-PUB-HLTH after hours or weekends.

Please follow the guidance below in assessing patients for measles.

  • Healthcare providers should consider measles in the initial differential diagnosis of patients presenting with the following symptoms, particularly those who have a history of recent international or domestic travel, exposure to international travelers, or exposure to a possible measles case:
    • Fever ≥101˚F (38.3˚C) AND
    • Generalized maculopapular rash lasting > three days AND
    • Cough, runny nose or conjunctivitis
  • Isolate persons with suspect measles immediately (negative pressure room, if available). Patients should be managed in a manner that prevents disease spread in the healthcare setting https://www.cdc.gov/infectioncontrol/pdf/guidelines/isolation-guidelines-H.pdf.
  • Report suspect cases of measles immediately by calling either the District Health Office or Georgia DPH at 404-657-2588 (during business hours), or 1-866-PUB-HLTH after hours or weekends. Do not wait on laboratory results before reporting.
  • Obtain appropriate clinical specimens. Laboratory testing for measles is required for confirmation. This includes two throat swabs and urine for measles PCR and culture, and blood for serology testing. Detailed specimen collection and shipping guidelines are available at the DPH measles website. DPH will assist in coordinating measles testing at the Georgia Public Health Laboratory.
  • Ensure patients are up-to-date on their vaccinations according to CDC’s recommended schedules for children and adults.

The number of measles cases in the U.S. continues to increase almost daily. Just a few weeks ago, the country was very close to losing its measles elimination status – a very sobering thought in this day and age.

The current measles outbreak in Georgia is small compared to other outbreaks documented around the country. However, the toll even a single case of measles takes goes well beyond physical illness – impacting economies, work forces, education, health care systems, and creating a public health burden to protect vulnerable populations. As such, our role becomes even more critical in identifying every case of measles and preventing transmission and strengthening vaccine confidence among parents and patients.

Thank you for all that you do to keep Georgians safe and healthy.

Sincerely,

Kathleen E. Toomey, M.D., M.P.H.
Commissioner

Is your practice breastfeeding friendly?

Tarayn Fairlie, MD, MPH, Chair – EPIC Breastfeeding Education Program Advisory Committee

Have you noticed that more of your patients are breastfeeding? You aren’t imagining things-breastfeeding rates in Georgia are increasing. However, many mothers still don’t reach their breastfeeding goals, and studies cite lack of support from health care providers as one of the reasons for not meeting them. Georgia families need physicians who can actively support breastfeeding them.  Yet between 43% and 50% pediatricians, neonatologists, obstetricians/gynecologists, and family medicine physicians don’t feel they were adequately prepared for clinical evaluation of breastfeeding problems, and a similar proportion feel that they were inadequately prepared for clinical treatment of breastfeeding problems. This isn’t surprising, as there is little or no formal instruction on breastfeeding and human lactation in medical schools.  The EPIC Breastfeeding Program is here to help fill this gap for practicing physicians and can either jumpstart a big shift for your practice or be the impetus for small improvements. The modules and resources of the EPIC program can help you develop your skills and further develop your practice. EPIC has resources available to assist you to develop, enhance and/or update your skills. Here are some ways EPIC can help you better support breastfeeding families:

Start at the beginning! We know that a mother’s prenatal intention to breastfeed is strongly influenced by input from and support of her physician.  If you see expectant parents, encourage them to breastfeed and answer any questions they might have about breastfeeding. Another good place to start is to track breastfeeding rates in your practice. Knowing what your patient population is doing can be helpful at setting practical goals to help mothers adhere to AAP recommendations for breastfeeding: exclusive breastfeeding until 6 months of age and then continued breastfeeding until at least age 1. Through our modules, we can help train support staff and providers to have open-ended conversations about infant feeding that assesses an expectant mother’s breastfeeding intention in a comfortable, non-pressured way.

Look at your practice environment. What are you currently promoting? Do parents see formula companies represented in your practice? Do you still provide free formula gift packs or have formula marketing materials from your waiting area? Ensuring that your patient education is free of commercial influence is an important step in supporting informed feeding choices for all new families, whether breastfeeding or not.   Our resource kit includes samples of well- designed and up-to-date patient education materials in English and Spanish.

Put it in writing. Collaborate with staff to develop a written breastfeeding policy for your practice.  We can provide examples and guidance. A clear policy can ensure that your staff are supported when they return to work by providing space, time and supplies to express milk for their babies, increasing both their job satisfaction and performance.

Offer culturally competent feeding care. Different cultures have varying beliefs and customs relating to infant feeding.  Knowing them and providing appropriate anticipatory guidance can improve your practice and your customer satisfaction ratings. Do you and your staff encourage breastfeeding in the waiting area and provide a private place if desired? Having posters and signs welcoming and encouraging breastfeeding can help parents feel comfortable and supported.  We provide samples in our Resource Kit.

Triage breastfeeding concerns easily. Your phone triage nurses should be provided with training and resources to provide evidence-based recommendations to families calling for advice.  Our Resource Kit includes the AAP published Breastfeeding Telephone Triage and Advice book, 3rd edition.  Our one-hour breastfeeding education programs can provide this education, as well as continuing education hours for nurses and physicians, at no cost to your office.

Make it part of the visit. Our training will also help guide you in incorporating breastfeeding into routine care.  Learn what effective breastfeeding looks like, what mothers’ common concerns are, and what strategies to employ that preserve breastfeeding and milk production if/when problems arise.  Learn about milk expression and how to support mothers when they return to work or school. Our program also provides resources on coding, billing, and documentation so you can be paid for the work that you do!

Learn who else can help. When further breastfeeding expertise or peer support is indicated, it’s helpful to be familiar with lactation support in your community and where families can find it.  Also, more and more pediatricians, ob/gyns and family practice physicians whose practices see many newborns are directly hiring or contracting with lactation consultants to provide care in the office.  Accessible breastfeeding support can help your practice attract new and growing families, and Georgia is one of the first states to license lactation consultants.

Schedule your EPIC Breastfeeding Program today.  Let us provide you with resources to make your practice more breastfeeding friendly.  We offer convenient, physician-led, peer-to-peer breastfeeding education in your office or hospital. Our modules are one-hour sessions held during lunch or any time that is more convenient. Each program site receives a free Breastfeeding Resource Kit as part of the presentation, with resources for you, your staff and your patients. There are three topics to choose from: Breastfeeding Fundamentals, Supporting Breastfeeding in the Hospital, and Advanced Breastfeeding Support. Free continuing education is provided.  Complete an online program request form at www.GaEPIC.org or call the program office at 404-881-5068. The EPIC Breastfeeding Program is brought to you by the Georgia Chapter, American Academy of Pediatrics with support from the Georgia Department of Public Health.

 

The Georgia Academy Awarded AAFP Chapter Health Equity Planning Grant

The Georgia Academy Awarded AAFP Chapter Health Equity Planning Grant

The Georgia Academy of Family Physicians (GAFP) was selected to receive a $5,000 grant to participate in the AAFP Chapter Health Equity Planning Grants Program. The intent of the Program is to promote collaboration between the AAFP and AAFP chapters in establishing chapter health equity plans. A health equity plan is a set of goals and tactics that describe how the chapter will work to advance health equity. Health equity refers to the elimination of differences in health that are closely linked with social or economic disadvantage among population groups based on race/ethnicity, religion, socioeconomic status, gender, mental health, sexual orientation, or geographic location.

For more information about the AAFP Chapter Health Equity Planning Grants Program please contact Kevin Kovach at (913) 906-6143 or kkovach@aafp.org.

Register Now for the June Webinar – Models of Transition of Care: Autism

 

DPH Webinar

“Models of Transition of Care: Autism”

Thursday, June 13, 2019

Time: 12:00 pm – 1:00 pm

Click Here to Register link 

The Georgia Academy of Family Physicians, in cooperation with the Department of Public Health invites you to participate in an interactive live webinar on Transition of Care: Autism.

The webinar will focus on providing guidance on how to plan and execute better health care transitions for patients with Autism Spectrum Disorder and will cover the following objectives:

  • Define transition and transition quality indicators for individuals with ASD
  • Review lifespan approach and barriers to access to care
  • Become familiar with transition resources and innovative practices
  • Reflect on the role of clinicians to support and empower families of children with autism

Presenter: 

Cheryl A. Rhodes, MS, LMFT, LPC

Director, Care Coordination

CME Information:

AMA Credit: The Georgia Academy of Family Physicians is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.  The GAFP designates this live educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Can’t Listen Live?  Register anyway – and we’ll send you the recording notice once it’s posted on our website.

Register Now!! May Webinar, May 22nd, 12:00 pm – 1:00 pm

Register Now!! May Webinar, May 22nd, 12:00 pm – 1:00 pm

Through a partnership with the Georgia Department of Public Health, GAFP is offering a webinar on Expedited Partner Therapy (EPT).

This month’s webinar will be held on May 22nd at 12:00 pm and will feature a presentation by Candice Joy McNeil, MD, MPH. – Assistant Professor, Infectious Diseases Office of Women in Medicine and Science, Comprehensive Cancer Center, Wake Forest Baptist Health. Dr. McNeil is an infectious disease specialist in Winston Salem, North Carolina and is affiliated with Wake Forest Baptist Medical Center. She received her medical degree from Wayne State University School of Medicine and has been in practice for over 15 years.

Webinar Objectives:

  • General overview of Expedited Partner Therapy (EPT)
  • Benefits of Expedited Partner Therapy (EPT)
  • Georgia Law & rules regarding Expedited Partner Therapy (EPT)
  • Eligibility criteria for Expedited Partner Therapy (EPT)
  • Differences between Georgia Law for EPT and DPH Rules and Regulations

Click the link to register for the May 22nd webinar.

https://attendee.gotowebinar.com/register/8861986052741120001

Can’t Listen Live?  Register anyway – and we’ll send you the notice of the recording once it’s posted on our website.

Register Now!! April Webinar – April 18th, 12:00 pm – 1:00 pm

Through a partnership with the Georgia Department of Public Health, GAFP is offering a webinar on Steps to Transition Planning.

This month’s webinar will be held on April 18th at 12:00 pm and will feature a presentation by Andrea Videlefsky, MD – Medical Director, Adult Disability Medical Healthcare and the ADMH team. Dr. Videlefsky is a family practice physician with the Urban Family Practice Associates, an active member of US Down Syndrome Medical Interest Group and serves as a Family Physician Champion for Health Care Transition. She is dedicated to serving patients through the patient-centered medical home model. She has a special interest and ability in treating teens and adults with Down syndrome and other developmental disabilities. From this webinar, you’ll learn the steps to transition planning. She will be joined by Susanna Miller-Raines, MSW, Adrienne Melnyk, M.Ed. and Janice Nodvin, Clinic Director.

Webinar Objectives:

Medical Transition

  • Background
  • Identifying the ages of transition

Education Transition

  • Assistance with IEP

Planning for life after school and options available

  • Inclusion Post-Secondary Education
  • Vocational Rehabilitation – employment
  • Medicaid Waiver

Emergency planning

Long term goals

  • Guardianship or options
  • Residential
  • Legal

 

Please click the link to register for the April 18th webinar.

https://attendee.gotowebinar.com/register/5096154328656991747

Can’t Listen Live?  Register anyway – and we’ll send you the recording once it’s posted on our website.

What is Trauma-Informed Care?

Why are health care professionals across the nation embracing trauma-informed care? The Center for Health Care Strategies (CHCS) posed this question to clinicians and patients to gather first-hand perspectives on the value of trauma-informed care. Trauma-informed care shifts the focus from “What’s wrong with you?” to “What happened to you?”

A trauma-informed approach to care acknowledges that health care organizations and care teams need to have a complete picture of a patient’s life situation — past and present — in order to provide effective health care services with a healing orientation. Adopting trauma-informed practices can potentially improve patient engagement, treatment adherence, and health outcomes, as well as clinician and staff wellness. It can also help reduce avoidable care and excess costs for both the health care and social service sectors.

Click the links below to explore videos addressing the benefits of trauma-informed care. LEARN MORE 

 

Content provided by the Trauma-Informed Care Implementation Resource Center – Center for Health Care Strategies website

New Preventive Care and Transition Toolkit Available

Incorporating Health Care Transition Services into Preventive Care for Adolescents and Young Adults: A Toolkit for Clinicians

Preventive care visits represent an important opportunity to discuss health care transition with adolescents, parents, and young adults. Yet, national survey data reveal that, 85% of youth have not received guidance about health care transition from their health care providers. To address this unmet need, The National Alliance to Advance Adolescent Health/Got Transition with the University of California, San Francisco’s Adolescent and Young Adult Health National Resource Center created a new free online toolkit titled Incorporating Health Care Transition Services into Preventive Care for Adolescents and Young Adults. The toolkit is available in both English and Spanish. Advising Got Transition and the Adolescent and Young Adult Health National Resource Center was a national advisory group of pediatric, adolescent medicine, reproductive health, and internal medicine experts, public health officials, and young adult advocates.

This toolkit provides suggested content for providers to introduce health care transition during preventive visits with early adolescents (ages 11-14), middle adolescents (ages 15-17), late adolescents (ages 18-21), and young adults (ages 22-25), consistent with the American Academy of Pediatrics’ Bright Futures’ age groupings and format. The toolkit includes transition questions and anticipatory guidance for each age group including a motivational interviewing approach to engage youth with and without special health care needs. This toolkit aligns with the clinical report on transition jointly published by the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians. According to Dr. Patience White, Co-Director of Got Transition, “This is an exciting addition to Bright Futures, offering practical guidance for busy clinicians working to improve the ability of adolescent and young adults to manage their own health and effectively use health services.”

For more information about health care transition and this toolkit, please visit Got Transition at www.GotTransition.org or contact Annie Schmidt at ASchmidt@TheNationalAlliance.org.