Reply to Care manager at children’s shared details of child’s ER visit with school

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[quote=Anonymous][quote=Anonymous]The health care providers, the ER case managers and the school nurses, see themselves as part of the same team, both are part of managing the care - they just work in different physical locations. One who works in a location where there is easier access to follow up with the child. It isn't really any different from a follow up from the ER to see how the child is doing. There is sharing of information within a healthcare team but you can't share that outside the health care team. The school nurse can't share anything with anyone else at the school and likely all health information is in an electronic documentation system that is the same system being accessed in the ER or remotely from whereever the health care teams work.

There would be a major privacy issue if the school nurse shared any information with the school or anyone outside of the health care team. The fact she is physically located inside the school is typically about ease of access to the children - it makes no difference in terms of what information she has access to or who she can share it with. It would be the same if she was physically located in a community health center or at a hospital or anywhere else.

Healthcare legislation and policy also has implied consent built in - that anyone who needs the information within the team to provide care can access it. For example, at the ER, you don't have to give express consent to each health care provider and they can share information and read the EHR if they are providing care.

The only real potential issue here is the blanket policy. The nurse located at the school has been given the role and responsibility to assess all the files and determine who needs follow up. However if not that nurse, then another nurse would be taking on that same role of assessing files of children who came to the ER to determine if follow up is needed. Neither would have been people actively providing care in the ER. Blanket policies however can be an issue at times and they should revisit the roles and responsibilities of each on the team.[/quote]

Disagree. The school nurse is not in every instance a “member of the care team.” There absolutely is no implied consent that every medical/psychiatric visit my child makes results in implied consent to share the health record with the school. And once it goes to the school is is covered by FERPA not HIPAA, which means that some random school nurse could decide that my child’s medical records could be shared with teachers without my consent.

The Children’s ER is outsourcing its followup to the school nurses who are working for the school. Not OK. [/quote]

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