Telemedicine - Keeping the Community Connected

October 23, 2018

‘Taking medical care to the next level’ is the goal of telemedicine

The flu hit with record-breaking fury in late 2017 and early 2018; with more than 130 deaths in Dallas-Fort Worth, it killed far more people in North Texas than Hurricane Harvey did in Houston.

Fortunately for many families, Children’s Health had laid the groundwork for just such an emergency. Starting in 2013, Children’s Health initiated a unique School-Based Telehealth program that is now the fastest-growing program of its kind in the nation and the only one in North Texas.

Rolling kiosks in more than 100 schools are now equipped with video conferencing technology that allows the school nurse, a patient and a Children’s Health physician to interact virtually. An electronic stethoscope sends real-time audio of a patient’s heart beat while another instrument shows high-definition video of the patient’s eye, nose, ear, throat or skin. The video is so sharp that doctors can see detail down to a hair follicle. Test kits for ailments such as flu and strep were stockpiled in nurses’ offices, ready to be administered at a doctor’s order.

The School-Based Telehealth program has expanded in five years to encompass 17 school districts. More than 20,000 students are enrolled in the program, with more than 5,000 virtual encounters recorded last year. This has proven enormously cost-effective and efficient: Children don’t miss classroom time; parents don’t miss work; and more kids have access to treatments early on before their conditions worsen and may require a visit to the emergency room.

 Last winter’s brutal flu season demonstrated just how far-sighted and proactive Children’s Health was in establishing the program.

For parents like Trisha Rushing and Amber Ayres who have children in elementary school in McKinney, the program was critical. Their children both contracted the flu, and the Children’s Health telemedicine option provided timely diagnosis without the inconvenience of a trip to the doctor. More importantly, it slowed the spread of the flu by quickly getting contagious kids out of school.

All four of Trisha Rushing’s children tested positive for the flu in the 2017-2018 school year. She said telemedicine was a huge and immediate help because her kids were tested and diagnosed by a doctor who immediately called in an anti-viral prescription to the family’s drug store.

“It has saved the kids from having to leave school and go sit in a doctor’s office inconveniently, uncomfortably and then take more time to get the prescription filled,” Ms. Rushing said. “It’s more convenient for the kids, and it’s more convenient for me because I can still work while they’re being seen by a doctor, and then I can go pick up their prescription on the way home. It’s been a lifesaver.”

6-year-old Trevor Ayres, a McKinney first grader who was diagnosed with the flu through school telemedicine, and his mom, Amber Ayres

Ms. Ayres said telemedicine also made life easier for her when her 6-year-old son, Trevor, tested positive for the flu. His telemedicine consent form was already on file because the previous year he had tested positive for strep during a virtual visit. Before the strep throat diagnosis, Mrs. Ayres said she was not aware that telemedicine was available.

“I said something like, ‘Man, I am going to have to see if I can get him to the doctor today. It’s going to cost $150.’ And the school nurse said something like, ‘If you fill out a consent form, we can test him here,’ ” she said.

The next year, flu was a hot topic among parents as constant news reports documented its spread. Mrs. Ayres told another parent about telemedicine.

“She said, ‘Wait, what? She can just test the kids right there in the nurse’s office? Where’s the consent form? I’ll sign it.’ ” Mrs. Ayres recalled.

Leaders of the Children’s Health telemedicine program said this immediate, meaningful help for families was their goal. They sought to make things more convenient for parents who signed up for telemedicine while also helping the greater good by getting sick kids out of school if they are contagious. It was a dramatic improvement over just sending kids home if they had flu symptoms, according to Danielle Wesley, Children’s senior director of school-based initiatives.

“In many cases the school nurse calls and says, ‘Pick up your child, and you may not be able to come back tomorrow.’ A lot of times our parents were spending time at the emergency room,” she said.

Ms. Wesley said Children’s Health’s work in telemedicine has extended its expertise into urban and suburban schools as well as rural areas nearly 80 miles from the Children’s Medical Center Dallas campus. Many children reached have no medical home at all, she said.

Additionally, there are plans to expand the program to  help children with disease management by providing education, monitoring and follow-up for chronic conditions such as asthma, allergies and weight management.

Dr. Stormee Williams, a Children’s Health pediatrician and medical director of school telemedicine, said she was interested in the program as soon as it started taking shape in 2013.

“When we did the pilot program, I saw what an impact this could have,” Dr. Williams said. “I said, ‘If this ever goes full time I want to do it.’ I think this is the future. l think this is what’s going to take health care to the next level.”


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