UF telehealth pilot program aimed at reducing absenteeism, increasing graduation rates

Students in three Alachua County Public Schools will have access to telehealth appointments during school hours this year as part of a joint effort between UF Health Physicians and UF Health’s Department of Pediatrics Telehealth outreach programs.
 
With parental consent, students will be able to take part in telehealth appointments from a private area within the school. The pilot program will be implemented in Howard Bishop Middle School, Metcalfe Elementary School, and Rawlings Elementary School. 
The School Board of Alachua County (SBAC) approved moving forward with the program at its last regular meeting and will enter an agreement with Florida Clinical Practice Association, Inc. also known as UF Health Physicians.
According to University of Florida’s Dr. Sanjeev Tuli Associate Chair for Clinical Affairs and External Business Development Chief for the Division of General Academic Pediatrics, the pilot program has been in development for a year and was designed to decrease students absences which they predict will increase graduation rates.
 
A 2018 study published by the American Academy of Family Physicians report that, “Frequent school absenteeism has immediate and long-term negative effects on academic performance, social functioning, high school and college graduation rates, adult income, health, and life expectancy.” 
 
The study states that, “a recent national survey found that 14 percent of students — or about 6.8 million children and adolescents in kindergarten through 12th grade — are chronically absent, defined as missing at least 10 percent of the school year or about 18 days.”
 
The study also notes that absenteeism “is often perceived as a high school problem,” but half of chronically absent students are enrolled in elementary and middle schools.
 
There are three parts to the mission, Dr. Tuli said. They are to decrease absenteeism so that students can stay in class and learn, to improve the health of the population, and to help prevent parents from missing work.
 
“If they won’t have to take them to an appointment, they won’t take off work,” Dr. Tuli said about how often parents have to take hours or day away from work to make sure their children receive medical attention.
According to Jon Moller, administrator for Telehealth and Outreach Programs for the UF College of Medicine’s Department of Pediatrics, each telehealth appointment will depend on the circumstance and what is presented. 
“We will establish live video and audio connection between parent, kid and physician,” Moller said, just as UF Health is already doing in other clinical situations. In some circumstances, the “Child will present at the nurse’s office, and will establish a connection with or without parent.” Details are still being worked out, he said.
What is necessary for the program to start is parental or guardian consent up front at the beginning of the school year which starts next week. Once a parent has given authorization and enrolled their child to participate in the program, telehealth appointments can be arranged.
Moller said that the equipment needed for the program will be a video camera, microphone and a speaker. UF will work with schools to make sure they have the necessary equipment. The telehealth appointments will be HIPPA compliant, Moller said. And the virtual “waiting rooms” will be maintained and controlled by the physicians.
UF Health Physicians Telehealth Manager Stuart Clarry said that telehealth appointment security will be taken very seriously by using a Zoom endpoint to endpoint encryption. “Nothing is recording,” he said. “We maintain security that way,” he added about encounters that could be happening between the school nurse, a student, a provider, and a parent.
Dr. Tuli emphasized that the process works not only for unanticipated health appointments but also for students who have ongoing medical and behavioral health issues such diabetes, asthma or a learning disability and even stress or anxiety that might require counseling.
“States fund schools for the reason to teach children and care for them in the complete picture,” Dr. Tuli said about how schools serve as education institutions but also help keep students healthy mentally and physically as well. 
As it pertains to students who might present symptoms that could be signs of COVID-19, Dr. Tuli said the telehealth visit would mirror those being scheduled already by UF Health Physicians. “We would do the telehealth appointment just like at home,” he said. “And can tell if the student can stay in school.” If COVID-19 is suspected, the student would be tested.
Alachua County Public Schools Director of Student Support Services Donna Kidwell said she looks forward to seeing the program implemented.
“I’d like to see it in action. It sounds very promising,” she said. “Especially for students with chronic conditions.”

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