Elementary School Nurses: Monitoring Health via Electronic Health Records

Walden University

Carrie Vanzant

February 7, 2010

Objectives

• Current Challenges • Need / Solution• What is an Electronic Health Record (EHR) • What are the EHR Benefits and Usage • Next Steps

Current Challenges

• Time Spent Monitoring Chronic Disease

– Asthma

– Diabetes

• Communication of Health Data

– Receiving Data

– Sending Data

• Readily Available Access

Current Challenges: Chronic Disease Time Management

• Asthma = 1/3 of Nurse Time

– What is it• Chronic respiratory disease

most common in children. (CDC, 2009)

– Prevalence• In 2007 Nationwide 7.7%

diagnosed in US with 10M being children ages 0-17

(EPA, 2009)

– Influences• Asthma triggers: Tobacco

smoke, Dust mites, Outdoor air pollution, Pet dander, Mold, Pollen,

(CDC, 2009)

• Diabetes = 1/3 of Nurse Time

– What is it• Type 1: Diet management• Type 2: Insulin dependent

(CDC, 2009)

– Prevalence• More than 13,000 cases in

children diagnosed each year.

(CDC, 2009)

– Influences• Complications: Heart disease,

High blood pressure, Blindness, Kidney disease.

(ADA, 2010)

Current Challenges: Communication

• Receiving Health Data– Immunization updates

– Medication• Administration information

– Allergies

– Provider treatment plan• Diets

• Activity Monitoring

• Physical Needs

• Behavioral Therapy

• Sending Health Data– Free Programs

• i.e. Mobile dental van

– School Care Knowledge• Delayed or inaccurate

– Treatment Plan Results• Diets

• Activity Monitoring

• Physical Needs

• Behavioral Therapy

Current Challenges: Readily Available Access

School

Nurse office manages all health data information in the child’s health record manual file

Family

Collects paper information from various healthcare entities (i.e. ER, doctor visit), articles of research, combined with bills and lab/x-ray results

Doctor

Information is collected in either an electronic or paper chart and stored at the facility

Need / Solution

Save Time, Increase Communication and have Readily Available Access

EHR can help:– Single storage place for

all data – Create emergency plan– Improve communication– Privilege access control– Data accuracy enabled

(i.e. auto upload)– Preventative alerts

and more

(EPA, 2009)

What is an E.H.R.

Electronic Health Record vs. Electronic Medical Record

EHR and EMR differentiation

EHR: Person centric all encompassing

EMR: Healthcare (i.e. clinic) focused application

An EHR allows one to capture and organize tests, results, prescriptions, treatment plans, etc across medical, dental, behavioral health, allergist, pediatrician, compiling all personal defined important data in one area.

Information within an EHR

What influences health? The Electronic Health Record

• Medical diagnosis

• Genetic make-up

• Clinical procedures

• Mental/Physical stresses

• Socioeconomic influences

• Education

• Native language

• Etc, etc, etc

EHR Benefits and Usage

• Early detection of potential

– mental/behavioral needs

– dental needs

– vision needs

– medical needs

• Chronic care management

– (e.g. weight, activity, food intake, etc)

• Bridge communication gap

– Family

– Provider

Benefits and Usage: School Nurse

• Track student’s health longitudinally

• Know who diagnosed the student with what, when

• Have data at your fingertips

– Child’s last immunization information

– Child’s medication list

– Child’s allergies and triggers

– Child’s recent laboratory results

– Child’s treatment plan

• Keep track of all of the child’s caregivers contact information

• Communicate with the provider and parent via EHR

Benefits and Usage: Significance on Healthcare

School Nurse

• Save time

• Improve communication

• Decision support information

• Collaborative effort

• Increase health management

• Accuracy of information

• Longevity perspective

• Holistic perception

Family / Healthcare Provider

• Save Time

• Improve communication

• Efficiency of care

• Collaborative effort

• Accuracy of information

• Longevity perspective

• Holistic perspective

• Treatment plan decisions

Benefits and Usage: Integration and Communication

• Search qualified health databases: download relevant health information (i.e. latest research on Diabetes management)

• Auto or manually upload discrete data values from healthcare devices

• Allow access to pull from or send to other electronic healthcare devices

Benefits and Usage: Chronic Management Diabetes

Diabetes Management

• Expected Outcomes disease management

negative experiences

educational focus

knowledge of disease

Bridging the gap

Benefits and Usage: Chronic Management Asthma

Asthma Management

• Outcomes disease management

episodes or attacks

disease awareness

Next Steps

• Determine what benefits and usage best meet your needs

• Select an EHR to monitor your student population (some are free)

• Build profiles for each student (replacing current manual charts)

• Educate families on the benefits of student continuity care

– Encourage family and student usage

– Identify their needs and benefits

– Encourage the student’s provider usage

• Create and educate student specific Action Plan

• Educate and train relevant staff

Thank you

Questions and Answers

References

 American Diabetes Association.(ADA). (2010). Diabetes statistics. Retrieved from

http://www.diabetes.org/diabetes-basics/diabetes-statistics/ on January 23, 2010.

 

Centers for Disease Control and Prevention. (2008). Diabetes project. Retrieved from

http://www.cdc.gov/diabetes/projects/cda2.htm on January 23, 2010.

 

Centers for Disease Control and Prevention (CDC). (2009). Asthma: basic information. Retrieved from http://www.cdc.gov/asthma/faqs.htm on January 22, 2010.

Centers for Disease Control and Prevention (CDC). (2009). Asthma triggers. Retrieved from http://www.cdc.gov/asthma/triggers.html on February, 2 2010.

Environmental Protection Agency (EPA). (2009). Asthma action plan. Retrieved from http://www.epa.gov/asthma/pdfs/asthma_action_plan.pdf on February 5, 2010.

Environmental Protection Agency (EPA). (2009). Asthma prevalence. Retrieved from http://cfpub.epa.gov/eroe/index.cfm?fuseaction=detail.viewInd&lv=list.listByAlpha&r=201583&subtop=381 on February 6, 2010.