Ease of Use Framework

The Center will focus on four domains of ease of use: universality, access, value, and affordability.The concept "ease of use" is not easily defined. It is difficult to operationalize and until recently it has not been explicitly addressed in the context of services for CSHCN. A literature review of a various databases yielded only two articles specifically focused on concepts such as "ease of use/ease of using of services for CSHCN" and "services easy to use.” Both articles utilize the definition of ease of use as outlined by the National Survey of CSHCN, a survey developed by the Maternal and Child Health Bureau (MCHB) and the National Center for Health Statistics to monitor the state of health and services of CSHCN. One purpose of the survey was to evaluate the progress of implementing and improving services for CSHCN according to the six core outcomes that comprise a comprehensive system of care as defined by MCHB.

User's satisfaction and perceived barriers can be helpful in understanding the notion of ease of use, as these factors may serve as proxy measures for the concept. Extensive literature has been written about specific barriers and sources of satisfaction for families caring for CSHCN. In many instances, these indicators point to concepts contained in the other five MCHB outcomes, suggesting that ease of use is a broader umbrella construct and several criteria have to be met for services to be perceived as easy to use.

Four key domains emerge out of the literature and form the basis for our framework. These guiding principles are descriptors of a system of care for CSHCN built on the assumption that ease of use should be defined from the family, youth, and children’s perspectives. The guiding domains are Universality, Access, Value, and Affordability.

  1. Universality of System: Engages all eligible families and children with special health care needs:
    1. Identification of families and youth eligible for services
    2. Effective outreach specifically tailored to families/CYSHCN (Children and Youth with Special Health Care Needs)
    3. Screening and referral promote utilization and access
    4. Continuous monitoring/assessment of sub-populations in need
  2. Accessibility of Services: Families and CYSHCN get the services they need
    1. Services are available to families and CYSHCN
    2. Labor/Workforce Development activities are tied to needs of families/CYSHCN
      1. Supply of providers/specialists meets population needs
      2. Competencies of providers/specialists
      3. Providers/specialists accept FCYSHCN (Families of CYSHCN) into practice
    3. Services are convenient for FCYSHCN
  3. Value of Services: Services are valued by families and CYSHCN and make measurable advances in functioning and development.
    1. Family/CYSHCN experience indicators are included in quality assessments
    2. Family and child/youth satisfaction ratings are acted upon to improve service delivery
    3. CYSHCN measures of functioning in school, home, and community are outcomes of services
    4. Services for CYSHCN are measured for improving growth and development
    5. Community based services meet the full comprehensive needs of families and CYSHCN
  4. Affordability: Services are affordable and enable families to maintain economic security
    1. Direct costs of services are reasonable
    2. Direct costs are predictable
    3. Indirect costs of services are contained (such as but not limited to?
      1. Travel costs
      2. Family time off from work
      3. Child time out of school
      4. Job attachment
      5. Time spent acquiring or waiting for services is minimal