The North Carolina-based Center for Rural Health Innovation’s mission is to apply innovative technologies to improve access to healthcare in rural communities, from hospitals to clinics to schools and more. The student population that the CRHI’s Health-eSchools program works with does not have easy access to healthcare, due to a shortage of resources and lack of funds.

The problem

As a non-profit, the CRHI’s Health-eSchools program relies on grant funding, and in the past has used standard telehealth examination tools that proved difficult to scale. The program’s previous telehealth examination tools offered limited reliability and portability, could be difficult to use, and were very costly.

Since the CRHI’s previous telehealth solution was not portable, only six of the 26 Burke County schools were able to receive telehealth coverage. Due to these factors, finding a cost-effective, portable and reliable tool was critical to delivering top-quality care to CRHI’s many students to keep them healthy and in class.

Proposal

The Center for Rural Health Innovation selected telemedicine technology from Tyto Care with the goal of breaking down barriers to healthcare access by delivering a portable, reliable and cost-effective alternative to existing tools, CRHI said.

Marketplace

There are many technology vendors on the market today that offer telemedicine tools. These vendors include American Well, Avizia, GlobalMed, MDLive, Novotalk, SnapMD, Teladoc, TeleHealth Services and Tellus.

Meeting the challenge

CRHI selected Tyto Care upon receiving new grant funding in 2017.

The program purchased several TytoPro examination kits, which include: a hand-held modular examination tool for examining the heart, lungs, skin, throat, ears and body temperature; a complete telehealth platform for sharing exam data, conducting live video exams and scheduling visits; a cloud-based data repository with analytics; and built-in guidance technology and machine-learning algorithms to help ensure accuracy and ease of use, according to Amanda Martin, executive director of the Center for Rural Health Innovation.

The technology transmits data using a Wi-Fi connection and does not require any significant upfront set-up or integration to use, so implementation was fairly straightforward, Martin said. In addition, the device and platform are very intuitive to use so training requirements were minimal, she added.

“And the portability ensures that the telemedicine technology can be used by more than one school if needed, and the price point is significantly less than traditional cart solutions,” she said.

CRHI’s Health-eSchools program implemented the technology in Burke County in the fall of 2017. Since piloting the program, there has been significant improvement in the level of care the CRHI provides to its students, Martin said.

“The portability enabled Burke County school nurses to take their telehealth clinic from school to school,” she explained. “This, in combination with the lower price point, enabled the CRHI to now cover all 26 schools, vastly more than the previous solution.”

"About 89 percent of students who completed a telehealth visit were able to return to class, thus reducing absenteeism."

Amanda Martin, Center for Rural Health Innovation

The portability extended the reach of nurses, reducing associated costs of hiring and training additional staff. Further, CRHI was able to easily train nurses, who travel between multiple schools daily, and other staff members, due to the ease-of-use of the technology, allowing for quick, on-site primary examinations for students, Martin said.

“Using the technology, school nurses can examine and treat common complaints including: strep throat; ear, sinus and respiratory infections; chronic conditions; flu; and even lice,” Martin said. “About 89 percent of students who completed a telehealth visit were able to return to class, thus reducing absenteeism.”

Results

The new telemedicine technology enabled staff at CRHI to perform a successful telehealth visit 98 percent of the time, 26 percent more often than past telehealth examination tools. Staff quadrupled the number of telehealth-served locations compared with the previous technology. The new tech also experienced significantly fewer technical issues during a visit than past telemedicine carts.

Eighty-nine percent of students who completed a telehealth visit were able to return to class. And the telemedicine technology enabled CRHI staff to provide telehealth to all 26 schools, compared to the previous solution, which covered only six schools.

Advice for others

“Using a telehealth solution like TytoCare has the potential to make a huge impact in rural communities,” Martin said. “Rural populations are experiencing hospital closures, and a major shortage of local, accessible clinicians. As such, many children are facing limited access to healthcare resources.”

In addition, many of these children and their families face economic hardships that make it difficult to see a doctor when needed, she added.

“School telehealth removes these barriers and provides great value for our children within the academic framework,” she concluded. “CRHI advocates using innovation to establish more accessible, high-quality healthcare.”