Telemedicine for kids catches on in Rochester
ROCHESTER -- Melody Gagner lives a 15-minute walk away from Rochester General Hospital's emergency department, and that is where she often turned for care if one of her three children suddenly became ill.
But that was before the Rochester City School District joined forces with the University of Rochester Medical Center's Health-e-Access program four years ago to offer telemedicine care to students in several elementary schools.
"It's better than going to the emergency department and just sitting there for hours and hours," noted Gagner, who has children in three city schools.
It also came in handy recently when her son, James, who attends Mary McLeod Bethune School No. 45, came down with an ear infection, his second in two months. Each time, Gagner was able to call the school nurse, explain the situation and have her call in a roving certified telehealth assistant (CTA) to meet her son at the nurse's office.
The technician carries a portable laptop, which features such attachments as a stethoscope and ear and throat scopes. This equipment is used to take images of the child that can be electronically transmitted to his or her primary-care physician, if the doctor participates in the program, said Sharlyn Cruz, one of three Health-e-Access CTAs. Otherwise, on-call network doctors or nurse practitioners make the diagnosis, she said. A prescription, if needed, is then called in to a pharmacy.
"They called me on my cell phone, and I didn’t have to leave (work) and stop what I was doing to help with J," Gagner said of James. "That was helpful."
Allowing parents to stay at work and offering them more convenient access to health care for their children -- especially for inner-city parents who may lack transportation -- are some of the main reasons the program was created, said Nancy Wood, program coordinator. Reducing student and employee absences as well as community health-care costs for nonemergency ER visits also have been significant results of the program, said Dr. Kenneth McConnochie, a URMC pediatrics professor and Health-e-Access founder and director.
"When we ask families how they feel they have benefitted (from the program), they most often say that having prescriptions called in so they have only one stop to make is the biggest help to them," Wood noted. "Also, quite often kids can be cleared to stay at school and not be sent home sick and miss class."
The idea for this program came about in 2000 when Wood's son was a preschooler. Wood said she often was called out of her office to attend to her son's illnesses, oftentimes on Fridays when it was the most difficult to get an appointment with his doctor. She and McConnochie then began thinking about the possible ways telehealth equipment -- which they had seen used in home care -- could be used in such situations.
"It evolved into a pilot project and snowballed from there," Wood said.
Since launching the program in 2001 at seven child-care centers, McConnochie said research has shown a 63-percent reduction in student absences and a 22-percent reduction in emergency-room visits. He also noted the price difference between the $55 average insurance copayment for a telemedicine visit and the $350 cost for an emergency-room visit for the same illness.
There is a "large potential for health-care cost reduction (as a result of using the program)," McConnochie noted.
Currently, the program -- which has expanded into 11 schools with access to 5,000 children -- is available at schools and child-care centers in the Children's Surround Care Community area, which covers the northeast neighborhoods of Rochester, Wood said. The program even occupies office space in the Surround Care building. The university is in talks with the school district to possibly expand the program into other areas of the city, she added.
"We are helping them (the school district) seek out the necessary funds, mostly to cover the roaming telehealth assistants," Wood said. "The hope is we can cover the entire district by next fall."
Tom Petronio, the school district's communications director, said the program has been very well-received.
"Children who are healthy are children ready to learn," he said. "Our students get the professional care they need without losing valuable time in school."
The university also has tried reaching out to schools outside the City of Rochester and had previously covered a couple of suburban schools, Wood said. It continues to operate at St. Rita School in Webster, but Wood noted that demand in the suburbs has been low.
"Suburban families seem to have more options during the after-hours period," including access to the Eastside Urgent Care program in Penfield, "and more flexibility within their jobs to leave during the day if needed," she said.
Rochester health center creates unique telehealth program
ROCHESTER -- The Anthony Jordan Health Center created a unique telehealth program last fall to offer management of students' chronic conditions, such as asthma.
Mary K. Perrello, a nurse practitioner who works part time out of a Jordan satellite office, received training to start the program at eight schools in the Rochester City School District. The health offices at those schools would coordinate visits with roving certified telehealth assistants (CTAs) who would send the information to Perrello.
Despite losing funding this spring from the Children's Surround Care Community for the chronic-care portion of the program, Perrello said that with the help of a roving CTA she continues to see students with such acute illnesses as sore throats.
Jordan staff members are working to obtain another source of funding for the chronic-care portion of the program, as this was an ideal way to monitor illnesses and catch issues before they became a crisis, Perrello said.
It's also another entry point to health care for children whose parents may not have health insurance or transportation, she added.
Donna Quinn-Braswell, a school nurse at Henry Lomb School No. 20, which joined University of Rochester Medical Center's Health-e-Access program last fall, said city parents benefit from the telehealth option. When her children were young Quinn-Braswell worked as a nurse at a local hospital, and knows the difficulty she would have faced in leaving her patients to care for her own sick child.
"It's a great program overall," she said of Health-e-Access. "I hope more people will sign up for it. ... For me, it makes sense."
Both Quinn-Braswell and Christy Lamberton, a School No. 45 nurse, agree that parents are more likely to enroll in the program when they hear about it personally. Both nurses send out program information and enrollment forms at the beginning of the year, but said they find more people enroll when the nurses explain the program at school events. Once enrolled, Lambert said the nurses always give parents the option of picking up the child or doing a telemedicine visit.
"Most parents choose telemedicine," she added. "They're happy with it. They're amazed by it."