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Virtual Health Coordinator, Blessing Health System
Ros e A. Ghat tas , RN
DISCLAIMER: The views and opinions expressed in this presentation are solely those of the author/presenter and do not necessarily represent any policy or position of HIMSS.
President, Hospital and Health Systems, Teladoc Health
Jos eph DeVivo
Piloting a School Telehealth Program in a Rural CommunitySes s ion # 9, Augus t 10 , 2021
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Welcome
President, Hospital and Health Systems, Teladoc Health
Jos eph DeVivoVirtual Health Coordinator,
Blessing Health System
Ros e A. Gha t tas , RN
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Conflict of Interest
Rose A. Ghattas, RN
Has no real or apparent conflicts of interest to report.
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Conflict of Interest
Joseph DeVivo
Salary from Teladoc Health
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Agenda
• Learning Objectives
• Care Access Challenges
• Telehealth Overview
• Blessing In-school Telehealth Program Implementation
• Outcomes
• Next Steps
• Conclusions
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Learning Objectives• Identify the benefits of a school-based telehealth program
• Analyze relevant applications, offerings, and settings for a school-based telehealth program
• Compare how a school-based telehealth program can improve student learning and support teachers
• Evaluate how a school-based program can be initiated based on current or future telehealth models
• Predict the challenges in implementing a telehealth program and strategies to facilitate patient and provider adoption
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Healthcare Access Challenges In Rural Areas
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Primary care Burden Solutions
Shortage in Rural Areas Access and Cost Telehealth
*Bureau of Health Workforce Health Resources and Services Administration. 2021. Healthcare Access in Rural Communities. Accessed July 12, 2021. https://www.ruralhealthinfo.org/topics/healthcare-access
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Criteria for Choosing a Telehealth Partner
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Purpose-built platform
Integrated clinicalworkflows
Industry -leading security and privacy standards3
24/7/365 managed services and support4
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Telehealth Benefits
Improves quality of care
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Wider reach
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Potential to cut costs
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Need for In-school Healthcare in RuralSchool Districts
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Lack of Healthcare Access
Farm and rural populations across have some of the lowest levels of access to healthcare in history, with cost also being a major barrier
Impact on Children
Children in rural areas are more reliant on school-based healthcare programs than their urban counterparts
Impact on Learning
Children miss more school for in-person doctor’s appointments
Blessing Health System sought to combat these challenges in its rural community in Missouri by initiating the region’s first-ever school-based telehealth program.
School-based Healthcare Gaps
Rural schools often lack nurses with the ability or qualifications to meet the various medical needs of students
Impact on ParentsParents may not be able to take time off work for a child’s medical appointments or may lose pay for doing so
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“
Randy JobePractice Administrator, Hannibal Clinic
Parents can face a heart-wrenching dilemma when the school calls to tell them their child is not feeling well. Is it serious enough to pick up the child from school and take them to see a doctor?Now that question can be answered more conveniently through telemedicine.
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Blessing Health System• Hospitals
• Blessing Hospital• Illini Community
Hospital
• Outreach/Affiliates• Denman Linen• Denman Medical
Supply• Brown Drug• Scotland County
Hospital• MeDonough
District Hospital
• Physician Groups• Blessing Physician
Services• Hannibal Clinic
• Rural Clinics &Urgent Care• 18 alternative care
sites including employer clinics, rural clinics, urgent care, convenient care and wellness centers
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Blessing Health System School-based TelehealthHow We Implemented Telehealth Services
• Palmyra School District has an average of 1105 students grades Pre-K, K-12
• Hannibal Clinic Administrator and a Special Project Sales Specialist worked
closely with Blessing Telehealth to develop a scope for services
• Program brought to a school board meeting for presentation and approval
• Other programs are offered in the region• 100% telehealth by a contracted provider group
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• High rate of health-related absences in the school district
• Prevalence of high-deductible insurance or no insurance
• Local providers available with a 2-mile radius of each of the district’s schools
• Same day care or hybrid care by local practitioners
• School nurses highly embedded in the process
• Rural community14
What Made Telehealth Appealing?
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Implementation
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Reliable and flexible technology
Unbeatable customer support
Good connection rates
Blessing and its telehealth partner ensured the successful launch and implementation of the Palmyra school-based program by delivering on their three key objectives
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• Patient loyalty• Registration packet online, mailed,
and at school offices • Opt in and opt out • Record stays with provider group
and follow up done by provider staff• Workflow
• School nurse and counselors have a major role with their students
• Parents contacted at each encounter; provider then contacted
• Equipment• Laptop with Viewpoint• Axillary devices
• Marketing• A community that has never been
exposed to telehealth • Community programs
How we made the program work
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Rapid Deployment of In -school Telehealth in 2019
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Blessing Notified of Need for
Telehealth Program
Proposal Submitted to School Board
SchoolBegins
Telehealth Program
Implemented
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Obstacles
Connectivity1
Contracting space3
Telehealth as a new concept2
Equipment learning curve4Rapid deployment5
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Lessons Learned
Privacy expectations of the school counselors were different than the expectations of the Blessing LCSW
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Public awareness and education efforts3
Tips and use guide created for the axillary equipment2
Use cases and education4How to support the school nurse, administrators, and providers5
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Teddy Bear Clinic
UNIQUE APPROACH TO INCREASING STUDENT AND PARENT FAMILIARITY AND COMFORT WITH TELEHEALTH
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Role of School NursesBlessing’s hybrid telehealth workflow model relies heavily on the school nurse.
• Two school nurses serve a 1200-student population
• The nurses were quickly trained and have adapted to the program
• Nurses assess students and make the final determination on whether
the student would benefit from the school-based telehealth visit • If yes, the nurse
• Checks the student’s telehealth opt-in status• Contacts the student’s parent or guardian for consent• Utilizes the platform to beam in a Blessing physician to
conduct a telehealth consult with the student
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<3080% 1–2
TELEHEALTH RESPONSE TIME
PER WEEK
STUDENT ABSENCES PREVENTED
TELEHEALTH OPT-IN RATE
MINUTESOF STUDENTS
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OUTCOMES
Telehealth Visit Types
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10%
15%
75%
Common Cold
Skin-related
Other• 18 visits in the first
school year• Telehealth visits
resulted in no loss of attendance
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Next Steps
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Behavioral Health
Expand to Other Schools
Marketing3
Budgeting4
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Replicability
Contracts
Information Technology
Workflows
Care Providers
Billing
Project Management
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Conclusions• In-school telehealth prioritizes students’ health
• Provides high-quality and affordable healthcare• Facilitates healthier student body
• School district nurses report significant benefits• Helps parents with jobs that don’t allow time off• Keeps kids at school and parents at work
• Solves two key challenges of cost and access• Provides low-cost care for students who are uninsured or underinsured• Reduces need for time-consuming in-person doctor visits
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Questions
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Thank you!• Rose Ghattas, R.N.
Virtual Health Coordinator, Blessing Health System [email protected]://www.linkedin.com/in/rose-ghattas-9a0927170/
• Joseph DeVivoPresident, Hospital and Health Systems, Teladoc [email protected]://www.linkedin.com/in/joe-devivo/
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