Most school districts only used the state’s new telehealth program a few times in the 2022-23 school year, but program administrators say they are working to increase participation and have already seen positive results.
The school-based telehealth program was created by the Mississippi Department of Education, which gave $17.6 million of pandemic relief money to the University of Mississippi Medical Center to administer the program. The grant, which expires in Sept. 2024, covers laptops for video conferencing, rapid strep and flu tests, and specially equipped stethoscopes and otoscopes that transmit information to the doctors or nurse practitioners on the other end of the call.
The program, which is free to students, began under the direction of former State Superintendent Carey Wright, with the goal of increasing access to medical care and keeping children in school more hours each day. Over half of the counties in Mississippi have no practicing pediatricians according to the Office of Mississippi Physician Workforce, something this program aims to help address by decreasing the amount of time families spend traveling to access care.
The program was open to all 145 school districts in the state, and 100 signed up. Of those 100, data from UMMC shows only 34 districts had at least one visit in the 2022-23 school year. However, some visits were not assigned to a school district, making it possible that more participated.
Dr. Saurabh Chandra, the hospital’s chief telehealth officer, said he is very proud of the speed at which his team has been able to successfully roll out the telehealth program. This is the largest school-based telehealth program in the country he is aware of, adding it was implemented faster than many others. While he was pleased that connectivity did not end up being a major issue, he said the shortage of school nurses has been a challenge.
After spending the first year focused on implementation, Chandra said the goal is now increasing participation. He said nurse educators are communicating regularly with school districts to understand their concerns. UMMC has already made at least one change – allowing school nurses to call and schedule an appointment instead of doing it in the computer software – based on the feedback.
The outreach already seems to be helping: the program averaged about 150-170 visits a month last year, but August and September of this year have seen about 275 visits each month.
“(The program) is in a stage of infancy,” he said. “You have to implement the program, you have to understand the barriers, you have to do the engagement, this is a continuous work, but we are seeing good trends.”
Lauren Hunt, the nurse at Stone County Elementary School, is a regular user of the program. Stone County does not have any practicing pediatricians, but there are several in neighboring coast counties, according to the physician workforce data.
Hunt brings up the service to parents when she thinks a student could benefit and said she has had very few parents refuse. She said she “has not been able to brag on it enough” and expressed a desire for more school nurses to start using it so it can be a greater benefit to the state.
“The school nurse is really the keyholder – she is the one that has to want to implement it and use it,” Hunt said.
She also emphasized the importance of outreach to parents so they’re aware they can request visits and don’t automatically take their children to the doctor on their own. Hunt said she has seen this be effective in action, particularly for children without health insurance who have used it for ear infections and other small issues.
Parent outreach is also a priority for UMMC, but Chandra said his team depends on school districts to spread the word. He hopes as parent awareness of the program increases, their trust in it will rise as well leading to increased participation.
Jana Miller is one of two nurses covering five rural schools in the Greene County School District. Her favorite part of the program is the convenience: appointments are usually available within 30 minutes, and students are not required to check out and wait to be seen, saving parents time as well.
Miller said her district has also utilized the teletherapy portion of the program, which provides mental health services to children. The school identifies students for it based on parental requests, school staff’s knowledge of difficult circumstances, or a child reaching out for someone to talk to. She also schedules these appointments but does not participate in them like the telehealth visits.
“I was really apprehensive (of the telehealth program) at first because I just didn’t know how it was going to work, but I’m very glad we took the leap of faith and went through with it,” she said.
One district hopes to use the program more now that technical issues have been resolved. There are no pediatricians in Chickasaw County, where nurse Dawn Vance works in the schools.
“I think with a little push, maybe the nurses get a little more training and the IT stuff gets all worked out, I think it would really pick up, especially in an area like ours where there’s not many options,” she said.
Other districts have said they don’t have as much of a need for the program because of existing school-based clinics or parent preference for local pediatricians.
Hunt, the Stone Elementary School nurse, said she hopes more schools start using it so the state will have an incentive to keep funding the program after the federal pandemic relief money expires.
UMMC is looking for other grants to continue funding the project or considering turning it into a program that takes insurance, Chandra said.
“We know that there’s a need for it out there,” said Scott Clements, director of healthy schools for the Mississippi Department of Education. “We have a lot of rural areas … and in those rural areas you oftentimes don’t have the services you have in a metropolitan area.”