Summary
Objective Asthma is a common childhood chronic lung disease affecting greater than 10% of children
in the United States. School nurses are in a unique position to close gaps in care.
Indeed, effective asthma management is more likely to result when providers, family,
and schools work together to optimize the patient’s treatment plan. Currently, effective
communication between schools and healthcare systems through electronic medical record
(EMR) systems remains a challenge. The goal of this feasibility pilot was to link
the school-based care team with primary care providers in the healthcare system network
via electronic communication through the EMR, on behalf of pediatric asthma patients
who had been hospitalized for an asthma exacerbation. The implementation process and
the potential impact of the communication with providers on the reoccurrence of asthma
exacerbations with the linked patients were evaluated.
Methods By engaging stakeholders from the school system and the healthcare system, we were
able to collaboratively design a communication process and implement a pilot which
demonstrated the feasibility of electronic communication between school nurses and
primary care providers. Outcomes data was collected from the electronic medical record
to examine the frequency of asthma exacerbations among patients with a message from
their school nurse. The percent of exacerbations in the 12 months before and after
electronic communication was compared using McNemar’s test.
ResultsThe pilot system successfully established communication between the school nurse and
primary care provider for 33 students who had been hospitalized for asthma and a decrease
in hospital admissions was observed with students whose school nurse communicated
through the EMR with the primary care provider.
Conclusions Findings suggest a collaborative model of care that is enhanced through electronic
communication via the EMR could positively impact the health of children with asthma
or other chronic illnesses.
Citation: Reeves KW, Taylor Y, Tapp H, Ludden T, Shade LE, Burton B, Courtlandt C, Dulin M.
Evaluation of a pilotasthma care program for electronic communication between school
health and a healthcare system’s electronic medicalrecord.
Keywords
Childhood asthma - electronic health records and systems - messaging - provider-provider
communication - school health
