Improving Access to Early On® Michigan Through a Technology & Information Intervention
Michigan’s Early On program, led by the Michigan Department of Lifelong Education, Advancement, and Potential (MiLEAP), is a statewide early intervention system that provides services for families with children from birth to age 3 who have developmental delays or are at risk of developmental delays due to a medical condition. To streamline the physician referral process and improve access to Early On, the University of Michigan Youth Policy Lab (YPL) and the Michigan Chapter of the American Academy of Pediatrics (MIAAP) partnered with large and small medical institutions across Michigan to integrate an Early On eFax referral template into the existing electronic medical system at their clinics. Between summer 2023 and summer 2025, nine clinics received trainings about Early On and successfully integrated the eFax template into their EMR systems. YPL evaluated this intervention, and found that the implementation of the eFax referral template for the Early On program had an overall positive effect on physician referrals for families with children experiencing development delays and increased physician understanding of the program.
Key findings
To measure the impact of intervention, we compared data collected in the spring and summer of 2024 from Cohort 1 clinics (who had implemented the EMR eFax template) to the same data from Cohort 2 clinics (who had not yet begun implementation). Analyzing survey responses from over 80 physicians participating in this project and administrative records submitted from participating clinics, we observed the following:
- The project had a positive impact on physicians’ self-reported frequency and methods of referring patients to Early On. The eFax intervention prompted physicians to be more proactive in discussing Early On with families during well-child visits and in directly submitting referrals.
- The project enhanced one component of physicians’ self-reported beliefs in the social validity of Early On, which refers to the acceptance, appropriateness, and effectiveness of the Early On program in supporting families and their children. Physicians were much more likely to agree that Early On is NOT too complicated for most families to understand because of the intervention.
- Despite asking physicians to include more medical and developmental information for the family in the referral form than was previously required, there is no evidence that the eFax referral system significantly increased the time needed to complete a referral to Early On.
- The project also improved physicians’ knowledge of key Early On referral features. Because of the provided trainings, physicians were significantly more likely to know that anyone, including a family friend or a neighbor, can submit a referral to Early On.
Moving forward, we recommend providing additional technical and financial support to facilitate broader eFax implementation across more pediatric clinics, especially among small practices, as well as strengthening mutual understanding and cross-sector communication between Early On and the medical community.
