Published: April 2026

ID #: 283-5026

Journal: N Engl J Med

Authors: Suarez L, Avery C, Montez K, Cholera R

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Many eligible families face barriers to WIC enrollment, including administrative challenges (such as navigating eligibility criteria) and logistical issues (such as a lack of transportation to in-person appointments and insufficient time for attending enrollment appointments). Pediatricians in academic medical systems are well positioned to promote WIC enrollment because of the frequency of their well-child visits for children younger than 5 years of age and the high proportion of Medicaid enrollees in their patient populations. Children who are WIC-eligible can be easily identified during primary care visits because patients enrolled in Medicaid automatically have adjunctive eligibility for WIC. Duke University School of Medicine and Wake Forest University School of Medicine collaborated with local WIC agencies to develop and implement two electronic health record (EHR) innovations to facilitate WIC enrollment during pediatric well-child visits: a WIC screening prompt in templates for well-child visits and an EHR referral to local WIC agencies. Across institutions, implementation of automated WIC screening and referral has facilitated enrollment in WIC for large populations of eligible but unenrolled children. This EHR-facilitated process leverages current clinical workflows that were adapted to function in collaboration with existing WIC workflows. The approach permitted critical data to be shared with WIC, reducing barriers to WIC enrollment and allowing for complete virtual enrollment. This type of clinic-community partnership offers an opportunity to reduce the gap between WIC eligibility levels and enrollment numbers, potentially improving food security and reducing inequities related to food access among young children.

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