The Doctor Will See You Now. What’s the Definition of “See”?
There’s a great future in plastics. Think about it. Will you think about it?
The “one word” for success for Benjamin Braddock in The Graduate (1967) was plastics. The “one word’ in 2016 is Virtual and has replaced the 1967 plastics. The 2016 method of making money is providing virtual services. Virtual services are particularly important in education, especially when student performance is linked with student medical information…which is tied to ESSA regulating the amount of time a student spends in school (pg 45 in the Federal Register).
How Telehealth (aka Virtual services) will be used in Missouri schools from prweb.com:
More information on PresenceLearning may be found here. It’s virtual therapy online and its data (including mental health services) will be entered onto student data sets and shared with various Federal agencies and third party researches. Is there is HIPAA protection afforded to students and their data via telemedicine? As it is Medicare reimbursable, this student data will need to be shared with agencies connected with Medicare services/billing. From this 2014 PresenceLearning article, the company suggests that practitioners use encrypted connections and secure platforms to enter the data, but after that, the data is there for the taking by Only online SLPs and authorized school administrators have access to this information, thus further protecting student privacy. As long as the data is gathered, and if PresenceLearning has done its job to ‘protect’ the data required by the government, what happens to the data after that is not its legal concern:
There are many recent instances of computer data hacking of private companies, governmental agencies and even a presidential candidate’s emails. Just because PresenceLearning utilizes current best practices for data privacy gives small comfort to large privacy concerns. More reading on the gutting of FERPA rendering it basically useless for student/family privacy and how the Department of Education allows the access of personally identifiable information may be found here. Note that PresenceLearning wants to use many of these services for special needs students. Data will then be accessible to entities unknown to parents and services will be rendered by unknown practitioners.
Moving beyond privacy concerns, there are other questions on why virtual medicine in schools is being used. An article from Detroit (2013) highlights mobile medical clinics located next to public schools for underserved children. From Henry Ford and Children’s Health Fund Launch Second Detroit Mobile Clinic:
“The children of Detroit are our greatest asset for the future,” said Nancy Schlichting, CEO of Henry Ford Health System. “It is our job to keep them healthy so they can stay in school and get a good education. We are grateful to Children’s Health Fund for our partnership, and to the national and local funders who have made this second mobile medical clinic a reality and are supporting its operation.”
Question: Who is ‘our’ in its ‘our job to keep them healthy’? Is it in private foundations, government agencies, and school administrators’ job descriptions to keep children healthy? Should that be a parental job? Where does the line get crossed between government existing to protect individual rights/liberties vs government existing to assume parental responsibilites? Fair question.
What is concern to many parents about public school ‘compassion’ about the health of children is not that it is compassionate about children (can a governmental agency actually practice compassion), it’s primarily concerned about that 95% students’ time in seats in ESSA. Student human capital can’t be absent for doctors’ appointments because that is entered as taking a district’s school seat time. If those appointments can be carried out in school, there are no missing minutes recorded.
An example of how virtual medicine operates in a school setting can be found in this Yahoo News video about the Elwood (IN) school district:
- If their temperature is too high or their ear is a little too pink, the doctor is called virtually to make a diagnosis, not the parents, because healthcare can become a hassle. To address a child taking time out of the classroom to go to a doctor’s appointment, the district’s solution is to utilize virtual medicine. Shouldn’t kids with temperatures go home so they don’t infect other kids? Can sick kids learn? Do they feel like paying attention or do they just want to sleep? Is this to keep seat times up? Don’t forget the bonus! That medical student data is now accessible to other federal agencies and third party researchers!
- Administrators hope that it decreases the downtime experienced by the child, the parent, and even for us (administrators) having the kid out of the classroom…it’s truly a win-win for everybody.
- Is virtual medicine a win win for the school nurse? She is now able to do many tests (via doctors’ orders) that she was not able to do before, so do these extra tests she mentions she now can perform (lab tests such as flu testing, strep testing, urine dips) actually take more of her time? She can now dispense prescription medicine. Where will this be stored? Who pays for the medicine? The parents? The district? Does she need to provide follow-up visits? How does this additional medical care impact school budgets for additional medical services?
- The superintendent hopes it will increase student attendance and student health. Is there a third component of concern, that of increasing academic excellence? Academics is not mentioned in this video.
Are school budget tax dollars being used for medical care for ESSA seat time targets? Are parents aware that these medical records become part of a student’s educational record and PII can be accessed? Parents in all states should research on how Telehealth is or will be used in their district/state.
UPDATED: An explanation of how Indiana parents are invited to school for a child’s virtual appointment, insurance billing and pharmacy pick up may be found here: http://fox59.com/2016/09/06/first-school-based-telehealth-clinic-opens-in-indiana/
Gordon typically sees 60 to 80 students a day. If she thinks a child should be seen by a doctor, she calls the parents and invites them to the school for the exam and then gets Dr. Robert Zentz with St. Vincent Medical Group on the line. Dr. Zentz has more than 20 years of experience.
Using special exam equipment with cameras attached, the two work together to diagnose the problem.
A student might be seen for cuts, abrasions, rashes, pink eye, coughs, colds, strep throat, earaches and flu-like symptoms.
“It’s going to cut down the time that they’re out of school,” said Gordon. “If they can stay at school, they can have a prescription ready and stay here and it’ll be ready when they get home.”
“I wouldn’t have to miss work and my child wouldn’t have to miss class,” said parent Shari Vehikite. “I like that he can be seen right away and not have to wait for a couple days to get in.”
After the exam, Dr. Zentz sends the exam notes to the child’s family doctor.
“I’ve heard a lot of other parents say they are excited about not having to interrupt their day to be able to have their child seen right away,” said Vehikite. “Sometimes as a parent, you get up first thing in the morning and think, oh they’re fine, once they get moving they’ll be just fine, but then we get that phone call a few hours into the day that says, oh no your child is sick, come get them. So it’s nice that it’ll be a lot more convenient that way.”