For families and children in rural areas, telemedicine is one of the most effective – and often one of the fastest and least expensive – ways to deliver care. In North Carolina’s Appalachia region, the Center for Rural Health Innovation’s (CRHI) Health e-Schools initiative knows the benefits of telemedicine – and is using it to help meet the health care needs of children in schools, two-thirds of whom are covered by Medicaid and 13% of whom had no form of health insurance.
Health-e-Schools uses video-based meetings to offer students school-based care in 80 different schools in four counties in the rural western part of the state and 3 counties in eastern North Carolina. Most of the schools that are part of the initiative do not have full-time school nurses, and the long distances between rural areas make it difficult for health care providers to travel from clinic to school and back with regularity.
The cost of the used technology is affordable: what was once $20,000 is now only $2,000 per site. This means more schools can be part of the initiative – and more students can be served.
CRHI’s unique approach to engaging health care providers allows the initiative to care for a wide range of health needs. The organization partners with centrally-located primary care physicians and mid-level providers (e.g., family nurse practitioners), who are trained to help with everything from stomach aches to medication management.
Despite its success, the Health-e-Schools initiative continues to face many barriers and limitations. These include:
- Helping parents feel comfortable about telemedicine services
- Not being able to provide some services that children need for school-like vaccinations
- Existing state policies that prevent reimbursement for services that could be provided through schools like sharing a behavioral health expert across sites
To reduce these barriers, CRHI works to educate parents and policymakers about the specifics and value of telemedicine for school children. Overall, telemedicine has made great strides in delivering reliable care to children on Medicaid. For those living in rural areas, this means a more convenient method of delivery and “right place” care that allows students to be seen for minor illnesses in the acute care setting rather than the emergency room, which leads to healthier futures.