In 2008, School Health Connection (SHC) and Louisiana Public Health Institute’s (LPHI) Information Services (IS) Division began implementing electronic health records (EHR) and practice management (PM) systems in school-based health centers (SBHCs) in Orleans and Jefferson Parishes.

EHR and PM systems have been one of the most promising administrative and operational innovations in health care delivery over the last two decades.  When fully implemented “within” a medical care organization or agency, these systems improve quality of care and simplify billing. The systems also connect to other external State and private systems such as immunization registries and prescription information, providing caregivers timely access to patient-related information at the point of care.

The LPHI initiative was funded by the Robert Wood Johnson Foundation and the W.K. Kellogg Foundation and worked toward the following goals:

• Implementation of a standard EHR practice management system for use within SBHCs
• An integrated billing system throughout SBHCs in the Greater New Orleans area
• A platform for health information collection and information exchange among SBHCs, safety-net providers, and school district personnel
• Collection of robust data that can be used for population health monitoring
• Improvement of workflow efficiency within SBHCs
• Improvement of quality of care through the inclusion of a clinical decision support system (CDSS)

Working with vendor, eClinicalWorks and site sponsors, Jefferson Parish Public School System (JPPSS), Louisiana State University School of Medicine – Dept. of Pediatrics (LSUHSC Peds), Tulane School of Medicine, and Interim LSU Public Hospital, ten SBHC sites successfully implemented EHR/PM over two years.  

In addition, to the implementation, sites needed assistance in meeting Meaningful Use requirements that the federal government now mandates. This ruling requires providers to demonstrate “Meaningful Use” of Health Information Technology in order to be eligible for enhanced Medicaid reimbursements. Therefore, it became an underlying priority to help the SBHCs meet the requirements of Meaningful Use, which will increase their reimbursements in 2011 and beyond.

“The systems implemented have made billing and reimbursement so much easier and efficient for us. It gives us more time to focus on the care of our students, which in itself is a great benefit,” Belinda Schouest, Data Coordinator, Jefferson Parish Public School System, School-Based Health Centers.

Overall the following has been accomplished through the implementation of the EHR systems:

• Ten sites within Orleans and Jefferson Parishes are meaningfully using EHRs as their primary medical record.
• Clinic staff created more than 10,500 patient records and electronically documented more than 50,000 patient visits.
• 40 doctors, nurses, and social workers who provide primary care at the 10 SBHCs use the system to record children's health status and document clinical encounters.
• JPPSS sites are well-positioned and leading the way as they attest for Meaningful Use through the EHR Incentive Program offered by the Centers for Medicaid and Medicare, for all 5 of their sites. Orleans sites will also take advantage of the Meaningful Use program.
• In JPPSS and LSUHSC Peds Orleans sites billing is now done completely electronically.

“The importance of this project is that it developed, implemented and now maintains a critical information management system that will increase revenue capabilities though efficient billing, support administrative functions and provide continuity of care for SBHCs. As a result, children’s health and safety will be better documented, while medical providers, parents and educational partners will have a systematic approach to health-related services delivery, accountability and resources,” Marsha Broussard, DrPH, Program Director, School Health Connection.

About School Health Connection

School Health Connection (SHC) is a regional collaborative effort formed after Hurricane Katrina to support the rebuilding and expansion of SBHCs in the New Orleans Metropolitan area. SHC collaborative partners include local and state government and school systems, universities, medical institutions, foundations, and community partners. In 2006, SHC received funding to support the construction of SBHCs and enhance physical and behavioral health services in public and charter schools in the four-parish area. The Louisiana Public Health Institute (LPHI) administers funds provided by the W.K. Kellogg Foundation on behalf of the SHC program and its partners. For more information about SHC and a complete list of locations, partners and medical sponsors, visit www.schoolhealthconnection.org.

About The W.K. Kellogg Foundation

The W.K. Kellogg Foundation, established in 1930, supports children, families and communities as they strengthen and create conditions that propel vulnerable children to achieve success as individuals and as contributors to the larger community and society. Grants are concentrated in the United States, Latin America and the Caribbean, and southern Africa. For further information on the foundation, please visit www.wkkf.org.

School Health Connection, an affiliated program of the Louisiana Public Health Institute

www.schoolhealthconnection.org