Facilitating Access to Children's Eye Care and Vision Needs in an Urban Neighborhood Using Vision Screening Tools in a School-Based Health Information Exchange (HIE)

Introduction: A health information exchange (HIE) was established in 2010 to assist school-based health centers (SBHC) in an urban community in San Diego to provide needed health care services to their primarily uninsured/underinsured and/or newly arrived immigrant/refugee students and community members. This system assesses, monitors, and manages the unmet needs for vision care within the participating schools.

Methods: The HIE is an intuitive interface utilizing Microsoft Access, allowing for surveillance of student visits including chief complaints, diagnoses, treatments and education offered or referrals made. In addition, the SBHCs provide primary eye care, facilitate access to refractive correction, provide follow up, and track student’s reading scores and differences in academic performance before and after vision treatment. The system records various health screens, including a vision screen, for each student and generate monthly reports. Data collected from a vision screen in 2012 was analyzed to provide an assessment of the general eye health of students served by the SBHCs. Second year’s data will be available in 2014.

Results: In 2012, there were 5,044 elementary students screened at the SBHCs. Of those screened, 2,111 (42%) children were referred for secondary examinations. 914 students received secondary consultation; of which 77.4% of students required and were provided glasses. Among unique diagnoses, cases of legal blindness, eye tumors, an inordinate amount of astigmatisms, and multiple possible glaucoma’s were caught early by utilizing this HIE system. 

Conclusions: Implementing an HIE between schools and health clinics allows for more complete care and increases children’s access to eye care.