Electronic Health Records

Since 2009, most health care providers have been moving toward the implementation of Electronic Health Records (EHR) in place of prior paper charts. This includes school-based health centers! 

EHRs are an important tool for SBHCs. They represent a first step in enabling SBHCs to participate in “health information exchanges” which will enable SBHCs to better connect the care they provide on school campuses with the care many students receive in community settings.

Some of the EHR systems used by SBHCs in California include NextGen, Epic, eClinical Works, GE Centricity, Athena and Practice Fusion. It is usually the same system used by the lead medical agency. 

EDRs are Electronic Dental Records and have also been widely implemented. 

EHRs are still less well developed for mental health services but this is a growing area as well. Many community health centers are now adapting their EHRs to reflect their behavioral health service needs and incorporating screening tools for depression, anxiety, substance use, etc.  

Pediatrics – medical services for children and teens – typically requires some additional or enhanced EHR functionalities. In addition to standard EHR functionalities, pediatric systems generally include the following:

  • Well Child Exam Templates which differ by age group.
  • Sick Visit Templates for Common Pediatric Problems e.g., injury, upper respiratory infections, STIs
  • Immunization Management supports the ability to track immunizations needed, and immunizations given, including detailed information about administration of immunizations. Most of these moduloes can be interfaced with the state Immunization registry (CAIR).
  • Growth Charts that automatically plot height, weight and other parameters. 
  • Asthma Flow Charts/Action Plans including peak flow charts.
  • Weight-Based Dose Calculators to help calculate medications dosing using patient age and weight.
  • School, Sports and Camp Forms Management utilize the data collected in templates to be printed out in formats required for various settings. 
  • Confidential Documents to designate all or part of a chart as confidential for staff viewing and parent/guardian access.
  • Consent Management to track consents needed for various types of treatment.

It is also worth noting that any patient portals need to be configured to prevent a parent or guardian from having full record access when their child turns 12, per California law. This requires some simple configuration and a clear understanding by clinicians, support staff and IT departments that support the EHR. 

View the Special Considerations/Configuration for SBHCs resource which includes some of the key clinical functions of an SBHC, the functionality in an EHR system that will support the task and a discussion of any special configuration that might be needed specifically for an SBHC.