On a Tuesday at Crothersville Community Schools, a student is in the office complaining of an earache.
Soon after, others complain of flu-like symptoms, a sore throat and a rash.
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In the past, they wouldn’t have been able to receive treatment from a school nurse because she’s only there Thursdays, so the students may have been sent home early so they could go to the doctor. That might have resulted in them being counted absent for the day and then possibly other days if they still didn’t feel well.
But since the school corporation began offering a telehealth clinic in January, students have access to treatment five days a week.
With parental permission, students can be taken to the school nurse’s office, where equipment is set up for a virtual doctor’s visit.
Trained school staff members would enter the student’s information (name, gender, birth date and vitals) into a program on a laptop and use noninvasive scopes and other diagnostic equipment (otoscope, stethoscope or dermatoscope) based on their symptoms.
The information and photos are shared with a nurse practitioner or physician’s assistant at the Southern Indiana Rural Health Clinic in Austin. A Skype type of video option also is available where the school staff member could talk to the nurse practitioner or physician’s assistant.
The health official then would diagnose and call in prescriptions as needed.
If an onsite visit is deemed most appropriate, the student would be transported to the clinic by a school official, and a nurse practitioner or physician’s assistant would treat them and determine if they can return to school.
The clinic can be used instead of a student going to the emergency room for nonemergency symptoms and get healthier faster.
So far, no Crothersville students have had to use the clinic, but it’s there if they need it.
About 50 of the 250 students in the elementary school and nearly one-third of the 220 students in the junior-senior high school have parental permission to use the clinic.
“I think it’s like anything new, once some kids start using it and parents see how convenient it could be, I could see a lot of uses, and I think it’s going to be a great thing,” said Tina Kilgore, a Title I teacher at the school that’s trained to use the telehealth equipment.
“I think for the most part, our parents at Crothersville are pretty good about taking their kids to the doctor and that kind of thing,” she said.
Crothersville, Austin and Southwestern Jefferson County schools partnered with the Indiana Rural Health Association to have access to the Southern Indiana Rural Health Clinic.
In September, the association opened a pilot school-based telehealth clinic at Elwood Community Schools.
The association received a Health Resources and Services Administration grant to help rural schools provide better health care access to students.
The funding covers the cost of equipment and additional needs, so there is no cost to the schools, and the association also ensures there is enough broadband connection for internet, said Hayley Ready, rural community outreach coordinator for the Indiana Rural Health Association.
The four school districts involved are a part of the Indiana Rural Schools Clinic Network. Through the duration of the four-year grant, Ready said they will be working with other rural districts in the state to apply to launch telehealth clinics.
“It’s a rolling application, and we are pretty much booked through 2018,” Ready said. “We are looking at the 2018-19 school year or 2019-20 school year for schools to apply at this point.”
Schools that have their own full-time nurse use the telehealth equipment, but Crothersville is unique because it only has a nurse from the Jackson County Health Department available at the school once a week.
Along with Kilgore, other Crothersville staff members trained to use the equipment are Adam Robinson, junior-senior high school art teacher; Greg Kilgore, athletics director; Megan Lucas, Title I assistant; Liz Crater, elementary aide; and Angie Keasler, junior-senior high school secretary.
In mid-November, they went to the Austin clinic to learn how the telehealth services work and try out the equipment, all of which connects to a laptop via USB ports.
The school’s health department nurse is not trained to use the equipment, but the trained staff members could use it on the day she is there if needed. The nurse’s duties include tending to students who come to her office, filling out paperwork and keeping health data updated.
Crothersville parents who don’t have their child signed up for the telehealth services can fill out a consent form at either of the school offices.
“If a parent can’t get (their child) to a doctor or a physician because of their work schedule, this is another option or another avenue they can take,” Robinson said.
Services provided at the clinic are billed to the child’s insurance company. If a child doesn’t have insurance, services are provided on a sliding scale fee based on income. No student will be denied services because of an inability to pay.
For parents who want to learn more about the telehealth clinic, equipment will be available to see during Crothersville’s Family Literacy Night from 6 to 8 p.m. April 6. Consent forms also will be available during the event.
“I think, as a parent, one of the things that would make me feel better is if I knew what the equipment looked like, what are you actually doing to my child when you take them (to the clinic),” Tina Kilgore said.
Also that night, a Leadership Jackson County project team will conduct a health fair, and representatives from a mobile dentist from Greenwood will be there.
This is the sixth year the school has had a contractual agreement with that dental checkup service, which visits twice a year, said elementary Principal Chris Marshall.
“The original intent of that was to keep kids in school, and No. 2, to spare parents time to get out of work to take kids (to the dentist),” he said. “It has been a win-win on that mobile dentist. Parents are just really telling us how much they appreciate it.”
Marshall said nearly 50 elementary students use the mobile dentist.
“That program took two to three years to really get off the launchpad,” he said. “I think (the telehealth clinic) will be the same thing. We’re hoping the program will grow in future years.”
David Schill, principal of the junior-senior high school, said it’s good to have the telehealth clinic as an option for students.
“We don’t have adequate health care in Crothersville,” he said in reference to no doctor’s offices being in town and some socioeconomic disadvantages. “So if we can help some of our students out by providing anything to get them some adequate health care, that’s a plus for us.”
Tina Kilgore agreed with Marshall that the school needs to promote the clinic more so parents have a good understanding of it.
“As far as Crothersville, I think it’s going to take us a little while to figure out how it fits in and parents to know how it fits into our school and the way our community works,” she said. “Once we figure out that kind of niche, then I just think it will be like one of those other things, like the mobile dentist, that is just one other service that we have here that parents can use.”
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Services offered by the telehealth clinic
- Screened, examined, diagnosed, treated and monitored for signs of cuts/abrasions, rashes, pink eye, coughs/colds, strep throat, earaches and/or flu-like symptoms
- Limited laboratory testing
- Management and ongoing care of existing medical conditions, such as diabetes and asthma
- Behavioral health services and referrals
Advantages of using the telehealth clinic
- Fees are billed directly to your insurance provider, just as if your student had been seen at the doctor’s office.
- Improved detection and management of chronic diseases, such as asthma and diabetes.
- With permission, a student can be seen without parents having to leave work.
- Prescriptions can be sent to a pharmacy and can be ready for pickup when you get out of work.
- Your child will not have to leave school to see a doctor. The telehealth clinic will be able to reduce the amount of time spent out of the classroom, resulting in better school outcomes.
- Fewer emergency room visits, meaning greater cost savings and less out-of-pocket expenses.
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For information about the telehealth clinic at Crothersville Community Schools, visit crothersville.k12.in.us/telehealth or call 812-793-2622 (elementary school) or 812-793-2051 (junior-senior high school).
For information about the Indiana Rural Health Association, visit indianaruralhealth.org.