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Poster Session 3

Category: Digital Health Technologies (DHT)

Poster Session 3

(802) Improving Perinatal Depression Screening Adherence via EMR Integration: A Phased Health System Implementation Study

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Presenting Author(s)

HV

Hari C. Vedantam, BS (she/her/hers)

MPH Candidate
Johns Hopkins University Bloomberg School of Public Health
Baltimore, Maryland, United States

Coauthor(s)

MD

Melanie Danso, BS

Medical Student
Johns Hopkins University School of Medicine
Johns Hopkins University School of Medicine, Maryland, United States
KB

Kim Brooks, RN

Nurse Manager of Maternal-Fetal Medicine Clinic
Johns Hopkins University
Johns Hopkins Hospital, Maryland, United States
JS

Jason Straub

Senior Programmer and Analyst
Johns Hopkins Hospital
Johns Hopkins Hospital, Maryland, United States
JS

Jamie Swietlikowski, CNM, DNP

Mental Health Midwife
John Hopkins Hospital
Johns Hopkins Hospital, Maryland, United States
CE

Cybill Esguerra, MD

Assistant Professor
Johns Hopkins University
Johns Hopkins University, Maryland, United States

Submitting Author(s)

Marika Toscano, MD

Assistant Professor
Johns Hopkins University
Baltimore, Maryland, United States

Objective:
To enhance perinatal depression screening adherence by implementing a systematic, EMR-integrated Edinburgh Postnatal Depression Scale (EPDS) workflow across outpatient prenatal clinics in a large health system.

Study Design:
This quality improvement initiative was phased through 12 outpatient prenatal clinics in one health system from 7/2023-7/2025, divided into a pilot clinic (Cohort 1), four intermediate clinics (Cohort 2), and seven final clinics (Cohort 3). EPDS screening in English and Spanish was embedded into the EMR via patient portal check-in before visits at three time points: initial prenatal, 26–30 weeks’ gestation, and postpartum. The primary outcome was EPDS screening adherence during two follow-up periods—0–6 months and 7–12 months post-implementation. A mixed-effects logistic regression model with random intercepts for clinic sites and time periods nested within cohorts accounted for data hierarchy and clustering. Analyses were conducted in R.

Results:
Among 9,614 patients (Cohort 1 n=2,438; Cohort 2 n=2,848; Cohort 3 n=4,328), antepartum EPDS screening was strongly associated with higher adherence odds (aOR 11.9, 95% CI 8.8–16.2, p< 0.001). Compared to Cohort 1, patients in Cohort 3 had lower odds of adherence (aOR 0.26, 95% CI 0.14–0.48, p< 0.001), suggesting less sustained effect with phased implementation. Racial disparities persisted: Black (aOR 0.56, 95% CI 0.45–0.70, p< 0.001) and Other race (aOR 0.47, 95% CI 0.37–0.59, p< 0.001) groups had reduced adherence compared to White patients. Payor type, Hispanic ethnicity, and Asian race were not significantly associated.

Conclusion:
The phased intervention improved antepartum screening adherence; however, sustained postpartum improvements were not observed. Persistent racial disparities highlight the need for targeted efforts to promote equity and address postpartum screening barriers, to sustain gains and improve perinatal mental health outcomes.