Point of Care Testing Improves Lead Screening Rates at 1 and 2 Year Well Visits.

Objective To increase blood lead level screening rates in children at 12 and 24 month well visits through provider education and the implementation of a point of care (POC) lead screening program in four primary care practice offices located in and neighbored by counties with ≥5% prevalence of blood lead levels ≥5 μg/dL. Study design Baseline data were collected 7/2017-6/2018. All providers received education on screening recommendations and local prevalence of elevated blood lead levels in 7/2018. POC testing began 6/2019 at one of the four practice sites. Screening rates were measured by electronic medical record abstraction. Rates were plotted monthly on statistical process control charts during implementation and analyzed using logistic regression under an interrupted time series approach for program evaluation. Results There was a small but significant increase in screening following provider education (odds ratio [OR] 1.04 per month, 95% confidence interval [CI] 1.02-1.07). POC testing was associated with a substantial immediate increase (OR 4.17, 95% CI 2.45-7.09) and a substantial continued increase (OR 1.34 per month, 95% CI 1.17-1.54) in screening at the site that implemented POC. Conclusion POC testing substantially increases blood lead level screening rates at 12 and 24 month well visits and may be beneficial in other primary care settings.