Childhood asthma and diabetes rates have risen in recent years, meaning school nurses are taking on an increasingly important role in the healthcare system, according to STAT.
However, even as children and adolescents face a growing need for healthcare services, roughly 60 percent of U.S. schools lack a full-time nurse, according to data from the National Association of School Nurses. Some schools are using telemedicine to address the issue, partnering with hospitals, nonprofits or health IT companies to provide comprehensive healthcare services to its students.
Here are five things to know about the trend.
1. In a school-based telemedicine program, a student referred to a nurse's office will typically be connected to a physician via videoconferencing technology. A remote physician will proceed to evaluate the patient's ears, throat and heartbeat, among other vital signs, using computer-connected otoscopes and stethoscopes.
2. Advocates in favor of school-based telemedicine say the practice helps nurses treat students with complex or chronic conditions, which will help to keep more students in school, rather than traveling to and from a hospital or urgent care center. A report on the use of a school-based telemedicine program in New York state determined the practice reduced socioeconomic disparities in regional acute care access.
3. One challenge to the program is billing. Typically, a student is billed using their parents' private insurance. For families without private insurance, some schools may bill Medicaid. However, only 23 states have agreed to reimburse for school-based telemedicine. Schools in states that do not cover the technology must apply for local grants or government funding.
4. The fluctuating nature of telemedicine program funding also poses a barrier for schools. Funding sources may change year-to-year, between evolving telemedicine legislation and lack of guarantee for long-term grant funding. "One thing we need is sustainability," Stormee Williams, MD, a pediatrician who sees students via video told STAT. "Waivers and grants aren't going to last forever."
5. Another consideration is that, although telemedicine is often discussed as a way to address the low number of school nurses, this limitation creates its own barrier. A student can only use a school-based telemedicine program if a nurse is there to connect them to a remote physician.
"At a school with a part-time nurse, a child who gets sick when the nurse isn't in wouldn't have access," Steve North, MD, an adolescent medicine specialist and medical director for Health-e-Schools, a school-based telemedicine program in North Carolina, told STAT.