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The camera will see you now

Cutting-edge medical technology could soon be available in a place most might not think of when considering advances in medicine – the local school system.
Treatment for students and staff of the Carter County School system could leap into the future with a virtual doctor’s office through a technology advance being called Telemedicine, which a company representative said can be implemented at no cost to the school system.
The Carter County School System is in talks with Integrated Care Professionals that could create telemedicine clinics at all 14 of the system’s schools.
At a Board of Education workshop on May 15, board members and several school system employees – including the school nursing staff – heard from Tony Shipley, vice president of Integrated Care Professionals Tennessee, about the benefits which telemedicine could provide to the school system.
“This is a true outside-the-box health care system,” Shipley said. “The terminal your nurses operate is a virtual waiting room. It’s a virtual doctor’s office”
Shipley said the telemedicine clinic system his company provides uses the Internet and Web video chat technology to link the nurse and patient in the school to a nurse practitioner who can work with the nurse to diagnose and treat the patient on site – rather than having to send the student or staff member home from school to seek treatment on their own.
The patient and the school nurse sit down in front of a computer terminal equipped with a high-definition web cam to talk with the nurse practitioner to discuss symptoms and treatments, Shipley said. He compared the technology used by the program with the popular program Skype, which allows people to video chat with each other through the Internet.
“Literally, the students and nurse practitioner are face-to-face regardless of the distance,” Shipley said.
Many times when a student is sent home from school with an illness, the school nursing staff doesn’t know what, if any, treatment the child received for their condition, Shipley said. He added that for some of the childhood illnesses that students are sent home for, if no treatment is received, the illness could progress and lead to an emergency room visit, which is more costly for the families.
“This program makes early intervention easier because we can provide access to treatment on site,” Shipley said, adding that catching many of these illnesses early can cut down on the number of school days missed by students and staff.
Shipley touted the system as having the ability to financially benefit the school system in two ways – no loss of state funding due to students missing days and the potential for the school system to see lower costs on its health insurance premiums.
State funding of local school systems is calculated based on the average daily attendance of students. Shipley said that by decreasing the number of days which students miss, the school system could see more funding from the state.
The insurance premium savings could be reduced, Shipley said, because it would show that the school system is taking a proactive approach to staff health. “You have enacted a program that will be a cost savings to your insurance provider,” he said, adding that there are cost savings for the insurance provider because office visits are cheaper than trips to the emergency room or an urgent care clinic.
Shipley said the financial support for the program comes from TennCare and private insurance companies by billing the telemedicine visit with the nurse practitioner as any normal doctor’s office visit would be billed.
“All insurance companies in Tennessee will now pay for telemedicine visits,” Shipley said, adding that the initiative for telemedicine coverage started in the Tennessee State Legislature five years ago. “If you have a student who is indigent, has no TennCare or other insurance, we will see them for free.”
Shipley is a Tennessee state representative from Kingsport.
Shipley said that the billing for the nurse practitioner consultation is what makes the program self-supporting and of no cost to the school system. He also said that no visit co-pays are collected at the school site, and that all billing will be handled by his company.
In order for the program to be self-sustaining, Shipley said there must be at least 2.2 billable visits on average per day per school. Insurance companies will not be billed for visits to the school nurse that do not result in a consult with the nurse practitioner and that no child would be referred to the nurse practitioner without the parent or guardian’s consent.
“With a school system the size of Carter County that will not be a problem,” Shipley said. “You had a nurse in your system who just the other day saw 75 students in one day.”
Members of the Board of Education asked what would happen if that number was not maintained. “That will be our problem, not yours,” Shipley said in response.
Shipley said Carter County would not be the first Tri-Cities school system to use the technology.
“This is a functioning system in Kingsport,” he said. “Kingsport was the pilot program for this for the State of Tennessee.”
The Carter County Board of Education has not reached a final decision on this program yet. During the workshop members of the Board stated they wanted to hold further discussion and research on the program and how it would affect the school system.