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

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ABSTRACT Pediatric injury is the leading cause of child mortality and acquired disability in the United States, affecting 20 million children annually. Among school age children alone, more than 2 million are treated in Emergency Department or admitted to the hospital annually for injury, incurring billions in medical and work-loss costs each year. After hospital discharge, many injured children experience pain that is not well-controlled, and approximately 1 in 6 develops persistent posttraumatic stress symptoms (PTSS). Both pain and PTSS have been shown to be associated with health and functional outcomes following injury. Health systems face increasing economic accountability for short- and long-term patient outcomes, but 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 department, hampering follow-up care and impairing optimal outcomes. There is currently no practical, validated means to screen children, post-discharge, for pain, PTSS and functional recovery in a timely fashion and to make these data actionable to healthcare system stakeholders or to beneficiaries such as parents. We propose a novel, validated child self-report screening system that is delivered to pediatric trauma patients in a child-friendly modality, scored in real time, and integrated with external healthcare IT systems. The system addresses an urgent unmet need, and will transform pediatric trauma care by connecting screening results to follow-up care and predictive analytics to improve injury outcomes. Building on Phase I efforts that demonstrated the system’s feasibility, usability, subjective appeal and commercial potential, and learned from key stakeholders, this Phase II project continues system development and commercialization, with the active involvement of a potential customer. The integrated digital screening system takes advantage of advances in e-Health and developmentally-appropriate user engagement strategies, as well as a shifting economic landscape that provides health systems with incentives for optimizing short- and long-term patient outcomes and achieving meaningful use of health information technology. The 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.