Elementary School Nurses: Monitoring Health via Electronic Health Records

1. Elementary School Nurses: Monitoring Health via Electronic Health Records Walden University Carrie Vanzant February 7, 2010

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

3. Current Challenges • Time Spent Monitoring Chronic Disease • Asthma • Diabetes • Communication of Health Data • Receiving Data • Sending Data • Readily Available Access

4. 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)

5. 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

6. 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

7. 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)

8. 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.

9. 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

10. 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

11. 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

12. Benefits and Usage: Significance on Healthcare School Nurse Family / Healthcare Provider Save Time Improve communication Efficiency of care Collaborative effort Accuracy of information Longevity perspective Holistic perspective Treatment plan decisions • Save time • Improve communication • Decision support information • Collaborative effort • Increase health management • Accuracy of information • Longevity perspective • Holistic perception

13. 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

14. Benefits and Usage: Chronic Management Diabetes Diabetes Management • Expected Outcomes disease management negative experiences educational focus knowledge of disease Bridging the gap

15. Benefits and Usage: Chronic Management Asthma Asthma Management • Outcomes disease management episodes or attacks disease awareness

16. 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

17. Thank you Questions and Answers

18. 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.