On Monday, the American Academy of Pediatrics presented its "Updated Clinical Report on Health Care Transitions for Youth and Young Adults," which will be published in the November issue of "Pediatrics."

The National Survey for Children's Health found that only 15 percent of youth received transition planning from their health care providers.

In my house where in less than three months, my son will become an adult, we've started talking to him about his health care, especially what things he needs to stay health, and we're talking to his doctors, but we're having to initiate the conversation. It's part of the growing up, right?

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This transition, especially when it comes to mental health, is something that researchers at Dell Medical School at the University of Texas have been working on through a grant from the Michael and Susan Dell Foundation.

Dr. Stephen Strakowski, psychiatry chair at the medical school, told us in April, this age group is a key age group because it is when many symptoms for depression, schizophrenia and bipolar disorder begin to show. As well, it’s an age in which people are trying to find their independence. In this age range, he says, “60 to 80 percent drop out of care.”

It's also something the Livestrong Cancer Institutes at UT have been working on when it recognizes that adolescent and young adults with cancer need a separate space for care.

The researchers in the update report were looking at whether teens and their doctors were doing these three things:


Youth had time alone to speak with the doctor or other health care clinician during his or her last preventive visit.
The doctor or other health care clinician worked with youth to gain self-care skills or understand the changes in health care that happen at 18 years of age.
The doctor or other health care clinician talked with youth about eventually seeing doctors who treat adults.

One of the biggest barriers to adolescents beginning to do the "adulting" when it came to health care was a reluctance to leave their pediatric doctors.

On the health providers' front, the researchers found a lack of communication between pediatric and adult providers when it came to that transition.

They recommended health care providers and systems do these things:


Integrate health care transition into routine preventive, primary, specialty and subspecialty, and mental and/or behavioral health care.
Work directly with their electronic health record support team and/or vendor representative to integrate the six elements: transition policy, registry, readiness and self-care assessments, transition plan of care, medical summary, transition and/or transfer checklists, and feedback surveys.
Incorporate health care transition support as a recommended element in all medical home and health home recognition and certification programs.
Articulate specific health care transition roles and responsibilities among pediatric and adult health care clinicians and systems to facilitate the provision and coordination of recommended transition support.
Increase the availability and quality of care coordination support, particularly for adult practices and systems serving young adults with chronic medical, developmental, and behavioral conditions and social complexity.
Integrate health care transition support into other life course systems such as changes in education, guardianship, and power of attorney as needed.
Expand the availability of pediatric consultation for adult clinicians caring for youth with pediatric-onset conditions.
Incorporate health care transition into the transition policies and plans of other public program systems (eg, special education, foster care).
Create up-to-date listings of community resources (eg., adult disability programs) and adult clinicians interested in caring for young adults with pediatric-onset conditions and other special populations.
Increase education and training opportunities for pediatric and adult health care clinicians in health care transition, youth and young adult development, pediatric-onset diseases, interprofessional practice, and team-based care.
Compensate clinicians and systems of care for the provision of recommended health care transition support related to planning, transfer, and integration into a new adult practice. This included creating new payment codes to pay teams for this work.
Do more research about health care transition processes and outcomes.