The ability for a student to be seen by a provider not physically located at the school has been around for at least 20 years. Even before the pandemic, the use of telehealth in School-Based Health Centers (SBHC) grew almost threefold from 7% in the 2007/2008 school year to 19% in 2016/2017.
As a well-defined and oftentimes well-run care delivery model in schools that involves teaming up with a local clinic, SBHCs are, however, only available in 2% of all schools. It stands to reason that therefore the percentage of telehealth visits is not representative of access to telehealth in all schools.
Yet it shows the potential for adoption and the potential for growth, especially after the widespread experience with telehealth across the health system during the Covid-19 health crisis
It is therefore not surprising that more and more school-based telehealth services are emerging in many of the approx. 100,000 public schools all across the US.
As superintendents, principals, school nurses, health centers, or health systems are considering to expand access to care for students, here are 7 aspects to consider when launching school-based telehealth services:
- School Staff
1. Leadership Engagement is Key
As with any change effort, the engagement of leadership is key. Who exactly is a leader, however, is not a clear cut as in other change efforts. Telehealth well done requires effective coordination and collaboration between the school administration, the school nurse, the student, the student’s parent, the clinician, and the clinic staff.
At best, a telehealth offering involves at least two organizations (the school and the clinic), and the situation gets more complex when parents become involved.
For a smooth design, launch, and ongoing support of a well-performing telehealth service the involvement of key leaders is necessary. That includes the school’s principal and superintendent; the school nurse; the clinical leader; and the clinic’s administrative leaders.
Prior to even considering a school-based telehealth service, getting these key stakeholders together is key.
2. Space Constraints
Depending on the type of school (elementary vs. high school) and the types of services (primary care vs. behavioral health), telehealth requires a dedicated space that affords privacy — space that is often difficult to come by in the school nursing environment.
Not all telehealth services need that separate level of privacy, though. Especially in primary care, the visit with a telehealth provider can be thought of as an extension of the nurse visit — and whatever privacy measures are already in place can still be used.
Fortunately today’s telehealth technology does not require a large footprint, even with exam tools or a system on a mobile cart.
When a private space is needed, though, measures such as sound insulation or white noise can be explored for consideration.
3. Ultimately, Telehealth is not about the Technology
Except when the technology does not work.
In essence, video visit only telehealth services only need (ideally) a computer or laptop with proper HD webcam, a speaker, and/or a headset (or a connector for personal headsets). The ability to conduct exams adds additional expenses for an otoscope, dermascope, or remote ECG, depending on the nature of the clinical services provided.
But even assuming that the technology works, there are key additional peripheral technical considerations including a reliable internet connection, electrical outlets, proper lighting, on-premises tech support, etc.