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Case Study

Why Rock Hill Schools Uses Frontline School Health Management Instead of Their Student Information System to Maintain Health Records

Director of Nursing Sadie Kirell points to all-in-one Medicaid billing, faster documentation, robust reporting, and better care.

Rock Hill Schools Hero Image

District Background

  • Location

    Rock Hill, South Carolina

  • K-12 Enrollment


  • Campuses


    • 15 elementary schools
    • 5 middle schools
    • 3 high schools
    • 1 early childhood center
    • 1 alternative learning program
    • 1 mental health day treatment center / elementary alternative program
  • Product & Solutions

Rock Hill Schools chose Frontline School Health Management and saw the following benefits:

  • Faster documentation: Templates make it easy for nurses to document care quickly and consistently, including generating Individual Healthcare Plans (IHPs) in minutes.
  • Improved Medicaid billing: Nurses document all office visits and with the addition of the Frontline Medicaid Billing Management system, they automatically bill for eligible students, leading to greater compliance.
  • Enhanced reporting capabilities: The nursing staff can identify trends like rising illness or which classrooms send students to the nurse’s office most often, monitor health office visits, and justify the need for additional staff or resources.
  • Better patient care: Less time spent on documentation means nurses can focus on students, offer proactive health training, collaborate with pediatricians, and support IEPs and 504 plans.

Rock Hill Schools sits on the outskirts of Charlotte, NC, just over the border in South Carolina, and serves approximately 17,000 students. Sadie Kirell, Director of Nursing, says good medical care can be hard to find for some students, especially children of immigrant families or who are economically disadvantaged, and there is a high need for mental health care providers. Still, she says, the district is fortunate to have a nurse in every school building, in addition to a day treatment program for students in kindergarten through 8th grade.

Ten years ago, nurses at Rock Hill Schools were using the limited capabilities of their student information system to document the health services they provided. “It had a health component, but it was not very good,” Sadie says. “It was an afterthought, basically. It did not provide any benefit other than a place to write notes.”

Because each nurse used their own method for documentation, there was no consistency across the district. Reporting was virtually non-existent, and there was no ability to see how many students visited the health office, what kids were being treated for, or which classrooms had a high number of office visits from students. “We could not get any data, and everything is data-driven. You make decisions from data. That is how you advocate for positions.”

The district began looking at electronic health record (EHR) systems. They briefly used one that helped with reporting, but it did not meet their needs for Medicaid billing. The health department set out to find a system that would allow nurses to efficiently document services provided for use in Medicaid billing.

Implementing Frontline School Health Management

After demoing several systems, Rock Hill Schools chose Frontline School Health Management (known at the time as HealthOffice Anywhere). The district implemented Frontline over the summer, adding on-site training for eight super users in the district who then trained the nurses when they returned for the start of school — a highly beneficial move, Sadie says. “We had it planned out well so that we could provide good solid training and get that foundation for our nurses prior to going live. Once we went live, I had those super users available for onsite support, telephone support, whatever it was that we needed so that we could be successful in the implementation.”

Sadie Kirell Photo

“It was a wonderful investment. We felt like this one served our needs better than any of the other programs we looked at.”

Sadie Kirell
– Director of Nursing

The Results:

More Efficient Documentation

Now that the district has switched to Frontline, nurses have a far better way to document care. “The consistency and the efficiency that it provides cannot be matched,” says Sadie. “I am big on being efficient and not double documenting, not creating processes that make the job of the school nurse hard. This makes it pretty seamless.”

Day-to-day operations now run much more smoothly. Because documentation is so easy for nurses, Sadie can have confidence that every interaction with a student is entered into the system. Templates for various types of visits and services ensure the right information is collected and logged, and they speed up the process of creating individual healthcare plans (IHPs). “For individual healthcare plans, we have templates for asthma, seizures, diabetes. It is super easy. They choose the template and then make it specific to the student. You can do that IHP in probably three to four minutes, whereas we used to hand write and it would take you all day to write an IHP,” Sadie says.

“It is very efficient, especially med documentation. I can document that I gave a medication in ten seconds.”

Sadie Kirell
– Director of Nursing

When a supervisor wants to audit IHPs and ensure a care plan has been created for each student who needs one, they can quickly look in Frontline. “I can run a report to see who has medical alert, and then I go in and look at those students and make sure they have an IHP. I can do the audits very quickly from my desk to make sure we are in compliance or if there need to be corrections, because it is all in the system.”

Easier Medicaid Billing

Rock Hill Schools was drawn to Frontline by the fact that nurses can document services for every student — not just those who are covered by Medicaid. This has ensured that all care is well documented, and eligible service can easily be included in Medicaid claiming. Sadie says the Medicaid revenue the health department generates as a result of this documentation has allowed her to justify the School Health Management program’s cost. “By pulling reports of how many kids had Medicaid, I was able to show how many visits we were seeing. ‘Look, if we have this system, this is how much potential revenue can be generated.’ This allowed me to show that I could pay for the program with Medicaid reimbursement funds versus requiring funds from the general fund.”

Better Reporting

Frontline School Health Management helps Sadie get the most use out of the district’s health data, whether that is keeping kids in class or making decisions for the health program. “The reports that the program gives us are fantastic,” she notes. Sadie will share reports with principals that highlight which students or classrooms have more health office visits than normal, making it easier to create a plan to address it.

She can also see where the health department might need additional support or justify extra staff. Sometimes it simply helps her cover nurses who are out for the day. “If I have a nurse call out in the morning, I can pull up the dashboard and see what their schedule looks like for the day to determine when we need to send help to the school.”

Sadie loves that she can quickly get at-a-glance information from her desk at the central office, rather than driving to each school. “Before, when medication and medical procedure schedules were on paper, you could not see that. You did not know unless you went there. It allows us to look at the specific needs of students remotely, which we love.”

Improved Patient Care

Sadie says Frontline helps the nurses at Rock Hill Schools to care for students more proactively. When a student moves from one school to another, the nurse can be notified about specific needs they may have in their IHP and if they should be in contact with the parents about any particulars.

The system also facilitates communication between the health office and a student’s doctor. “For diabetics, we can print a blood sugar report from Frontline and send it to the doctor,” Sadie says, explaining that sometimes a doctor needs to make modifications to a student’s care plan based on data in their electronic health record. “It helps us partner with the parent and physician’s office to make sure the kids are getting what they need.”