A new telehealth program spearheaded by the Mark Twain Health Care District (MTHCD) aims to streamline student health care by making visits to the school nurse easier and more affordable for Calaveras County families.
Aptly named “Robo-Doc,” the program will facilitate on-campus, virtual doctor’s visits involving the student, the school nurse and the student’s guardian, avoiding unnecessary pickups from school and costly visits to a clinic for minor health complaints.
A pilot version of the program will be coming to one campus per each of the county’s four school districts this winter: Albert Michelson Elementary School, Mark Twain Elementary School, Valley Springs Elementary School and Bret Harte High School.
Bret Harte High School Nurse Becca Hancock says the program will bypass a lot of time, paperwork and money spent by parents on something as simple as providing an over-the-counter painkiller to a student, which cannot be administered at school without a doctor’s orders.
“To be able to take Tylenol for a headache, (the student) would had to have preemptively talked about that with their primary care doctor and fill out a form that has to be done every year – just to be able to administer something for a simple headache,” Hancock said. “Sometimes, when I call to let parents know, the doctor’s office wants to charge $20 just to have paperwork filled out. … This really does solve some of the hang-ups we’re having, because we don’t want kids carrying medications and distributing them to their peers.”
Robo-Doc will also free up time for school nurses to focus on their many routine duties such as caring for students with chronic health conditions, she says. Currently, each school district has only one nurse, and the new program will allow for increased flexibility by providing professional “backup.”
“We hope this program will kind of bring back to life the value that school nurses play,” Hancock said.
The tax-funded program piloted by the MTHCD is budgeted for $60,000 in its first year, though much of the costs are one-time purchases of equipment including Robo-Doc carts stocked with a laptop and a camera. The Valley Springs Health and Wellness Center, owned and operated by the healthcare district, will provide pediatric doctors’ visits for the program, utilizing its pre-existing “athenahealth” software to remotely access school campuses.
According to county Superintendent of Schools Scott Nanik, Robo-Doc is a “critical step forward” in the county Office of Education’s vision for school-based health centers.
“We have been working very hard to find ways to provide improved health services to the students of Calaveras County,” Nanik said. “Every improvement in our ability to support student wellness on school campuses is a win-win for our students, their families and our schools.”
With many jurisdictions nationwide implementing similar programs, Dr. Randall Smart, CEO of MTHCD, said that technological leaps in telehealth during the COVID-19 pandemic have “opened the door” for Robo-Doc.
“For a couple years now, the health care district has been analyzing gaps in health care, behavioral health and homelessness,” Smart said. “I’ve always thought one of the biggest gaps was with the school nurses, and we’re wanting to maximize the work we do and how we support them.”
Smart’s consultations with school administrators and nurses revealed a cumbersome school health care system that often interfered with nurses carrying out their duties and placed a financial burden on low-income families.
“I was personally like, ‘Why aren’t we doing more for the rural health care gap?’ Especially for students. Many parents work hours away and getting them to the doctor is costly,” Hancock said.
Nancy Minkler, voluntary attorney and co-executive for the program, says that MTHCD stands out among other health care districts due to its dynamic approach in utilizing taxpayer dollars.
“Dr. Smart is super proactive and is actually creating programs to help the community,” Minkler said.
If they choose to sign up for Robo-Doc, families pay nothing for on-campus consultations and treatment, while parents can remain at work and students can get back to class faster. The program can also provide consultations for remote students during the pandemic.
Out of respect for families, Robo-Doc will not offer any reproductive health services, nor will it supersede primary care physicians.
“We don’t want to interrupt the relationship between the family care doctor and the student,” Smart said. “If they have a family care doctor, we intend to send them information.”
Additionally, the program will not serve the role of a “COVID-19 clinic.”
“(Robo-Doc) is not really related to COVID-19, it just seems to coincide with the pandemic,” Smart said. “That said, if a student is in the nurse’s office having COVID symptoms, we’ll be fully capable of advising the nurse.”
Debuting at Bret Harte High School in early December, Robo-Doc will become available at all four pilot campuses in the coming months. If the first year goes well, the MTHCD hopes to expand Robo-Doc to every school in Calaveras County.
“We regard the first year as sort of a pilot year,” Smart said. “We’re going to responsibly put these carts and the technology and the doctor in place. Things will need to be adjusted a little bit. As we go along, we’ll modify this. … As we go into the third year, we’ll probably have something much more stable.”