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For children in some areas of Mississippi, a visit to the pediatrician can mean an hour-long drive and missed class time. Some parents miss work or lack access to transportation, and in the worst cases, the child never makes the appointment at all.
But thanks to a new effort on the part of the Mississippi Department of Education and the Mississippi State Medical Association, students could have access to physicians and mental health professionals through telehealth — from within the walls of their school.
With an influx of federal money flowing into the state from the Coronavirus Aid, Relief, and Economic Security (CARES) Act, Carey Wright, state superintendent of education, began laying the foundation in late spring for a pilot telehealth program in a small number of schools.
The telehealth and teletherapy efforts are part of a larger program called Mississippi Connects. The program was developed in response to the COVID-19 pandemic and aims to provide every public school student in the state with the technology needed to learn at home. Components of the program include the provision of devices, professional development for teachers, students and parents, and connectivity resources.
The final piece of the puzzle is virtual medical and behavioral services.
“Everybody’s come together to figure out what this would look like and what it would take,” Wright said, noting she’s been in meetings with the University of Mississippi Medical Center, the Mississippi Chapter of the American Academy of Pediatricians, the Mississippi Department of Health and the Mississippi Division of Medicaid.
Dr. John Gaudet, a Hattiesburg pediatrician and president of the state chapter of the American Academy of Pediatrics, said the need for a program like this is apparent.
“When you really look at the distribution of doctors in Mississippi, you have plenty in Jackson, Hattiesburg, Tupelo and Biloxi, but you get out to (those rural counties) and you are really in a health care desert,” he said. “Telehealth is a way to keep kids learning, keep kids engaged in school and keep from having to pull them out to drive 40 miles for an appointment that could’ve been accomplished rapidly and easily by telehealth.”
While the details of the program are still in the works, and a small pilot program isn’t set to begin until late spring, Gaudet said one of the models they are looking at is Health-e-Schools in western North Carolina.
Students in several districts have access to a centrally located health care provider with the use of high-definition video-conferencing with specially equipped stethoscopes and cameras. The provider can manage both acute issues such as sore throats and ear aches and long-term issues such as chronic disease management and sports physicals. Mental and behavioral health services are also offered, and a sliding fee scale is used for the uninsured.
The goal is not to disrupt existing doctor-patient relationships, but to create access to a provider where there is none.
And teletherapy is immensely needed right now, said Gaudet, who described access to mental health services in the state as “abysmal.”
“Mental health problems are skyrocketing. If you had a little bit of anxiety, now (during the COVID-19 pandemic) you have a lot. If you had a little bit of depression, now you have a lot,” he said of what he’s seen in his pediatrics practice. “Add on top of that financial stresses, educational stresses…”
Telehealth is also useful for patients with chronic conditions, said Gaudet and Dr. Jennifer Bryan, a family physician practicing in Flowood and chair of the Mississippi State Medical Association Board of Trustees.
“We can assess obesity issues, diabetes — we’ve got children with hypertension,” said Bryan. “If we get ahead of these chronic conditions in these rural areas, we can really impact overall health outcomes in Mississippi.”
The Mississippi State Medical Association currently runs the Mississippi Telehealth Network, a network developed during the COVID-19 pandemic for member physicians to use to see patients. Bryan said this network will be helpful when creating the school program.
Bryan said there is a huge willingness on the part of physicians to get involved, and the state medical board’s loosening of restrictions around telemedicine in April now makes it easier for doctors to use.
The program will start small in school districts that currently have nurses, and the estimated cost per school is from $3,000 to $5,000. The equipment will be paid for with CARES Act funds, and the school nurse will serve as the point person at each site.