Sunday, November 07, 2010

Electronic Health Records, Electronic Special Education Records: What are the issues? (Usability, utility, user-centered design, data security, interoperability, Section 508 accessibility...)

I suppose this topic intrigues me more than most school psychologists because of my IT training.  In recent years,  I've taken a few graduate-level HCI related courses, including a course about looking at privacy and security in IT from a human-computer interaction perspective.  As a user of information systems, I understand that this is a complex issue.


I know that there are important emerging issues in the EHR field that most likely will impact student information systems and electronic special education records, but I'm not sure how this will play out.  Who will be responsible for the expenses that public school districts will incur in the future if EHR regulations and requirements are mandated for student records that include health information?   Who will be responsible for ensuring that the information systems used by public school employees follow usability, accessibility, and privacy/security standards?     


Although school districts are not typically considered to be health organizations,  they employ nurses, occupational, physical, and speech/language therapists, and psychologists.  These professionals serve students who have special needs, and some of their services are reimbursed through Medicaid.    


Like IT systems used in the health care industry,  many IT systems that handle student information were initially developed during the late 1990's, if not before, and over the years have been upgraded and tweaked to handle requirements that simply did not exist even five years ago. Data regarding students is stored in many places, for different purposes, and accessed by different people.  Some student information systems don't play well with one-another.   As more data and information is required to be stored and accessed on-line, the chances for errors and security breaches increase.


 My hunch is that "best practices" in EHR will inform future best practices in electronic student information systems, including systems designed to handle information regarding students with special needs.  This is a topic I'd like to explore further!

Below is a list of of links to a  few articles and presentations I think are important to review if you are interested in this topic:

Electronic Records Usability  (Includes recent publications on this topic, including a few articles about usability and electronic health records that can be accessed through mobile phones and related devices.)  HiMSS 
"Usability is defined as the effectiveness, efficiency and satisfaction with which specific users can achieve a specific set of tasks in a particular environment. (ISO Bulletin. 2003;34:6)."
Can best practices help develop meaningful users? (6/21/2010, Chris Brancato) pdf
Understanding the Landscape of EMR Usability (4/13/2010, Jeff Belden) pdf
Applying Usability and User-Centered Design Methodologies to Achieve Meaningful Use
Lisa Battle, Jasmin Phua & Duane Degler, Design for Context, HiMSS  Virtual Conference 6/2010)
Accessibility of Health IT  (pdf)  Addresses Section 508 applies to E & IT that is developed, used, and maintained. (Government Health IT Innovation 2010 Conference)
Health Information Technology and People with Disabilities (American Association of People with Disabilities)
Health Information Technology and HIPAA  PDF
Access Board "A Federal Agency Committed to Accessible Design" 
Education Records
National Center for Educational Statistics, National Forum on Education Statistics:
The Forum Guide to Data Ethics
The Forum Guild to Data Ethics Online Course
Crisis Data Management: A Forum Guide to Collecting and Managing Data about Displaced Students
Family Educational Rights and Privacy Act (FERPA)
Section 508 Homepage:  Electronic and Information Technology




RELATED:  For your convenience, I've copied and pasted the following related links from the National Forum on Education Statistics website:



Appendix A: Related Resources

These materials may be useful to school, district, or state education agency staff considering data ethics.
Forum Guide to Metadata: The Meaning Behind Education Data
Forum Guide to Metadata: The Meaning Behind Education DataThis document was developed to empower staff to use data more effectively as information. It explains what metadata are, why they are critical to the development of sound education data systems, what components comprise a metadata system, what value metadata bring to data management and use, and how to implement and use a metadata system in an education organization.
Every School Day Counts: The Forum Guide to Collecting and Using Attendance Data
Every School Day Counts: The Forum Guide to Collecting and Using Attendance Data
This Forum guide offers best practice suggestions on collecting and using student attendance data to improve performance. It includes a standard set of codes to make attendance data comparable across districts and states. The publication also presents real-life examples of how attendance information has been used by school districts.
Managing an Identity Crisis: Forum Guide to Implementing New Federal Race and Ethnicity Categories
Managing an Identity Crisis: Forum Guide to Implementing New Federal Race and Ethnicity Categories
This best-practice guide was developed to assist state and local education agencies in their implementation of the new federal race and ethnicity categories, thereby reducing redundant efforts within and across states, improving data comparability, and minimizing reporting burdens. It serves as a toolkit from which users may select and adopt strategies to help them quickly begin the process of implementation in their agencies.
Forum Guide to the Privacy of Student Information: A Resource for Schools
Forum Guide to the Privacy of Student Information: A nResource for SchoolsThis free publication was written to help school and local education agency staff members better understand and apply the Family Educational Rights and Privacy Act (FERPA), a federal law that protects privacy interests of parents and students in student education records. It defines terms such as "education records" and "directory information"; and offers guidance for developing appropriate privacy policies and information disclosure procedures related to military recruiting, parental rights and annual notification, videotaping, online information, media releases, surveillance cameras, and confidentiality concerns related specifically to health-related information. Much of the guidance relating to privacy policies would be of interest to organizations generating business rules about the topic.
Forum Guide to Protecting the Privacy of Student Information: State and Local Education Agencies
Forum Guide to Protecting the Privacy of Student Information: State and Local Education AgenciesThis free guide presents a general overview of privacy laws and professional practices that apply to information collected for, and maintained in, student records. The publication also provides an overview of key principles and concepts governing student privacy; summarizes federal privacy laws including recent changes; identifies issues concerning the release of information to both parents and external organizations; and suggests good data management practices for schools, districts, and state education agencies. Much of the guidance relating to privacy policies would be of interest to organizations generating business rules about the topic.
Forum Curriculum for Improving Education Data: A Resource for Local Education Agencies
Forum Curriculum for Improving Education Data: A Resource for Local Education Agencies
This curriculum supports efforts to improve the quality of education data by serving as training materials for K–12 school and district staff. It provides lesson plans, instructional handouts, and related resources, and presents concepts necessary to help schools develop a culture for improving data quality.
Forum Guide to Education Indicators
Forum Guide to Education IndicatorsThis publication provides encyclopedia-type entries for 44 commonly used education indicators. Each entry contains a definition, recommended uses, usage caveats and cautions, related policy questions, data element components, a formula, commonly reported subgroups, and display suggestions. This publication will help readers better understand how to appropriately develop, apply, and interpret commonly used education indicators.
NCES Nonfiscal Data Handbook for Early Childhood, Elementary, and Secondary Education (2007)
The NCES Handbooks are a valuable source of metadata for organizations and individuals interested in education data. These print and online resources define standard education terms for students, staff, schools, local education agencies, intermediate education agencies, and state education agencies. The Handbooks are intended to serve as a reference for public and private organizations, including education institutions and early childhood centers, as well as education researchers and other users of education data. In order to improve access to this valuable resource, NCES has also developed the NCES Handbooks Online, a webbased tool that allows users to view and download Handbook information via an electronic table of contents, a drill down finder, element name and first letter searches, and advanced query options.








1 comment:

Scart said...

I am most definately interested in your article. Over a decade ago I completed my schooling with a graduate degree in Health Care Administratoin. Somewhere along the way I ended up as a teacher of special education students.

It will be interesting to see how all of this plays out in the end; adopting EMR and the merging of school systems.