Insights (Essays)

Insights (Essays) April 2010

The Electronic Educational Record: Lessons from Healthcare

Neil Seeman

 

Do you get nervous before parent-teacher interviews? Apparently this is par for the course, according to a small sample size of my friends who say they never have any idea what to expect. "Is my child a demon in school?" they fret. And, they worry: "How can I afford the time to go to parent-teacher interviews, look fresh-faced for the school gala fundraiser, and then meet my client deadlines?"
 
The concern I hear the most: "Can I muster the energy and endure the grief of pointing out to my child's teacher that the grades on the report card don't at all reflect my child's actual performance?"

 

Unless your child is fortunate enough to attend a school where his or her teacher immediately alerts you when problems (behavioral or educational) surface, you will, at some point in your life, receive a body-shot on parent-teacher interview night. As Dr. Seuss might say, this is 98 and ¾ percent guaranteed.

This is one area where healthcare can teach the field of education some lessons from the trenches.

The Electronic Educational Record, or Report Card Wiki

It is fashionable in popular management books to point out that healthcare is a 'laggard industry,' a late adopter in trends like social media or client service excellence.  But there's one area in which healthcare has led many other fields (notably education), and that is in the area of electronic health records (EHRs).

Don't get me wrong: I'm not talking about widespreadimplementation of electronic health records. I'm speaking here of healthcare's leadership in documenting the strategic benefits of a shareable, living electronic record of personal data that can be used to reduce error and improve the client experience.

Whatever the problems of implementation, there is in healthcare a feverish discussion of the benefits of EHRs, and the main point of contention is why things have moved more slowly than hoped.

Let's compare this to education.

The report card of yore has gone through an evolution: now kids are told they are "progressing" or "meeting expectations" as opposed to receiving a letter grade - because grades have been deemed too conducive to competition and to secreting cortisol. You never, even as a young adult, own your report card, even at the University level. If you're headed to graduate school, you have to make a written request for an official transcript (for a fee), which gets sent (sealed) to the school of your choosing.

Students and parents never own the educational record; they are given a brief moment to skim it, and then ask a few quick questions, and hand it back - as if it were a wine menu at a fancy restaurant.

Healthcare could teach education a few lessons about the return-on-investment value of a shareable, editable, electronic educational record. Instead of a static report card, I propose a no/low cost alternative: a report cardwiki, or electronic educational record (EER). Using a wiki for EERs, such as wikispaces, teachers and students and parents could collaboratively edit a report card online - and could do so from anywhere on the Web. LikeWikipedia, each edit would remain for members of the wiki to see in perpetuity. A secure wiki would be invitation-only; you could invite (or disinvite) people into your EER, i.e., your educational 'circle of care,' which could include a grandmother or, perhaps, a trusted tennis coach or piano instructor. Certain areas of the wiki, like those dealing with disciplinary concerns, would be confidential, open to a select few. The student and parents would control access. In the case of divorced parents, there would (as with joint custody) be presumed equality of access to the EER, thus enabling non-custodial parents ongoing insight into the educational life of their child.

There would be legacy benefits for students and parents alike to the EER; you could trace your child's cognitive progression from sight words to reading phonetically to mastering the past perfect in Latin.

When transferring schools, a student could trigger wiki access for subsequent teachers. Parents (and students) could supplement, or correct, teachers' entries into the wiki-supported EER. This would reduce 'adverse events' in education, situations (like the assignment of reading or math levels) where children's self-esteem shatters because a teacher has failed to properly assess a child's capabilities.

Like healthcare, education would inevitably suffer the problem of take-up rates and incentives for teachers to participate in the EER wiki. Unless mandated, the wiki could theoretically flounder. But my instinct is that teacher take-up in EERs would create more 'teachable' students, and more engaged parents. Teachers would champion the EER. We could then thankfully say goodbye to paper report cards whose accuracy is questionable (since they try, elusively, to capture a six-month period or longer).

We could still have awkward parent-teacher nights. But parents wouldn't get as nervous beforehand, because they would know what to expect - they would have seen and co-created the EER.

Educating educators about the business reasons for EERs is a potentially lucrative business model for healthcare leaders. Healthcare experts can sell educators on the arguments and on the business case. Then it could be a race to the finish line. The EER vs. the EHR: who would you place your bets on?

About the Author(s)

Neil Seeman is a writer, and director and primary investigator of the Health Strategy Innovation Cell at Massey College in the University of Toronto.

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