Telehealth used to reduce ED visits

Atrium Health was considering expanding capacity at a busy hospital emergency department (ED) in Cleveland County, N.C., when its leaders saw clinical and census data showing children from a local school were using the ED to treat their asthma symptoms and low-acuity illnesses.

However, after contacting the school, Atrium Health learned that the school would send children experiencing extreme asthma symptoms or low-acuity illnesses to the ED at least every five days because its nurse didn’t have permission to administer necessary preventive medications, says Patricia Grinton, M.D., director of Atrium Health Levine Children’s school-based virtual clinic.

To remedy this, Atrium Health installed a school-based virtual clinic, which remotely connects to a pediatrician at the pediatrician’s office. Parents, who are often working or lack transportation to visit a doctor with their child, can join the consultation remotely or in-person. 

The doctor can evaluate and develop a treatment plan for the child in real time and send an electronic prescription, if needed, to the preferred pharmacy. 

If medication is prescribed, a medication authorization form — which permits school nurses to administer medication — then “goes home in a book bag,” Grinton says. “So, the parents just sign consent. And then, boom, it’s right back [at the school].”

By looking closely at its data, staff at Atrium Health were ultimately able to keep children healthy and in school, and reduce early school dismissal due to illness while also decreasing unnecessary ED visits. The program has also helped to connect students to an established medical home. 

“The virtual clinic provides local families the opportunity to seek medical care for their school-aged children more readily,” Grinton says. “The students are evaluated for their health care needs while they remain at the school and their parents continue their daily activities, such as going to work.”