More on Telemedicine in Schools
Telemedicine is also a gentle way to let moms and dads know their child needs professional help. "Parents are often unaware or in denial that there's a behavioral or developmental issue," says Garrett. "If a teacher has concerns, she suggests to parents that we set up a consult with a specialist via telemedicine." Because the school nurse is the one to make the appointment and handle any other clerical issues, the parent is less likely to put it off. The child can be seen faster this way, too, since specialists hold a certain number of spots open for telemedicine visits. After the doctor conducts diagnostic testing, parents--along with the school nurse, the teacher, and other professionals such as the school psychologist--are able to sit in and listen to the results. "It's helpful for the teachers, because they hear firsthand what the doctor is saying," says Garrett. "They often bring up points or concerns the doctors or parents may not have thought of."
Research shows that telemedicine may help keep chronic conditions in check. A Journal of Pediatrics study, for example, found that kids with type 1 diabetes who participated in a school-based telemedicine program had better blood-sugar control and fewer visits to the E.R. than those who were treated traditionally. When chronic conditions are better controlled, kids are less likely to miss school. In fact, Dr. McConnochie's research shows that child absences due to illness plummeted by an average of 63 percent at child-care centers that use telemedicine. Telemedicine can also be used for routine matters such as dental or vision screening. Eight years ago, the Marshfield Clinic, in Wisconsin, started a dental-screening program for children in local Head Start programs. Dentists at the clinic "see" children thanks to a camera used by a hygienist at the Head Start site. "Three out of every 15 children had decay so severe that they needed immediate treatment," says Nina M. Antoniotti, R.N., Ph.D., director of TeleHealth for the Marshfield Clinic. The new method of examining kids has been a big success; the children are less frightened than if they were actually at the dentist. "When they see their teeth on the screen, they're mesmerized," explains Dr. Antoniotti.
So if telemedicine has so many success stories, why isn't it more widely available? Lack of funding, for one thing. While many school-based programs get grants for start-up fees and equipment -- Medicaid and private insurance may also cover some or all costs -- programs are difficult to maintain for many reasons, explains Jenny Kattlove, director of strategic health initiatives at the Children's Partnership, a nonprofit, nonpartisan child-advocacy organization based in Santa Monica, California, and Washington, D.C.
Video courtesy of Too Small to Fail, toosmall.org.
Perhaps the biggest champions of telemedicine are the school nurses themselves. "I overheard a mother tell a secretary in our principal's office that her 8-year-old daughter's asthma had flared up, so she was keeping her home," recalls Garrett. "I told her about our telemedicine service and we got her to bring her daughter in to be seen by a physician that afternoon. He quickly realized she had pneumonia and needed to be hospitalized. If we hadn't caught it, the girl could have died."
Could Telemedicine Work in Your School?
If you're interested in having a telemedicine program in your child's school or day-care center, start by talking to other parents and the school health staff to gauge interest, says Jenny Kattlove. Encourage this group to engage with your PTA, principal, superintendent, and other pertinent community members, as well as with local and distant health-care organizations to see whether telemedicine is appropriate for your area and how it could be implemented. You should identify whether your greatest need is for acute or preventive care, or management of chronic diseases.
Your next step is to contact local hospitals and large pediatric practices to see if they already provide telemedicine services, says Dr. Ryan Spaulding. You can also reach out to any major medical center or university hospital in your area that already has a telemedicine program, since they may be willing to join forces.
Originally published in the October issue of Parents magazine.
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