Mercy Debuts Telehealth at School Clinics

August 27, 2013

Independence High School freshman Kason Carroll participates in

a three-way telehealth visit from the high school clinic. The first

telehealth visit of the school year, provider Carlos Venegas, APRN,

conducted Kason’s examination from the Mercy Clinic several

blocks away, while Wendy Deibert, Mercy’s vice president for

telehealth services joined the visit from her office in St. Louis to

help guide the participants through the trial run.

When Independence, Kan. public school students returned to the classroom last week, Mercy Clinic’s advanced practitioners came along, a virtual, high-tech sort of way, that is.

With the start of the school year, Mercy Independence and USD 446 launched a partnership to provide telehealth services in each of the community’s four public schools. Telehealth, or “telemedicine,” involves the use of advanced medical technology with a secure internet connection to link the school clinics with the Mercy Clinic and allow providers to conduct an “office visit” from several blocks away.

A high-resolution camera, video monitor and a microphone, coupled with a secure internet connection, allow the Mercy Clinic provider to interact in real-time “face to face” with the patient. Specially designed attachments, such as a stethoscope and otoscope (an instrument for looking inside the ear), equip the school nurse to assist with the exam by positioning the attachments as directed by the nurse practitioner on the other end.

Wendy Deibert, Mercy’s vice president for telehealth services, explained the Independence initiative is a pilot project for the health system, the first school-based telemedicine service to be undertaken in a Mercy community.

“We are thrilled to bring telehealth to the Independence schools and expand our capability to serve the community,” Deibert said, noting that while the technology is new in the school setting, Mercy has mastered the use of telemedicine in other service areas.

“We’ve been successfully utilizing telemedicine technology across Mercy, and specifically in Independence, since 2006, when we implemented our electronic intensive care (eICU) unit program,” she said. “EICU allows us to remotely monitor and assist with the care of ICU patients in all Mercy hospitals from a centralized command center in St. Louis, and today we have the capability to monitor nearly 500 patient beds simultaneously.”

Mercy Independence further expanded its telehealth capacity a year ago when it added the telestroke service in the Emergency Room, connecting suspected stroke patients with specially trained neurology physicians from states away who can examine, diagnose and treat them remotely.

Deibert explained that a major advantage of telemedicine services, particularly for a rural community such as Independence, is that patients can have more immediate access to specialized, quality care that might otherwise be difficult or less convenient to obtain.

In the case of the students and staff of Independence schools, Mercy’s goal is to offer convenience and peace of mind, said Rita Taylor, director of Mercy Clinic in Independence.

“Imagine not having to leave work or other obligations to pick up a sick child at school and take them to the doctor,” Taylor said. “Telehealth allows us to take care of your child right on site while he or she is still in the school clinic and, in many cases, they can return to class.”

Taylor explained that complaints that could potentially be handled via telemedicine include earaches, headaches, sore throats, rashes or bug bites, dizziness or management of chronic conditions, such as asthma or diabetes.

For Independence High School freshman Kason Carroll, it was a red and painful eye that sent him to the clinic on day two of the school year and won him the honor of being the first telehealth patient. After following her routine protocol to determine what help Kason needed, the school nurse aide decided a call to Mercy Clinic was in order.

An appointment was scheduled, and once connected, Kason met Mercy’s Carlos Venegas, APRN, “face-to-screen.” With the nurse aide’s help maneuvering the exam camera, Venegas examined Kason and asked him a series of questions about his recent activity, medical history, medications, etc., to uncover the cause of his eye irritation. While Venegas concluded that an in-person examination was necessary for more complete diagnosis and encouraged Kason to visit Mercy Convenient Care later that day, he was able to make the determination that Kason’s condition was not contagious, and he could return to class to finish out the school day.

“There will, of course, be instances in which the telemedicine visit will not be sufficient to make a diagnosis, and the child will need to come into the clinic for an in-person exam,” Taylor said. “But even in those cases, the telemedicine visit will give the patient a jump start and alert the provider as to how to prepare.”

Taylor noted that telehealth visits are billed just like a routine office visit, and in the case of an initial virtual visit that must be continued at the physician office, patients will not be charged “double” for co-pays or appointment fees.

Kason’s parents both happen to be employees of the school system - his father principal of an elementary school and his mother a middle school teacher. For them, the convenience of the telemedicine service was much appreciated and a “no brainer” decision when they got the call from the school nurse aide saying that Kason needed medical attention.

“We both have responsibilities at our jobs and can’t always leave at the drop of a hat,” said Kason’s father Brad Carroll. “As a principal, I was both excited and curious to see how telemedicine would work in our schools this year. As a parent, I was relieved it was available for my kid when I needed it.”