A trip to the nurse's office connected 13-year-old Kayla to a doctor without leaving school, thanks to a pilot school-telehealth program.
Children's Hospital Association, August 8, 2018
It was the middle of the school day when 13-year-old Kayla began experiencing an earache and headed to the school nurse. The decisions came next: Is she sick enough to call her parents, go home, or go to the doctor's office? Can she rest for a while and go back to class?
For Kayla, the school nurse recognized an opportunity to take advantage of a new telehealth program the Children's Hospital of Philadelphia (CHOP) in Philadelphia is piloting with local schools.
CHOP created a school telehealth program in February 2018 with support from the United Way of Greater Philadelphia and Southern New Jersey. In participating schools in the Philadelphia area, nurses examine students as they always have. But in cases where the school nurse determines a greater level of care is needed, the program offers a fast, more convenient way for the child to be examined by a CHOP provider—without interrupting the school day.
"It was a Friday afternoon, and I got a call from the school nurse," Tina, Kayla's mother, says. The nurse asked her permission to consult with a CHOP provider via a virtual visit. "I knew about the CHOP program because we had filled out a form to opt in," she says. "I know the school nurse well, and I trust her, so I told her I didn't need to be on the call." The consent form gives parents several options: The parent can listen in on the exam, allow the exam to proceed when the school can't reach them, or opt out of the program altogether.
With her mom's OK, Kayla was quickly connected to a physician without leaving the school nurse's office.
A virtual visit to the doctor's office without leaving school
Each participating school is equipped with an iPad and virtual visit software, as well as the digital equipment needed to make a complete in-school virtual visit possible. The nurse calls or sends a text prompting the provider to log into the secure app. Providers sign in using a computer—anytime, anywhere, comparable to a FaceTime visit, only much more secure.
Providers then perform heart exams, measure heart rates, listen to the lungs and abdomen, view high-resolution digital images of the ear, mouth, throat and skin, and get accurate temperatures—all virtually.
In Kayla's case, the physician determined she had swimmer's ear and needed antibiotic ear drops, then the prescription was sent electronically to the pharmacy Tina had designated.
Convenient, accessible care
"All I had to do on my way home from work was pick up the prescription," Tina says. "It was a big help. I was busy at work, and it would have been hard for me to leave. It was late on a Friday afternoon, so getting a doctor's appointment would have been difficult. Maybe we would have been heading to urgent care over the weekend. But this was perfect!"
The school telehealth program has benefits beyond parents' convenience and peace of mind. For children without family physicians or transportation to get to a primary care provider, the program offers the potential to improve access to routine care. It also seeks to improve chronic disease management and increase the chance of detecting a health issue earlier, with the goal of ultimately improving outcomes and overall health.
It also empowers school nurses to meet more student health needs. "School nurses are the only health care provider our schools, so the telehealth pilot with CHOP has been a great opportunity for us to work with other medical professionals to provide the best possible care for our students," says Eileen McKeron, RN, MEd, CSN, the school nurse who cared for Kayla. "We've been able to interact with the doctor on call to determine the best treatment for the students' symptoms."