Sarah Myers is a full-time working mom. She knows the struggle of achieving work-life balance, especially when her child is sick.
Recently while at work, she received a call from West Elementary School in Kings Mountain where her daughter, Mackenzie Myers, was a kindergartener.
“She had a sore throat and ear pain,” Sarah says.
The school nurse was calling her to not only let her know Mackenzie wasn’t feeling well but to also offer virtual care for her daughter through Atrium Health Levine Children’s School-Based Virtual Care program.
Sarah and a pediatrician with Levine Children’s separately joined the virtual call remotely, so Mackenzie could get the quickest and best care in the most convenient way.
“The provider with Levine Children’s was very comforting and caring toward Mackenzie, and that means a lot to me,” Sarah says. “I saw everything going on in real time, and I knew she was in great hands. At the end of the virtual visit, we had a diagnosis and a treatment plan.”
Mackenzie wasn’t considered contagious, so she returned to class with little disruption to her day, and Sarah never had to leave work.
History, Growth and Purpose
As a native North Carolinian who was born and raised in Cleveland County, Sam McGinnis is well aware of the local dynamics of the community. “Growing up, I saw a lot of health disparities that existed among public school children,” says McGinnis, administrative director at Atrium Health’s Levine Children’s.
Now, McGinnis helps lead the School-Based Virtual Care program, which has grown from a pilot program in 2017 at Graham Elementary School to now include more than 85 locations in Anson, Cleveland, Cabarrus, Forsyth, Lincoln, Mecklenburg and Stanly Counties.
“It’s been very rewarding to watch a program like this evolve into one of the leading telemedicine programs in the nation” McGinnis says. “Our program’s success has enabled us to partner and expand our services into neighboring counties to further impact the physical and mental health of children in our region.”
Prior to the COVID-19 pandemic, the program was seeing an average of one patient per day per school. Volume is much higher now, seeing three students on average daily for medical visits. The number of telepresenters (mobile medical professionals) is being increased to provide better coverage of the region and now has a total of 23 telepresenters spanning the program’s footprint.
There have been more than 5,400 patient encounters in the school setting since the program began.
How It Works
A simple process, including the student’s parent every step of the way, is the reason why this program is not only successful.
- The student tells their teacher they’re feeling ill, and the teacher refers them to the school nurse.
- The school nurse completes their own independent assessment to determine if this program’s services are needed. “We check their vital signs. Ask them what’s wrong,” says Mona McKnight, school nurse for Cleveland County Schools. “This program can treat common conditions, like allergies, stomachache, flu symptoms, coughs, colds and pink eye.”
- The school nurse then reaches out to the parent to ask for consent to use School-Based Virtual Care services and if they’d like to be involved in the virtual visit remotely in real time via audio and/or video.
- Then a telepresenter is deployed to the school to activate an innovative device (see how it works in the video above) to see images of the student’s eyes, inside their mouth and ears and listen to their heart and lungs.
- Once a Levine Children’s pediatrician joins the virtual visit, the telepresenter assists in conducting a comprehensive physical exam.
- After the visit, a care plan is established, which can include sending a prescription to the pharmacy and/or dismissal from school if the child is contagious. If they’re not considered contagious, they can go back to the classroom with minimal interruption to their day.
“School-based virtual care is designed to keep kids where they need to be and to do that we really need to be able to offer medical services within the schools themselves, which is what our program allows,” says Charles “Trey” Williams, MD, medical director of Atrium Health Levine Children’s School-Based Virtual Care.
Better Care Through Collaboration
McKnight says, “One of the goals as a school nurse is to keep all of my students in school and healthy.”
While this program helps her achieve that goal, other benefits along the way are just as important.
“School-Based Virtual Care has the potential to really affect a student’s grades and their attendance,” McKnight says. “A lot of times that student can be seen that day for that problem and not even miss a day of school.”
“Studies show that health and academic performance are directly related,” Williams says. “If we can improve students’ health, the academic team will have the tools they need to improve students’ academics.”
The program also encourages appropriate utilization of medical services, resulting in a 32% reduction in preventable emergency department visits.
Creating access to medical care in rural communities also plays a hand in recognizing contagious illnesses early to avoid spread (like COVID-19) and identifying underlying health issues.
“About 20% of the students at Graham Elementary School weren’t receiving medical care. We’ve been able to establish care for them with our pediatricians to ensure they are receiving more preventative and ongoing care,” says Williams.
Williams also says the program has delivered an unexpected benefit, too – better management of chronic care and care coordination.
“We didn’t anticipate this outcome,” Williams says. “Now that we have a collaborative program with nurses and educators, health care is so much better facilitated at schools.”
Expanding Care For All
Given the success seen in the school setting, the program has expanded to also serve adults in community settings as well. Atrium Health’s Community-Based Virtual Care operates much like the school-based program by offering medical care through video visits, including a virtual examination, diagnosis and prescription is needed. It’s available in Cleveland and Mecklenburg Counties at the locations below.
- Cleveland County YMCAs (Dover, Kings Mountain and Ruby C. Hunt)
- Mt. Calvary Church
- Kingstown Town Hall
- Northside Baptist Church
Most recently, School-Based Virtual Care has collaborated with Atrium Health Behavioral Health Services to expand existing teletherapy services in this format, allowing middle and high school students to access high-quality, expert mental health support wherever they are, whenever they need it.
“Improving access to mental health care has never been more crucial for our community,” says Eva McNeill, assistant vice president of outpatient services at Atrium Health Behavioral Health Charlotte. “The high demand for mental health care combined with limited mental health providers in many of our communities often leaves parents with few options to assist their child.”
Behavioral health services offered include:
- Individual therapy
- Family therapy
- School consultation
During the last school year, 96% of students referred to the School-Based Virtual Therapy program utilized the services compared to 60% in other traditional models.
“Many students will not receive mental health care unless they have the services available in school,” says McNeill. “This virtual therapy model is a way to provide high quality care with minimal disruption to educational time.”
Additionally, virtual therapy reduces time from referral to intake by 69%. Patients are able to be seen within nine days.
To learn more about these programs, visit us online. Ask your school’s nurse if these services are available for your child.
