Facilitating Health Information Exchange to Improve Health Outcomes for School-Aged Children: School Nurse Electronic Health Record Access

Overview

Journal Appl Clin Inform

Publisher Thieme

Specialties Health Services
Medical Informatics

Date 2022 Jul 20

PMID 35858639

Authors

Christina Baker

Figaro Loresto Jr

Kaci Pickett

Sadaf Sara Samay

Bonnie Gance-Cleveland

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: School-aged children with chronic conditions require care coordination for health needs at school. Access to the student's accurate, real-time medical information is essential for school nurses to maximize their care of students. We aim to analyze school nurse access to medical records in a hospital-based electronic health record (EHR) and the effect on patient outcomes. We hypothesized that EHR access would decrease emergency department (ED) visits and inpatient hospitalizations.

Methods: This retrospective secondary data analysis was conducted using EHR data 6 months pre- and post-school nurse access to students' hospital-based EHR. The main outcome measures were the ED visits and inpatient hospitalizations.

Results: For the sample of 336 students in the study, there was a 34% decrease in ED visits from 190 visits before access to 126 ED visits after access ( <0.01). Inpatient hospitalizations decreased by 44% from 176 before access to 99 after access ( <0.001). The incident rate of ED visits decreased (IRR: 0.66; 95% CI: 0.53-0.83; = 0.00035), and hospitalizations decreased (IRR: 0.56; 95% CI: 0.44-0.72; <0.0001) from pre to post access. These findings suggest school nurse access to medical records is a positive factor in improving school-aged patient outcomes.

Conclusion: School nurse access to medical records through the hospital-based EHR may be a factor to improve patient outcomes by utilizing health information technology for more efficient and effective communication and care coordination for school-aged children with chronic medical conditions.

Citing Articles

Findings from the 2023 Yearbook Section on Health Information Exchange.

Bloomrosen M, Berner E Yearb Med Inform. 2023; 32(1):195-200.

PMID: 38147861 PMC: 10751133. DOI: 10.1055/s-0043-1768755.

An mHealth Design to Promote Medication Safety in Children with Medical Complexity.

Jolliff A, Coller R, Kearney H, Warner G, Feinstein J, Chui M Appl Clin Inform. 2023; 15(1):45-54.

PMID: 37989249 PMC: 10794091. DOI: 10.1055/a-2214-8000.

Usability Evaluation of a Community Pharmacy Health Information Exchange Interface Prototype.

Hettinger K, Snyder M, Adeoye-Olatunde O, Russ-Jara A Appl Clin Inform. 2023; 14(4):811-821.

PMID: 37527792 PMC: 10567139. DOI: 10.1055/a-2145-6980.

School Nurse Perspectives on Collaboration With Primary Care Providers.

Goldberg L, Rankine J, Devlin B, Miller E, Ray K J Sch Health. 2023; 93(8):717-725.

PMID: 36917956 PMC: 10329996. DOI: 10.1111/josh.13325.

References

Snieder H, Nickels S, Gleason M, McFarlane A, Szefler S, Allison M . Stakeholder Perspectives on Optimizing Communication in a School-Centered Asthma Program. J Sch Health. 2017; 87(12):941-948. DOI: 10.1111/josh.12565. View

Hanson T, Aleman M, Hart L, Yawn B . Increasing availability to and ascertaining value of asthma action plans in schools through use of technology and community collaboration. J Sch Health. 2013; 83(12):915-20. DOI: 10.1111/josh.12110. View

Halterman J, Tajon R, Tremblay P, Fagnano M, Butz A, Perry T . Development of School-Based Asthma Management Programs in Rochester, New York: Presented in Honor of Dr Robert Haggerty. Acad Pediatr. 2017; 17(6):595-599. PMC: 5599804. DOI: 10.1016/j.acap.2017.04.008. View

ODonnell H, Suresh S . Electronic Documentation in Pediatrics: The Rationale and Functionality Requirements. Pediatrics. 2020; 146(1). DOI: 10.1542/peds.2020-1684. View

Stein R, Bauman L, Westbrook L, Coupey S, Ireys H . Framework for identifying children who have chronic conditions: the case for a new definition. J Pediatr. 1993; 122(3):342-7. DOI: 10.1016/s0022-3476(05)83414-6. View

Baker C, Gance-Cleveland B . Linking School Nurses With Health Care Systems Using EHRs: An Integrative Review. J Sch Nurs. 2020; 37(1):28-40. DOI: 10.1177/1059840520913323. View

Lemanske Jr R, Kakumanu S, Shanovich K, Antos N, Cloutier M, Mazyck D . Creation and implementation of SAMPRO™: A school-based asthma management program. J Allergy Clin Immunol. 2016; 138(3):711-723. PMC: 5085063. DOI: 10.1016/j.jaci.2016.06.015. View

. Role of the School Nurse in Providing School Health Services. Pediatrics. 2016; 137(6). DOI: 10.1542/peds.2016-0852. View

Rattler T, Walder A, Feng H, Raphael J . Care Coordination for Children With Sickle Cell Disease: A Longitudinal Study of Parent Perspectives and Acute Care Utilization. Am J Prev Med. 2016; 51(1 Suppl 1):S55-61. PMC: 4916339. DOI: 10.1016/j.amepre.2016.01.023. View

10.

Berger C, Valenzuela J, Tsikis J, Fletcher C . School Professionals' Knowledge and Beliefs About Youth With Chronic Illness. J Sch Health. 2018; 88(8):615-623. DOI: 10.1111/josh.12646. View

11.

Yaghoubi M, Adibi A, Safari A, FitzGerald J, Sadatsafavi M . The Projected Economic and Health Burden of Uncontrolled Asthma in the United States. Am J Respir Crit Care Med. 2019; 200(9):1102-1112. PMC: 6888652. DOI: 10.1164/rccm.201901-0016OC. View

12.

Reeves K, Taylor Y, Tapp H, Ludden T, Shade L, Burton B . Evaluation of a Pilot Asthma Care Program for Electronic Communication between School Health and a Healthcare System's Electronic Medical Record. Appl Clin Inform. 2016; 7(4):969-982. PMC: 5228138. DOI: 10.4338/ACI-2016-02-RA-0022. View

13.

OMalley A, Grossman J, Cohen G, Kemper N, Pham H . Are electronic medical records helpful for care coordination? Experiences of physician practices. J Gen Intern Med. 2009; 25(3):177-85. PMC: 2839331. DOI: 10.1007/s11606-009-1195-2. View

14.

Bourgeois F, Monuteaux M, Stack A, Neuman M . Variation in emergency department admission rates in US children's hospitals. Pediatrics. 2014; 134(3):539-45. PMC: 4144003. DOI: 10.1542/peds.2014-1278. View

15.

Lozano P, Houtrow A . Supporting Self-Management in Children and Adolescents With Complex Chronic Conditions. Pediatrics. 2018; 141(Suppl 3):S233-S241. DOI: 10.1542/peds.2017-1284H. View

16.

Volerman A, Dennin M, Vela M, Ignoffo S, Press V . A qualitative study of parent perspectives on barriers, facilitators and expectations for school asthma care among urban, African-American children. J Asthma. 2018; 56(10):1099-1109. PMC: 6447461. DOI: 10.1080/02770903.2018.1520861. View

17.

Rudin R, Friedberg M, Shekelle P, Shah N, Bates D . Getting Value From Electronic Health Records: Research Needed to Improve Practice. Ann Intern Med. 2020; 172(11 Suppl):S130-S136. DOI: 10.7326/M19-0878. View

18.

Antonelli R, Stille C, Antonelli D . Care coordination for children and youth with special health care needs: a descriptive, multisite study of activities, personnel costs, and outcomes. Pediatrics. 2008; 122(1):e209-16. DOI: 10.1542/peds.2007-2254. View

19.

Elliott P, DeJong W, Feinberg E . Navigating Privacy Laws to Deliver STI Health Services in High Schools. Pediatrics. 2020; 145(3). DOI: 10.1542/peds.2019-0712. View

20.

Nurmagambetov T, Khavjou O, Murphy L, Orenstein D . State-level medical and absenteeism cost of asthma in the United States. J Asthma. 2016; 54(4):357-370. DOI: 10.1080/02770903.2016.1218013. View