Curbside Consult with Dr. Jayne 1/27/25

Several people have reached out this week to try to schedule meetings with me at ViVE, which is coming up next month in Nashville. As much as I would like a good excuse to visit a city that can be a lot of fun, I just couldn’t justify the expense of another conference, especially given how close it is to HIMSS.

Registration for ViVE is over $2,000, which is a substantial sum when you’re paying for it out of your own pocket. I’ve attended in the past as a boutique consultant, and once I factored in travel and other costs, the return on investment just wasn’t there.

When I’ve written about the expense of going to conferences in the past, I’ve been asked why I don’t just get a media pass and go for free. It’s tricky to do that when you’re an anonymous blogger, since conferences undoubtedly want your real name. I managed to get CES to approve my application to attend virtually under the Jayne HIStalk, MD identity the year they had a virtual show. That made sense because people couldn’t see me as I listened to pitches and presentations. I can’t exactly walk around with a name badge that says “Dr. Jayne” without a lot of questions.

As for HIMSS, it’s still a place where I can accomplish a lot of meetings and gather the information that I need to help my clients, in an atmosphere with less hype. I’ve grown accustomed to the predictability of the large convention hall atmosphere and don’t need a lot of flashing lights or bold visual displays pulling my attention from the work at hand.

Exhibitors tend to send larger teams to HIMSS compared to other shows, so it’s easier to connect with resources when you find a new vendor that you want to explore. My past experiences at ViVE and HLTH have been that the person I need to talk to isn’t at the show, although I understand that I’m a small sample size and that experience might not be typical.

I got my first HIMSS party invite this weekend, which always makes me smile. I’ve already got my dancing shoes ready for the occasion, which puts me ahead of where I usually am with planning efforts.

I’ve done a fair amount of consulting work in non-traditional areas, so I wasn’t surprised when an organization contacted me to help with a project to migrate school health records from one system to another. I’m not new to technology in the school health setting or to record conversions.

If you haven’t been in school or haven’t had children in school in the last decade, you might not be aware that schools have been embracing healthcare IT. Initially, the uptake I saw was mostly around digital health histories and immunization records, which certainly made it easier for school health officials to identify students who might not be in compliance with state laws or district policies. Electronic systems were also used to track the forms that parents submitted to allow their children to self-administer medications such as asthma inhalers and allergy rescue injections. These are pretty straightforward uses of technology and wouldn’t make most people think twice.

As schools began to have more medically complex students wo attend full time (as opposed to being in a specialized school setting), I started to see districts invest in systems that supported medication administration documentation, not unlike those that are used in hospitals. I also saw inventory tracking systems and triage systems come into play.

Even before the arrival of COVID, school districts were starting to use technology to deal with the inability to staff a nurse into every school due to budgetary constraints. In situations where schools don’t staff a nurse, many of those nursing tasks fall to school secretaries, teacher aides, or other administrative staffers. If a nurse was shared between buildings, those resources could host a video conference while evaluating an ill or injured student.

Around the same time, we also started to see hospitals and health systems partner with school districts to deliver health services in the schools in an attempt to close gaps in care and reduce preventable visits to the emergency department. These school-based clinics often involved rotating nurse practitioners who would evaluate and treat patients in consultation with a hospital-based physician, using shared electronic health records hosted by the health system. Funding for these programs was often tenuous, however. As true telehealth rose to prominence, we started to see hospitals and health systems pull back on those in-person clinics and opt instead for virtual care, which could be delivered in a less costly way.

As I was putting together my proposal for the records conversion, I decided to see what was out there in the literature regarding school health. It was a timely search since there was a great article posted this week in JAMA Health Forum. It’s a good reference to learn about the history of the school nurse role and how much it has changed. The authors talk about health and hygiene efforts in the early 1900s and the evolution to where we are today.

I think most people consider issues like vaccines, injuries, illness, and preventive screenings as the purview of the school nurse. Unless they have personal exposure to other health needs in the school setting, they might not consider other responsibilities, such as assisting students with insulin pumps or with tube feedings. The number of students who are taking medications at school is much higher than 40 years ago, and people who don’t work regularly with young people are often surprised to learn how many people under age 18 are taking at least one daily medication.

School nurses are also more involved in behavioral and mental health interventions than in previous decades. In some areas, they serve as the only healthcare professionals who might interact with a child. I’m excited to see schools and communities that realize the value of school nurses as key members of the healthcare team, especially those who are willing to use data captured in the schools to better inform community health decisions.

Even though this project is primarily a records conversion, I’m excited to potentially become a resource for future projects involving health data in the schools. It’s much easier to craft a proposal around an area of informatics where I’m passionate, so here’s to hoping I ultimate win the contract.

What are your thoughts about the role of informatics in the schools? Have you worked on a school-based health project? Leave a comment or email me.

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