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Reducing Absenteeism in Area Schools through Virtual Care



Anyone who is a parent of a school age child has probably received a call from a school nurse telling them their child isn't feeling well and needs to be picked up.  That usually involves either leaving work or finding someone to pick the child up and take them to the doctor—when you can get them in.  Once the patient is on medication, it can be another day before they can return to school.

But a new program in six area schools—Monett, Ozark, Mountain Grove, Cassville, Reeds Spring and Forsyth--is a game changer when it comes to dealing with students who come down with an illness while in class.

CoxHealth received a grant called Act Now from the Missouri Foundation for Health to offer telehealth services in those schools.  Bridget O’Hara, Direct Connect product manager for Cox, said, "the goal of the program is to offer telehealth services to children in schools to reduce absenteeism from health-related needs."

Kristen Earnest is a school nurse in Monett, one of the schools participating in the program.  It started there in April shortly before school let out for the summer.

She said that was a chance for the district to try it out and see what changes they might make before they begin a full year of offering it.

"We saw, I believe, six children just in the few weeks that we had it open, and all of those children were able to get medication or treatment or whatever they needed, so, you know, so far our experience has been great," said Earnest.

Out of those six, she said, five were able to stay in school and have medications waiting for them when they got home.  One was sent home, started on medication right away and was back in school the next day.

Here’s the way the program works:  Generally, schools have a designated area for the telemedicine set up, which includes a computer with a web cam, an odoscope so a healthcare provider on the other end can look inside a child’s ear and a general view lens to see down the throat or to see the scalp, nose and eyes.  A stethoscope will soon be added to listen to the lungs and heart.

"And what we hear from our providers, being on the CoxHealth side of things, is they can actually hear and see some of those things better than they could with just some of the manual devices in the clinic because it's so magnified on a screen, it's such high definition," she said.

Chris Baumann, executive director of operations for the Ozark School District, said they’re also able to give children strep tests when they complain of sore throats.  And they’ve been able to immediately treat kids complaining of earaches.

"Really, the level of care has been elevated because of telemedicine and then the rapid response that we're able to bring to the child has also been increased," said Baumann.

He said it’s had “a dramatic impact on absenteeism for students who have had access to it.”

Parents have the option of taking part in the virtual exam either at the school or through a digital device.  Baumann said they would never provide the service without the parents’ knowledge.

"They're as involved as if they were present, which they can be,  or they can also be present electronically, and we've had cases were both have been true," he said.

According to O’Hara, the Missouri Foundation for Health is collaborating with Children’s Miracle Network for the two-year grant program.  Nurse practitioners on the C.A.R.E. Mobile will treat students who utilize the Direct Connect program at school.

The role of the school nurse hasn’t changed, Baumann said.  He or she still sees kids who aren’t feeling well, but, if they feel like the child could benefit from the Direct Connect program, they’ll refer them to the care assistant provided by Cox at each school to oversee it.  Earnest said having a virtual care option at her school hasn’t changed her basic nursing duties.

"You know, I'm still there to respond to emergencies, I'm still there to treat injuries and things like that," she said.  "I think the innovative part is that we're able to bring something unique to those students.  You know, sometimes kiddos have trouble--maybe it's insurance-wise or, you know, maybe it's just lack of a facility to, but I think we're able to be that first step to health care for them now.  You know, telehealth is becoming kind of an exciting new field in health care where we're able to just get some things to people faster, they're not having to wait for an appointment, hopefully reducing some of the loads on the urgent cares and E.R.'s for minor things." 

The goal is to eventually make the virtual healthcare at the schools participating in the grant program sustainable.  Right now, there is no cost to the students. Eventually, O'Hara said, there might be a small free for the service, but details are still being worked out.

According to O'Hara, while the telehealth program for students isn’t new nationwide, it’s new for the state of Missouri.  She said this is just the starting point.

"Typically, these kinds of things get the wheels turning for other types of services that we might be able to deliver or others could deliver to... students, so it's really just the tip of the iceberg  before you see the full capacity of what we can do with telemedicine, said O'Hara.

Baumann said CoxHealth has worked to make the program affordable for schools by looking at what electronic devices are available on the market today and utilizing those rather than using equipment specially designed for telemedicine.  Any digital device can be used, including iPads, laptops and smart phones.


Michele Skalicky has worked at KSMU since the station occupied the old white house at National and Grand. She enjoys working on both the announcing side and in news and has been the recipient of statewide and national awards for news reporting. She likes to tell stories that make a difference. Michele enjoys outdoor activities, including hiking, camping and leisurely kayaking.