The Los Angeles Unified School District, one of the country’s largest, will initiate a telehealth program this fall, enhancing the reach of overworked school nurses, providing healthcare for students in underserved areas and cutting down on missed school days by sick students.

Five selected schools will be part of a pilot study with Boynton Beach, Florida-based telemedicine company LifeMD, with plans to gradually expand further into the district. School nurses will assist in the use of LifeMD’s telehealth equipment such as ear, nose and throat scopes, medical-grade cameras, stethoscopes, thermometers and glucose meters that work with LifeMD’s mobile cart or kiosk, transmitting data across a cloud-based video conferencing system. The platform connects to a network of pediatricians from the community’s health providers, and parents will also have the option to join in remotely during the telehealth visits.

Typically, if a student goes into a nurse’s office complaining of an issue that is non-emergency but still requires a doctor’s visit, it can spell hours of waiting – for the parent, for the doctor and for the prescription, on top of missed work for the parent and missed school for the student. Now, students will have the ability to be seen by a pediatrician within minutes, allowing parents to stay at work and the student with minor, treatable conditions to return to class without losing valuable instruction time.

“This makes the whole process more convenient, faster and more affordable,” Tim Bruce, LifeMD’s director of telemedicine told MobiHealthNews. “A lot of schools are just not able to keep up without a little support.”

LifeMD works with a variety of organizations including hospitals, private correctional facilities and other schools across the country, but this is the biggest in-school service the company has taken on. The company hopes to reach the country's other large school districts of Chicago and New York City in the future, and Bruce said this represents a change in the overall expectation of what role schools can play in healthcare.

“What the typical school nurse used to be is really starting to shift,” Bruce said. “Schools are being required to provide increasingly complex diagnostics and services for a wide range of health problems for a population with very diverse cultural backgrounds.”

With LifeMD’s services, the school nurse can facilitate the doctor visit by examining the student with the provided equipment that transmits information to the doctor, who then interacts with the patient and nurse. The LifeMD system records the exam and creates a record for student, parents and insurer, and can translate communications in 10 languages.

Los Angeles’ district encompasses 720 square miles and serves more than 640,000 students across 900 schools and 187 public charter schools. It has long history of providing access to health care through schools, with the largest school nurse workforce in the state where insurer repayment for telehealth services has been allowed for 20 years. However, providing care still meets shortfalls given the wide range of health conditions and student demographics, so LifeMD said LAUSD was a logical partnership.

“These are situations where the parent may be working and may not have access to their phone, meaning they can’t even make the appointment to begin with,” said Bruce. “Also, we’re talking about a place where to drive 15 miles takes an hour in traffic.”

Additionally, the district enrolls many students who live in areas underserved by healthcare, with parents who may not be able to afford doctor’s appointments. The goal is to help close achievement gaps and reduce absenteeism while improving student grades and graduation rates.

Jason Faley, COO of LifeMD, told MobiHealthNews the partnership was embraced by LAUSD very early on.

“We put out feelers to a bunch of different districts and they were very interested. They are very forward-thinking,” Faley said. “The biggest thing, after we ironed out the details, was to make sure every kid got the same level of care, whether they have Medi-Cal (California’s Medicaid), private, or didn’t have insurance at all. No one is getting singled out and everyone gets the same care.”

It also helped that there was no cost to LAUSD upfront, thanks to county and state-level grants that cover telemedicine costs.
Bruce said a rise in the complexity of health problems has also taxed school nurses, as well as leading to more missed school and work days. Large percentages of students now have health issues like obesity, diabetes or asthma as well as mental health concerns or being on the autism spectrum. In the future, the offerings will expand to bring more physicians into the program, including mental health specialists.

“It used to be that you went to school for reading, writing and arithmetic," said Bruce. "Now, it’s healthcare and behavioral health services that the schools are also being required to take care of."