Despite a rocky start and some changes along the way, the telemedicine clinics in all of the Carter County schools are up and running.

The school system first began looking into the idea of telemedicine clinics in May of last year as a way to help improve student health.

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. Often the parents or guardians must take their child to an after hours clinic or emergency room or keep them home from school the next day to take them to their regular physician, provided they can get an appointment. This means lost work time for the parents and lost school days for the student.

By making use of cutting-edge medical technology, the school’s nursing staff can work with a nurse practitioner to treat the child on site rather than having to send them home.

The telemedicine system uses the Internet and 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 student, including prescribing medications such as antibiotics.

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. The technology used by the program has been compared to the popular program Skype, which allows people to video chat with each other through the Internet.

The computer system also uses specialized medical equipment to view inside a patient’s ears or nose and a special stethoscope. These special diagnostic tools can display images or transmit sounds through the Internet to allow the nurse practitioner to diagnose the patient.

Parents or guardians must fill out a permission slip in order for their child to be seen by the nurse practitioner for treatment.

In addition to treating students, the school system is also allowing its teachers and staff to be treated in the new clinics.

The clinics are now completely installed at all of the system’s schools, but getting the project completed was challenging at times.

When the school system first implemented the telemedicine program, the system worked with a company called Integrated Care Partners. However, that company was ultimately unable to complete the program.

During a recent workshop session, members of the Carter County Board of Education learned ICP had withdrawn from their agreement with the school system and another company had stepped up to the plate to keep the program going.

ICP’s plan for the program was to provide the equipment and pay the salary of the nurse practitioner at no charge to the school system. In return, the company would recoup its costs by billing the student’s insurance for an office visit.

The company’s business model did not work out because the company had not met all the insurance requirements for the state the program’s Nurse Practitioner Sharon Smith told board members. Because of that, ICP did not get reimbursement from the insurance companies for the six months it operated in the school system. Additionally, she said, one of the company’s investors pulled $250,000 in backing away from the company, which hastened its demise.

Prior to ICP pulling out of the school program, Smith said she and others could see the end in sight and had already begun looking for another company to support the program because they believed in the mission of providing health care to the children.

A company called eMD, a division of AllerVision, agreed to take on the program and began immediately working to complete the installation of the telemedicine clinics.

“They installed $75,000 worth of equipment on an act of good faith,” Smith said, adding eMD was operating based on the assumption the school system would enter into an agreement with the company.

During the Board of Education’s regular monthly meeting on Thursday, the group is expected to vote on the agreement with eMD for the telemedicine clinics.