Appl Clin Inform 2022; 13(04): 803-810
DOI: 10.1055/a-1905-3729
Research Article

Facilitating Health Information Exchange to Improve Health Outcomes for School-Aged Children: School Nurse Electronic Health Record Access

Christina Baker
1   College of Nursing, University of Colorado, Aurora, Colorado, United States
Figaro Loresto Jr.
2   Department of Research, Innovation, and Professional Practice, Children's Hospital Colorado, Aurora, Colorado, United States
Kaci Pickett
3   Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, United States
4   Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, United States
Sadaf Sara Samay
5   Department of Research Informatics and Analytics, Children's Hospital Colorado, Aurora, Colorado, United States
Bonnie Gance-Cleveland
1   College of Nursing, University of Colorado, Aurora, Colorado, United States
› Author Affiliations


Background and Objectives School-aged children with chronic conditions require care coordination for health needs at school. Access to the student's accurate, real-time medical information is essential for school nurses to maximize their care of students. We aim to analyze school nurse access to medical records in a hospital-based electronic health record (EHR) and the effect on patient outcomes. We hypothesized that EHR access would decrease emergency department (ED) visits and inpatient hospitalizations.

Methods This retrospective secondary data analysis was conducted using EHR data 6 months pre- and post-school nurse access to students' hospital-based EHR. The main outcome measures were the ED visits and inpatient hospitalizations.

Results For the sample of 336 students in the study, there was a 34% decrease in ED visits from 190 visits before access to 126 ED visits after access (p <0.01). Inpatient hospitalizations decreased by 44% from 176 before access to 99 after access (p <0.001). The incident rate of ED visits decreased (IRR: 0.66; 95% CI: 0.53–0.83; p = 0.00035), and hospitalizations decreased (IRR: 0.56; 95% CI: 0.44–0.72; p <0.0001) from pre to post access. These findings suggest school nurse access to medical records is a positive factor in improving school-aged patient outcomes.

Conclusion School nurse access to medical records through the hospital-based EHR may be a factor to improve patient outcomes by utilizing health information technology for more efficient and effective communication and care coordination for school-aged children with chronic medical conditions.

Protection of Human and Animal Subjects

The Multiple Institutional Review Board of the University of Colorado (COMIRB) approved the study (protocol # 18–0264).

Publication History

Received: 18 April 2022

Accepted: 15 July 2022

Accepted Manuscript online:
20 July 2022

Article published online:
31 August 2022

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