Pilot telemedicine program proposed for 10 local schools

Rick Wagner • Jul 7, 2013 at 3:24 PM

BLOUNTVILLE — Students in 10 local schools, five in Kingsport and five in Sullivan County, soon could have access to Holston Medical Group primary health care at their schools.

integrateMD is proposing a pilot or incubator telemedicine program with the county and city school systems to begin as early as August, Steve Clark, chief executive officer of integrateMD, told the county Board of Education Monday night.

Clark told the county BOE the initiative is called TennTelMed and could start by mid-August in the two systems, although neither system has approved a program.

In the county, schools proposed for the program are Sullivan Gardens K-8 with 520 students, Rock Springs Elementary with 410 students, Miller Perry Elementary with 424 students, Colonial Heights Middle School with 500 and Sullivan South High School with 930.

“Families get to choose to participate or not participate,” Clark said.

Vicki Johnston, director of nursing for the city system, has put together a proposal for telemedicine in Kingsport City Schools,

“For several years, we have been exploring a potential community partnership that could provide enhanced healthcare access for the children of Kingsport,” Johnston said. “integrateMD has the potential to help facilitate that process. We are excited at the prospect of partnering with HMG and integrateMD to continue developing plans that would provide this important service to our children.”

However, Johnston and KCS spokesman Andy True Tuesday said nothing has been finalized, including the identity of the five schools to be served in a potential pilot.

“I have been asked by Steve Clark to identify five schools for the inception of this project,” Johnston said via email Tuesday. “We have not made any decision at present.”

Clark said the five county schools were chosen for the trial with short commuting distances for the nurse practitioner in mind. Director of Schools Jubal Yennie provided a list of 12 potential schools, and Clark said the five chosen could be changed if needed.

“Provider reimbursement funds the program,” Clark said.

Asked about students with no health insurance by BOE member Robyn Invester, who represents the South zone proposed for the program, Clark said that would be a good way to locate students who are eligible but not signed up for TennCare coverage.

Integrating primary health care in school health clinics is a goal for all of Tennessee, Clark said, adding that the two local systems likely would receive statewide attention.

During a BOE work session Saturday, Director of Schools Jubal Yennie told the board that a second company, Beacon Analytics, also has floated the idea of a telemedicine program that could be a pilot program in Sullivan County.

Clark said that state Rep. Tony Shipley, R-Kingsport, has helped clear the way for the telemedicine program over the past four years. Shipley attended the county BOE meeting.

Since HMG has 60 to 70 percent of local students as patients, Clark said it made sense to start with HMG and then expand the program to other providers later. He said a draft memorandum of understanding between the school system and HMG should be available next week.

He said Blue CrossBlue Shield and United Health Care also are on board. They provide TennCare benefits in Northeast Tennessee as well as private insurance plans.

Clark said the system would decrease costs by reducing emergency room visits through preventive care and early diagnosis, support and sustain school nursing programs and healthcare programs, provide ready access to physicians and other specialists, including dentists, and facilitate emergency preparedness statewide in cases of illness outbreaks.

A full-time nurse practitioner would serve each set of five schools, rotating among the schools each week. He or she would see students in person at the school of the day and use telemedicine to serve students at the other four schools.

Other healthcare providers, including physicians and dentists, would be available online through telemedicine, and school nurses also would be utilized. Eventually, for students using a provider not in HMG, other groups or doctors could join the program.

In time, he said the 8 a.m. to 2 p.m. school nurse day might be able to be extended. The whole program, including the technology, would be paid for by insurance payments and the normal co-pay patients would make.

He said acute care, behavioral and mental health, and chronic disease management would be advantages, along with using the program to improve health education and training of education and support staff.

The system would be cost-effective and efficient for the school system, he said, hopefully increasing average daily attendance by keeping students in school instead of at home or at the doctor.

Parents and guardians would not have to drive their children to the doctor as much.

BOE member Todd Broughton later said the program could serve adult school staff and parents of children in the school.

Broughton said he’s already discussed expanding the program to include schools in the Sullivan North High zone he represents on the board.

With 15.7 percent of school-age children having asthma, 16.3 percent overweight and ripe for diabetes and a 23 percent annual growth rate in autism diagnosis from 1992 to 2003, he said telemedicine provides a way of improvement.

In addition, he said well visits, sports physicals and speech and dental services also could be provided.

A high-definition camera, electronic stethoscope, otoscope, spirometer and dental camera and computer would be provided at each site, utilizing a school Internet connection, Clark said.

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