Schools play a critical role in the development of children and adolescents. Providing health services in school settings helps to assure that children are physically, socially and emotionally prepared to learn and develop. Telehealth can provide timelier and improved access to these services.
School-based telehealth services may include, but is not limited to:
- Acute care for minor injuries and illnesses
- Behavioral health services including individua and group counseling or psychotherapy
- Case managemern
- Chronic disease care and management
- Clinical assessment interviews
- Clinical supervision and case consultation
- Medication management
- Nutrition counseling
- Occupational and physical therapy
- Oral health screenings
- Peer support
- Pre-participation (sports, camp or school) physicals
- Sports medicine consults for athletic injuries
School-based telehealth services may be used as the sole source of assessment and treatment or used in combination with in-person services.
Third party reimbursement for school-based telehealth is widespread and growing. Most third-party health insurances and Medicaid reimburse for school-based telehealth services. Some health insurances have separate conditions for school-based telehealth reimbursement. A growing number of states require reimbursement for school-based telehealth services that are comparable to in-person services. Additionally, many healthcare entities privately contract school-based telehealth service providers to cover shortage areas. Grant funding is also available to establish and grow school-based telehealth services.
Each profession that provides medical, behavioral or therapy services has guidelines (both clinical and ethical) for providing telehealth services.
State license regulations for telehealth vary by profession and from state-to-state. Learn more about Licensure and Telehealth. Additionally, there are are a variety of rules, regulations and best practices pertaining to school based telehealth.
Care options may include live-synchronous (two-way) video with peripheral devices such as stethoscopes and otoscopes. It may also include store and forward exams that are reviewed later by a provider.
Providing school-based telehealth services requires technology that meets HIPAA-security standards and permits clinical staff to fulfill their HIPAA compliance duties. The technology requirements for school-based telehealth will vary depending on the use-case, setting, record integration/sharing requirements (EHR/EMR integration) and other factors.
After the initial setup of the program, the role(s) needed to set up and facilitate school-based telehealth services will depend on many factors such as setting, size of the organization, the scope of services, business model and the support needs and preferences of the clinical staff and treatment population. In a typical setting, a clinical provider will be on one side of the video call and a presenter or facilitator will be on the patient side to facilitate the patient/client access. This presenter is often the school nurse or another member of the school staff.
The types of settings for school-based telehealth are school nurse office, dedicated space in the school, school-based health center, and mobile vans or buses. Clinical providers may be located either at a clinic, a hospital or the provider’s home, depending on the payment model, technical setup and organizational policy.
Running a new school-based telehealth service is simple, once established. However, it is challenging to design a new school-based telehealth service without experience and knowledge on a broad range of content areas that periodically change.
Startup entails activities like creating clear use-cases, creating a school-based telehealth business model, building referral systems, selecting and setting up HIPAA-secure software and secure technology, creating school-based telehealth-specific content, creating new school-based telehealth HIPAA administrative procedures, creating service policies and procedures, and complying with school-based telehealth professional guidelines and state license laws for each profession. To overcome the complexity of starting up, it is recommended that the organization engage with a mentor or consultant to efficiently guide the startup through the initial steps to achieve proficiency in the near term.
Dr. Steve North and Amanda Martin, leaders of the innovative Health-e-Schools program in North Carolina, share a 30-minute introduction to School-Based Telehealth.
