Successes from a Practice-Based Health Information Exchange (HIE) Integrating Schools and Health Clinics in an Urban Neighborhood

Introduction: In 2010, a health information exchange (HIE) was established to assist school-based health centers (SBHC) in an urban community to provide needed health care services. The SBHCs primarily serve uninsured/underinsured and/or newly arrived immigrant/refugee residents. The system monitors the health and well-being of those served by the SBHCs.

Methods: The HIE is an intuitive interface utilizing Microsoft Access, allowing for surveillance of visits including chief complaints, diagnoses, treatments and education offered or referrals made. In addition, geographic data of the school and student is used to identify higher than expected cases of various health outcomes. The HIE records various health screens such as vision, hearing, dental, BMI and blood pressure results for each student and generates monthly reports to the school district and other community partners. Data collected over the last 3 years was analyzed to provide an overall assessment of the health status of those served by the SBHCs.

Results: Between 2010 and 2013, there were 88,000 total visits among 12,000 visitors at the SBHCs, of which 82% were of school-age. Preliminary analysis shows the most common diagnoses were minor injuries and headaches. Of school-age children seen, 33.7% received social referrals, and 64.9% received medical referrals, of which 12.4% received dental referrals and 18% received vision-related referrals.

Conclusions: Implementing an HIE introduces the school nurse as a case manager; enhancing care and improving students’ ability to learn and thrive. HIE data can inform policy changes and create opportunities that positively impact both students and the community.