Examination Station

New video technology provides improved access to health care for school children.

It started with an innocent sneeze in homeroom. By second period, the normally energetic seventh-grader was feeling a bit feverish. Now, as she shuffles into the lunchroom, her body is aching, her eyes are watering, and her head is pounding. Sounds like someone might have the flu.

Situations like this often result in calls to parents who must leave work early to pick up their sick child, then spend countless hours in a crowded doctor’s office waiting room. But what if the school nurse could provide a diagnosis instead?

A telehealth stethoscope

A telehealth stethoscope uses the same wireless Bluetooth data transfer technology found in cell phones.

It may sound like concierge medicine in the Hamptons, but it’s actually made possible by a new health care technology system implemented at Knoxville’s Vine School Health Center (VSHC). Nan Gaylord, registered nurse and associate professor of nursing at UT, is the driving force behind this unique concept.

“The project began because we saw a lot of students in the area who we were trying to serve, but just couldn’t because they were unable to come to us,” Gaylord said. It was clear that an alternative method was needed to deliver vital medical services to the community, so she researched ways to connect with other schools and discovered a solution.

Gaylord partnered with Lisa Wagoner, registered nurse and director of health services for Knox County schools, to write a proposal to the US Department of Health and Human Services. In 2011 they were awarded a grant to purchase a telehealth system that allows VSHC staff to virtually examine patients at eleven other Knox County schools over a secure network.

“Many of the parents at our schools do not have transportation or are in jobs that make it very difficult for them to take off work and afford the services. We’re attempting to serve those students who don’t have easy access to health care,” said Gaylord. That is why the priority is to link to Title I schools where a majority of students are from low-income families.

How It Works

The telehealth system works like a video conference call, but with medical equipment.

School nurse uses the Bluetooth stethoscope on a child patient

School nurse Jennifer Hoskins uses the Bluetooth stethoscope that allows her and the VSHC medical professional to hear a patient’s heart and lung functions.

One examination room at VSHC serves as the hub. It contains a video camera, a large monitor, a laptop computer, and networking infrastructure that connects to similar setups at the other schools.

An appointment is initiated when a school nurse calls VSHC to request a session with a medical professional. Once the secure connection is made, video streams from each location appear on the monitors, and each person logs in to the telehealth software via laptop.

Sore throats, ear infections, skin rashes, and breathing issues can all be diagnosed via the telehealth system. For example, if a student is complaining of a sore throat, a school nurse can connect to VSHC and show the child’s throat using a lighted instrument with a small camera on the end.

Once the VSHC medical professional has provided a diagnosis, the school nurse can contact the parents and let them know what’s going on without them having to leave work or make an appointment after school. The system also helps cut down on the number of emergency room visits.

Getting Results

Nan Gaylord inspects health data

At the VSHC hub, Nan Gaylord looks at a visual representation of the heartbeat using a virtual heart monitor receiving data from the wireless stethoscope.

Only seven schools were connected and 152 children served during the first year of the program. The number of students almost doubled during the second year, and even more are expected to take advantage of this beneficial technology in the coming years.

Additional funding through the College of Nursing for intraprofessional education and practice now enables eleven Knox County schools to use the telehealth system. According to Gaylord, the VSHC has incredible community support but is constantly seeking additional public and private funding.

“I’ll talk all day about telehealth, I love it so much,” said Jennifer Hoskins, the registered nurse at Pond Gap Elementary School. “I’ve seen students receive health care that is desperately needed, such as getting an ear checked out before it becomes a full-blown infection. Early access to health care is huge, and this system allows me do my job better.”

For now, Gaylord is focused on increasing capacity and teaching medical professionals across several disciplines how to use the telehealth system. So the next time your child ends up getting sick at a school, they just might experience an innovative medical solution like the one Gaylord and her team brought to Knoxville.

Published online, Quest, May 14, 2015.

Photography by B. J. Crawford and Dustin Brown.

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