WIC staff and healthcare professional perceptions of an EHR intervention to facilitate referrals to and improve communication and coordination with WIC: A qualitative study

Abigail McCall; Ashley E Strahley; Katy W Martin-Fernandez; Kristina H Lewis; Angelina Pack; Beatriz Ospino-Sanchez; Ivy Greene; Gabriela de la Vega; Alysha J Taxter; Sally G Eagleton; Kimberly G Montez

doi:10.1017/cts.2024.488

WIC staff and healthcare professional perceptions of an EHR intervention to facilitate referrals to and improve communication and coordination with WIC: A qualitative study

J Clin Transl Sci. 2024 Feb 26;8(1):e47. doi: 10.1017/cts.2024.488. eCollection 2024.

Authors

Affiliations

¹ Section on General Academic Pediatrics, Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
² Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
³ Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
⁴ Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
⁵ Department of Implementation Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
⁶ Division of Rheumatology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.
⁷ Division of Clinical Informatics, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.
⁸ Clinical and Translational Science Institute, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Abstract

Objectives: Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has numerous benefits, yet many eligible children remain unenrolled. This qualitative study sought to explore perceptions of a novel electronic health record (EHR) intervention to facilitate referrals to WIC and improve communication/coordination between WIC staff and healthcare professionals.

Methods: WIC staff in three counties were provided EHR access and recruited to participate. An automated, EHR-embedded WIC participation screening and referral tool was implemented within 8 healthcare clinics; healthcare professionals within these clinics were eligible to participate. The interview guide was developed using the Consolidated Framework for Implementation Research to elicit perceptions of this novel EHR-based intervention. Semi-structured interviews were conducted via telephone. Interviews were recorded, transcribed, coded, and analyzed using thematic analysis.

Results: Twenty semi-structured interviews were conducted with eight WIC staff, seven pediatricians, four medical assistants, and one registered nurse. Most participants self-identified as female (95%) and White (55%). We identified four primary themes: (1) healthcare professionals had a positive view of WIC but communication and coordination between WIC and healthcare professionals was limited prior to WIC having EHR access; (2) healthcare professionals favored WIC screening using the EHR but workflow challenges existed; (3) EHR connections between WIC and the healthcare system can streamline referrals to and enrollment in WIC; and (4) WIC staff and healthcare professionals recommended that WIC have EHR access.

Conclusions: A novel EHR-based intervention has potential to facilitate healthcare referrals to WIC and improve communication/coordination between WIC and healthcare systems.

Keywords: Electronic health record; WIC; food insecurity; pediatrics; primary care.