School-Based Telemedicine to Improve Healthcare Access for Rural School-Aged Children

Children living in rural communities often experience disparity in access to healthcare services. The purpose of this project was to explore a school-based telemedicine plan to improve access to comprehensive healthcare services for school-aged children that live in the rural community of Coeur d' Alene (CDA), Idaho. The objectives of this project were to: (1) determine essential components of the proposed school-based telemedicine program; (2) involve community partners and other stakeholders in project planning; and (3) disseminate the development plan and results of the needs assessment at a larger community stakeholder's presentation and at the School Nurse Organization of Idaho (SNOI) annual conference. School-based health centers (SBHCs) have been shown to increase children's access to preventative care visits, improve screening rates for high-risk behaviors, provide a linkage between the health and education systems, provide an entry point and source of primary care connecting students to a medical home, and contribute to positive educational outcomes. By using electronic information and telecommunications technology, SBHCs deliver long-distance, clinical healthcare, counseling, and health-related education for students, school staff and others in the community. Following Institutional Review Board approval, a community needs assessment for the SBHC was distributed via electronic surveys to parents, students, and school staff. Focus groups and interviews with identified key stakeholders and community partners were held. The results of the needs assessment were presented to key school district administrators. Due to unforeseen stakeholder opposition, a greater community forum for discussion of the project's findings was not possible. Project findings will be presented on June 9 and 10 at the 2014 Annual School Nurse of Idaho Conference. Approval to present the needs assessment data to district board members and to continue forward with the school-based telemedicine program has not been granted and is currently under consideration by the CDA Superintendent and other key administrators. Both telemedicine and SBHCs are potentially controversial programs in Idaho, which is a conservative state and one of the last states to embrace SBHCs. Since beginning the project, two SBHCs have opened in the state of Idaho and state legislators are currently looking at existing policy regarding Medicaid coverage for telemedicine. As exposure to telemedicine and SBHCs increase, telemedicine in schools as a means to improve access to healthcare may become more accepted.