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

Appl Clin Inform. 2022 Aug;13(4):803-810. doi: 10.1055/a-1905-3729. Epub 2022 Jul 20.

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 (p <0.01). Inpatient hospitalizations decreased by 44% from 176 before access to 99 after access (p <0.001). The incident rate of ED visits decreased (IRR: 0.66; 95% CI: 0.53-0.83; p = 0.00035), and hospitalizations decreased (IRR: 0.56; 95% CI: 0.44-0.72; p <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.

MeSH terms

  • Child
  • Chronic Disease
  • Electronic Health Records
  • Emergency Service, Hospital
  • Health Information Exchange*
  • Hospitalization
  • Humans
  • Outcome Assessment, Health Care
  • Retrospective Studies