Cherokee Health System's S.M.A.R.T Telemedicine Program

Innovative Telemedicine in Action:
The Cherokee Health System's S.M.A.R.T Telemedicine Program Using Telemedicine at Seymour Middle School

About Cherokee

Children are absent from school for a variety of reasons, but the most common reason is the common cold. It is also not uncommon for a student to miss an extra day or two waiting for a doctor's appointment and for the parent to miss time from work. In many communities, especially rural and mountainous regions, there is also the compounding difficulty of a shortage of medical professionals, as well as lack of transportation options for parents, and a number of people without adequate health insurance.

"It doesn't make sense to pull a child out of the school setting so they could see a physician, when in many cases, the problem could be resolved through technology." "Telemedicine seemed to be the obvious alternative to help keep students in school and parents at work."

-Joel Hornberger, Cherokee Health Systems' Chief Operating Officer.

Health System Make School-Based Telmedicine work in SevierCounty, T N

In Sevier County, Tennessee, in the shadows of the Great Smokey Mountains, all of these scenarios apply.

Recently, the Sevier County School Corporation and Knoxville-based Cherokee Health Systems partnered on an innovative project labeled S.M.A.R.T. (Student Medical Assistance Response Team). At the heart of the project is a school-based medical clinic equipped with the latest remote technology that lets an on-site nurse assist in a health examination administered by a medical professional - typically a pediatric or family nurse practitioner- at another location miles away.

The S.M.A.R.T. technology allows a student to be screened, examined, diagnosed and even treated utilizing AMD devices and a two -way secure Polycom video link. The on-site nurse uses AMD's General Exam Camera, AMD's 400s Camera and Illumination System with exam scopes and AMD's 3700 Telephonic Stethoscope.

The partnership allows students to access a higher level of healthcare than what a school nurse is typically able to provide.

"During the telephonic visit, the medical provider can with amazing clarity and precision examine the eyes, ears, nose and throat, as well as listen to the lungs and closely examine the skin," Hornberger said. With parental permission, the medical provider may also treat minor cuts and abrasions, rashes, strep throat, earaches and flu symptoms. Laboratory testing for strep throat and influenza is also available.

In fact, Cherokee Health Systems medical professionals claim that the equipment in many cases helps provide a better examination because of the ability to amplify sounds and review and zoom in on targeted areas. Once the examination is complete, the medical professional will phone the student's parent to discuss their findings and to offer any recommendations.

Cherokee Health Systems is able to bill the telemedicine services to insurance and TennCare (Tennessee's Medicaid administrator). For those without insurance, Cherokee provides an affordable sliding fee scale for the visit and any lab work that may be needed.

A registered nurse examines a student's ear with a special instrument that allows the nurse practitioner to see it on the screen.

"Schools are the perfect setting for utilizing the conveniences and simplicity that telemedicine offers.

"School systems know that to improve the students overall performance that it is vital to have access to quality medical services," Normandin said. "It's about looking out for the best interest of the students, and telemedicine is the ideal alternative."

"Schools are the perfect setting for utilizing the conveniences and simplicity that telemedicine offers.

"School systems know that to improve the students overall performance that it is vital to have access to quality medical services," Normandin said. "It's about looking out for the best interest of the students, and telemedicine is the ideal alternative."

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