South Carolina’s school telehealth program started small—with a single provider in Charleston walking down the street to see children at a local school. It has since grown to encompass more than 80 schools across the state focusing on areas with high health disparities. The program increases access to certain school health services by linking students in school-based settings with local providers through technology.
The telehealth program is used in schools to treat acute illnesses (e.g., ear infections; sore throat) as well as to provide a limited amount of chronic care management such as asthma and ADHD. Participating schools are provided with HIPAA-compliant real time equipment on a mobile nurses’ cart.
Students receive care from a nurse in the school setting and a local provider on the other end of the line. The provider assesses the student and provides the needed medical advice. The nurse and the provider coordinate care and follow up.
The program’s positive impacts are clear: students receive more services; schools receive funding to support their student health work; a feedback loop ensures students’ medical homes are kept fully in the loop; and relationships between communities that support student health are built. “Local providers are actually very interested in seeing their clients,” says Kathryn Cristaldi, a professor at the Medical University of South Carolina. “Healthcare should be kept as local as possible, especially for children.”
South Carolina is a very rural state with significant healthcare deserts. For instance, one county has no pediatricians. As a way to reduce healthcare disparities, individual pediatricians and other clinicians began volunteering their time to provide in-person healthcare in elementary schools in pockets around the state. About five years ago, telehealth emerged as a viable way to more consistently improve access to services. Building off existing partnerships, telehealth programs organically spread, with clinicians serving as local champions.
The telehealth program got a push forward when the president of the Medical University of South Carolina (MUSC) became personally involved. The president went to the state legislature and highlighted the importance of telehealth and telehealth partnerships. That advocacy resulted in the state legislature providing funding and support for telehealth with a mission to target schools with the greatest health disparities.
Shelley McGeorge, the Director of Medicaid Services at the South Carolina Department of Education says her work on this program has helped her realize the importance of having dedicated partners. The state’s Education agency has been a champion of the telehealth program and that has made a big different in the program’s success, she says.
Creating and managing this program has also helped McGeorge realize how much opportunity there is. “A lot of times, we who work in education with Medicaid walk in and expect that things are already built, that there really is not a lot of room to build more. There really is.”
South Carolina is a member of Healthy Schools Campaign’s and Trust for America’s Health’s Healthy Students, Promising Futures Learning Collaborative, which has given the state the opportunity to share leadership on telehealth, and other school health services issues, with states across the country. As more states consider expanding access to school health services through telehealth, South Carolina’s story offers important lessons learned and best practices.