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School-based virtual clinic improves children's access to care

Thanks to a virtual school clinic, asthma sufferer Darihanna breathes easier. So does her mother.

Darihanna Ussery is a Cleveland County student who suffers from chronic asthma. At one point, it seemed as though Darihanna was spending more time in the doctor’s office than in the classroom. That was until her school launched a virtual clinic. It offers convenient telehealth services to students.

Darihanna’s mother, Detra Rice, hated seeing her daughter’s condition affecting her education.

“Before this virtual clinic, about three to four times a week, I had to go pick her up. [Her asthma] wasn’t under control then,” Detra said. “Now that we have the virtual clinic, I haven’t gone to the school to pick her up at all.”

The Atrium Health Levine Children’s Community-Based Virtual Care aims to improve students’ access to pediatricians. The doctors can diagnose and develop treatment plans while the students remain at school. This minimizes disruptions to the student’s educational experience. It also eliminates the need for parents to disrupt their schedules and head to the doctor’s office.

The virtual school clinics are located in rural and underserved communities in North Carolina, where access to pediatricians is limited. Since launching in 2017, the clinics have helped students stay in school all day. They’ve also decreased avoidable visits to the emergency department by 37%, according to Atrium Health.

Traditional clinic meets innovative technology

Here’s how the clinics work: Using a secure telemedicine platform and innovative technology, students are evaluated by a Levine Children’s pediatrician. The doctor completes a health exam using a tele-stethoscope to listen to their heart and lungs. They can also use a tele-otoscope to see their eardrums. A high-resolution camera allows the doctors evaluate students’ eyes, nose, throat and skin.

Students are treated for the same issues doctors would tend to at traditional clinics. This includes common colds, asthma, respiratory infections, headaches, sore throats, belly aches and minor skin issues.

“We finally had this aha moment that with innovative technology, we can access kids in their rhythm of life,” said Patricia Grinton, MD, director of Levine Children’s School Based Virtual Clinic.

Parents can join the virtual visit via audio or video or choose to attend in-person. The doctors then discuss the diagnosis and treatment plans, including prescriptions and follow-up care, with parents.

“Even though we’re not face-to-face, we’re still communicating with each other and that’s the key of this virtual visit,” said Detra. “It really has benefited not only my daughter, but it is also saving me time and money.”

[MUSIC Atrium Health logo]

[Valerie O'Kelley, PHD, EDD, Principal, Graham Elementary] Graham Elementary is located within Cleveland County in Shelby North Carolina. We don't have a doctor in every corner, so having a program here like virtual clinic helps our children to feel even safer at school.

In order to educate children, they have to feel safe first. You have to have those basic needs met. They will tell you what's wrong with them. They are able to see the nurse immediately, and the nurse, if she needs to go further, the virtual clinic is right there.

[Detra Rice, Darihanna's mother] My daughter has chronic asthma. Before this virtual clinic, about three to four times a week, I have to go pick her up and it wasn't under control then. So now that we have the virtual clinic, I haven't went to go to the school to pick her up at all. It really helped me out and her.

[Patricia Grinton, MD, Director of Atrium Health Levine Children's Shelby Children's Virtual Clinic] It's really difficult if you're a working parent to make an appointment for a rash or sore throat and so we thought that perhaps we can help the families out, help our community out, help minimize ED utilization for things that really don't need to ED any that really just need access during working hours.

[Darihanna Ussery, student] Usually I always go to the nurse and just take a breathing treatment. I take the asthma pump again after a couple of minutes and if that don't work, I have to go home.

Now that I don't get out of school a lot, I get to take tests, get extra time and now I'm making great grades.

[Valerie] Parents would pick them up last year but now instead of having to pick them up, they're able to be seen by the nurse, be seen by a doctor virtually. In many cases, the children are able to actually stay. With that, attendance is better, chronic illness is much better managed, you have less ER visits.

[John Smith, MD, CPC, Medical Director of Quality Based Network, Blue Cross NC] One of the focus areas of Blue Cross Blue Shield of North Carolina is pediatric care. Now we realize not everybody's got equal access to resources for medical care.

Blue Cross Blue Shield of North Carolina is investing 750 thousand dollars over a three-year time frame to the virtual clinic program actually helps ensure the children of Shelby North Carolina are able to have good quality care regardless of their socio-economic barriers they may have.

[Patricia] Maybe the child that night had an earache, mom writes a little note to their teacher and says could you please have my child evaluated in a virtual clinic. That child makes their way to the school nurse, the school nurse reaches out to our teller presenter, I or my pediatrician colleagues enter our virtual room. We also take the heart, the lungs, as we're talking to families we say “oh sure enough that is a left-side ear infection. Let me call some amoxicillin." You wanted it called into a particular pharmacy, so I'll go ahead and get that filled and send that over.

[Detra] I'm very grateful for Blue Cross Blue Shield North Carolina to invest in this virtual clinic. It really has benefited not only my daughter, but also it's saving me time and money, so I'm grateful for the investment that they are investing in this virtual clinic.

[CLOSING TEXT] Atrium Health Foundation would like to thank Blue Cross Blue Sheild of North Carolina for supporting Atrium Health Levine Children's.

Expanding beyond the classroom

The virtual school clinics are developed through a partnership between Atrium Health Levine Children’s, Atrium Health’s Community Health division, Cleveland County Public Health Center and Cleveland County Schools.  

In 2019, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) invested $750,000 to expand the clinics to additional schools in Cleveland County. The program is now being offered in 25 schools throughout the county.

This summer, its reach expanded even further. Now the clinics are available to youth enrolled in summer programming at the Cleveland County YMCA and Boys & Girls Clubs of Cleveland County.

Blue Cross NC understands that access to care is crucial for helping kids stay healthy. That’s why we invest in community programs like Atrium Health Levine Children’s Community-Based Virtual Care.

authors photo
Sinead Taylor
Sinead Taylor

Public Relations Communications Specialist

Sinead Taylor previously worked as a public relations communications specialist at Blue Cross NC, focusing on community and diversity engagement. She's passionate about writing and producing impactful stories to create social change.

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