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HIT in School Settings

"It is the framework which changes with each new technology and not just the picture within the frame." —Marshall McLuhan

School nurses may spend more waking hours with children than even some parents. By virtue of this exposure, they are exquisitely positioned to assess and evaluate both acute and chronic conditions in students and either treat or refer for further care. School nurses are, in effect, care managers. At the same time, they are outside the communication loop—as fragmented as it is—among primary care providers, specialists and hospitals that may be caring for students. Limited time and resources make it difficult for the school nurse to call and follow up with parents and various providers; but that information is critical to keeping students healthy and increasing time students are in their seats rather than out of the school setting because of illness.

Dan McNeil of AFT’s Legal Department discusses HIPAA and FERPA laws.

To better coordinate communication and care management, schools are moving to the use of electronic medical records and school nurses are advocating for electronic data sharing to make certain they have the most current information. (In a 2009 membership survey done by the National Association of School Nurses, 59 percent of respondents reported the use of electronic medical records.) Use of this technology potentially expands access to who sees the information. As a result, privacy considerations are extremely important. In schools, privacy issues are covered by both Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. Understanding the privacy provisions of both of these acts is important for all school health personnel. Watch this brief video clip (at left) to understand the similarities and differences and purpose of these acts.

FERPA is a federal law that protects the privacy of students’ “education records.” (See 20 U.S.C. § 1232g; 34 CFR Part 99). FERPA applies to educational agencies and institutions that receive funds under any program administered by the U.S. Department of Education. This includes virtually all public schools and school districts and most private and public postsecondary institutions, including medical and other professional schools. If an educational agency or institution receives funds under one or more of these programs, FERPA applies to the recipient as a whole, including each of its components, such as a department within a university. See 34 CFR § 99.1(d). (Private and religious schools at the elementary and secondary level generally do not receive funds from the Department of Education and are, therefore, not subject to FERPA.)

Congress enacted HIPAA in 1996 to, among other things, improve the efficiency and effectiveness of the healthcare system through the establishment of national standards and requirements for electronic healthcare transactions and to protect the privacy and security of individually identifiable health information.

For more information on experiences of others, expert recommendations and HIT resources, see the HIT resources page.