Electronic Health Records

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School health information exchange off to slow start in PA

By Jennifer Bresnick

A comprehensive health information exchange (HIE) network for students in Pennsylvania’s Lehigh Valley, intended to provide a complete EHR for children connected to local hospitals, primary care providers, and school district health centers, has had some trouble getting off the ground.  The “virtual health village” project has run into privacy snags and low enrollment in the opt-in program, currently reaching only 12.5% of its intended 32,000 student audience.

The Children’s Care Alliance, a partnership that includes the Allentown and Bethlehem Area school districts as well as a number of prominent health systems, received $850,000 in grants from the Harry C. Trexler Trust and Kresge Foundation to start up the network, reports The Morning Call, and began work in 2011.

But the program has seen disappointing participation due, in part, to HIPAA and Family Educational Rights and Privacy Act (FERPA) regulations that restrict the sharing of data and make some parents nervous about who will see their children’s data.  While it was originally envisioned as an opt-out program, organizers soon switched to the opt-in model favored by many state HIEs for their patients, reducing privacy concerns but creating a struggle to get parents to agree to take part in the network.

“We’re just having difficulties getting the authorizations signed,” said Harry Lukens, chief information officer at Lehigh Valley Health Network.  “It’s going slower than we thought.  I thought we’d be halfway there, and we’re not even close to that.”

Schools are relatively new members of the HIE community – so new that Lukens couldn’t find any examples of connected school districts when he reached out to HIE organizations for tips.  While some students use the school’s nurse for first-line primary care, coordination with other providers is severely lacking.  In Delaware, Nemours Children’s Health System is also pioneering connectivity with school nurses, writes Donna Mazyck, Executive Director of the National Association of School Nurses on Health IT Buzz, using hospital alerts to help school-based providers meet the needs of pediatric patients where they spend most of their day.

“School nurses provide care coordination for students by linking primary health-care providers, specialists, support services, and families,” Mazyck says. “School nurses practice with education and health professionals to meet student health needs.  When students transition from hospital to home and school and from dependent to independent management of their chronic disease, school nurses lead the way in coordination so that gaps in care are identified and filled.”

But success in Pennsylvania will depend on getting parents to understand the benefits of HIE and robust care coordination for their children.  School district officials hope to use the participating hospitals’ marketing savvy to introduce the idea to more parents at school functions, added Bethlehem Superintendent Joseph Roy.  “The hospitals have expertise in marketing,” he said. “My hope was that we could harness some of their expertise in getting the word out.”

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