Using Health IT to Support Children’s Health: Lessons Learned from the Beacon Communities

Dr. Barbara Yawn | January 21, 2014

When the Beacon Program began in 2010, ONC asked that each of us take steps to align our health IT investments with the top population health priorities for our community. Along with several other Beacon Communities, we in Southeast Minnesota selected children’s health, with a clinical focus on pediatric asthma. 

We knew that health IT offers innovative ways to address the unique challenges associated with improving children’s health that would help with information sharing between parents, schools, medical, wellness and social service providers, so we developed a program that used health IT to help with that sharing.  Now, as health IT tools addressing the needs of children continue to evolve, we are hopeful that our work and the work of our fellow Beacons serve as a source of inspiration and insight for other families and care providers across the country.

Our efforts in the asthma effort, and those of some of the other Beacons, are highlighted in a new issue brief by AcademyHealth titled “Spotlight on Kids: Beacon Community Efforts to Improve Pediatric Prevention, Care, and Outcomes.” This issue brief emphasizes the importance of communities working together to develop solutions for sharing and using health data to improve health care and outcomes for children.

Comprehensive care coordination and management of children who have asthma relies upon connections not only between the health care system and parents and/or caregivers, but also with schools. Through the electronic exchange of health data, communication can be improved, timely care facilitated, and the burden of children’s asthma management for schools, parents and health care systems can be reduced.

Our Beacon is one of the ONC Beacon Communities featured in the brief – we focused our efforts on the exchange of health information between the health system and school nurses. Through discussions with community and provider focus groups, we found that school nurses and health systems in our community both suffered in their ability to treat students from a lack of direct communication with one another regarding children’s asthma symptoms, even in the face of recurrent exacerbations. Due to the absence of a system for capturing parental permission to share health information, school nurses often had to spend time calling parents before treating a child with an exacerbation.

Our Approach

To address these challenges, we focused our efforts on promoting the development of Asthma Action Plans (AAPs), customized plans that describe how to control a child’s asthma and handle worsening asthma symptoms. At the same time, a team of community physicians, nurses, school nurses, public health experts, asthma experts, IT experts and a project manager worked together to develop standardized language for the AAP across health care systems, develop methods to obtain parental permission to share the AAP with schools, and develop a relatively inexpensive electronic transfer system that could be sustained with community resources.

We used a portion of our Beacon funding to develop a secure, locally hosted portal to provide the needed infrastructure, enabling storage of parental consent, electronic delivery of the AAP from the health system to the school, and communication and messaging between the two parties. It also incorporates a tool that school nurses can use to notify the child’s physician or nurse about asthma related problems, also sending a copy of the report to the child’s parent or guardian. The format and language of the AAP is standardized wherever possible.

Since this solution was implemented, we have been pleased to see a strong increase in the number of AAPs available to school nurses. In addition, participating health care systems have agreed to financially support this work (including a potential expansion) for at least the next five years, and the system is expanding to incorporate anaphylaxis action plans and possibly other action plans for other chronic conditions in school children.

Like the other Beacon Communities highlighted in this brief, we are proud to have developed innovative health IT-enabled strategies, partnerships, and tools to improve care quality and outcomes for children. By engaging parents, school nurses, and public health officials in using tools such as portals, admission-discharge-transfer (ADT) alerts, text message immunization reminders, and custom electronic health record (EHR) modules, we have collectively made strides toward improving care quality and addressing unique needs of promoting children’s health and wellness.