There are many reasons that telemedicine – virtual doctor visits over video – is an attractive solution for bringing healthcare to schools. There has been an increase in the number of children with chronic health conditions like asthma and diabetes. School nurses, when available, are being asked to deal with more complex problems, and access to physicians in rural communities remains limited.
How Telemedicine Addresses the Healthcare Needs of Children
For children with chronic conditions, the ability to be monitored and treated from school allows them to spend more time in the classroom and enjoy a school experience more similar to their peers. In addition to the educational benefits of fewer missed class hours, the approach improves their quality of life by allowing them to form a consistent routine and enjoy fewer interruptions in their social interactions.
For children with acute conditions like the flu or strep throat, telemedicine can speed the time to diagnosis and eliminate time-consuming and costly trips to the emergency room. When a child presents with concerning symptoms, parents can get reassurance that they’ve been checked out by a qualified medical professional, often with the assistance of the school nurse or a telehealth technician onsite at the school.
Many children get nervous at the doctor’s office or when meeting new people. One of the big advantages of telemedicine is that children can be seen in a familiar environment surrounded by the school’s staff that they already know and trust.
How Does Telemedicine Work in Schools?
Telehealth technology makes it possible for a secure video connection to be established between a computer or mobile device with a video camera at the school and one at the provider’s location. In some cases, special computer-connected otoscopes and stethoscopes are used to check ears, noses, throats, and heart rates.
The school nurse or other trained assistant helps position the child and use the instruments as needed. The physician is able to see the patient, analyze the inputs from the instruments and make a diagnosis and treatment plan. They can then discuss the results with the parent. Sometimes the parent will need to take the child home or to an in-person visit in the case of a serious condition. In other cases, the child won’t need to leave school at all.
Generally, the parent’s private insurance is billed for these types of visits. For kids without private insurance, coverage may come from Medicaid, but not in every state. Only 23 states and D.C. allow Medicaid reimbursement for school-based telemedicine, according to a 2017 report from the American Telemedicine Association.
In the states that don’t allow Medicaid to cover the visits, grants or local government funds sometimes pay for telemedicine programs. Some school districts use local government funds earmarked for public health initiatives.
School-Based Telehealth Program
One successful school-based telemedicine program was designed by the University of Rochester Medical Center. This program, called Health-e-Access, began in 2001 in three child-care centers and is now in all 37 of Rochester’s city elementary schools.
Director Kenneth McConnochie, M.D., M.P.H., and professor of pediatrics told Parents magazine that since the program started, there have been more than 13,000 telemedicine visits and there are at least 24 similar programs across the country, including The Georgia Partnership for TeleHealth and the Arizona Telemedicine Program at the University of Arizona in Tucson. “In one analysis of pediatric emergency-department visits,” he told the magazine, “We found that 40 percent [of emergency room visits] were for non-emergencies such as rashes and other problems that can be diagnosed with telemedicine.”
Treating Mental Health Conditions in Schools
Schools are often on the front line when it comes to recognizing mental health and development issues in children. Many are turning to telemedicine for help in treating issues like ADHD and autism. The shortage of child psychiatrists, psychologists, and autism specialist in the US is significant. It can be difficult for parents to find a nearby provider. And of course, getting tested for various conditions can mean a day away from school for the child, and work for the parent. Using telemedicine to connect children to providers for this type of treatment can increase access and decrease parents’ reluctance to recognize and start treatment for mental health concerns.
Telemedicine is not a panacea, and it is not the right approach for every health issue that comes up in schools, but in many cases, it can be used to make sure that each child gets access to the care they need.