The latest example comes from South Carolina, where an analysis of three years of Medicaid claims for children ages 3-17 in one underserved county found that a school-based telehealth program reduced Emergency Department visits by 21 percent for students living with asthma.
“Asthma is one of the most common and costly diseases in childhood,” Kathryn King Cristaldi, MD, a pediatrician with the Medical University of South Carolina who led the study, said in a press release issued by MUSC. “We showed that the program was associated with decreased likelihood of ED visits. We think that this was achieved by engaging the school nurse to ensure that children are getting their controller medications daily and increasing overall awareness of managing childhood asthma.”
The program – overseen by MUSC, one of two federally designated Telehealth Centers of Excellence – represents the next level in the evolution of school-based telehealth. Connected health platforms that once focused on non-acute, episodic cases like colds and infections are now taking on more student health concerns, including chronic care and especially mental health. The idea is to create a platform that can address all of the student’s health needs, keeping him or her in school, reducing stress on the family and reducing the likelihood of neglected or missed care.
Cristaldi, co-director of MUSC’s Telehealth Center of Excellence, said the study – which appeared in a recent issue of JAMA Pediatrics – compared results from a telehealth program launched in 2015 in Williamsburg County to telehealth programs in four surrounding counties.
She and her colleagues chose Williamsburg County because it’s rural and medically underserved, with a high poverty rate. This means many of the school’s children likely won’t get the care they need unless it’s offered at school – and in that scenario by a school nurse.
“The program connects school nurses, who are really the frontline pediatric public health professionals, to providers via a telehealth cart that provides two-way audio-video communications with electronic peripherals that are HIPPA compliant,” Cristaldi said.
“Our findings in JAMA Pediatrics show progress,” added James McElligott, MD, the program’s executive medical director. “This is just the beginning. I think this study offers really strong empiric evidence that they can improve their community, and we want to make sure that is heard.”
And it’s only the first step. The study did not find any connection between school-based telehealth and all-cause ED visits, so Cristaldi wants to further explore how this program is affecting healthcare costs, as well as how it might be implementing best practices for asthma care.