Mountain Comprehensive Health Corporation (MCHC) is experimenting with telemedicine in an effort to expand coverage in 12 schoolbased clinics located in Jenkins and Letcher County school districts.
“We have three providers that rotate through the school system, so it is hard to have someone in every school every day all day long,” said Dr. Van Breeding, a family practice physician at Whitesburg-based MCHC. “It is cost prohibitive to do that. There is no way we could put a nurse practitioner or a doctor or a nurse in every school each day.”
MCHC purchased equipment for a practitioner to be able to listen to a student’s heart and to examine ears and throats via a computer. Similar to the way FaceTime works on iPhones and iPads, the patient and practitioner will be able to see and hear each other on computer screens.
“We have a closed, private system so no information is shared,” said Breeding. “It stays in our system only. You have to have special passwords to get into our system and only our providers have that. Ours is a more secure network for HIPAA (The Health Insurance Portability and Accountability Act of 1996) and violations of privacy.”
Matthew Holbrook, a certified physician’s assistant (PA-C), told the Letcher County Board of Education at its Nov. 23 meeting that Holbrook is often told that people wish he could clone himself so he could be at multiple schools at once.
“Finally I’ve figured out a way to clone myself just through the me- chanics of (telemedicine),” said Holbrook. “Basically my clone will be our (medical assistant). She will be my hands, eyes and everything while I am not at school.”
MCHC Chief Executive Officer Mike Caudill said a trained medical assistant will operate a high-definition camera, stethoscope, otoscope and other tools while a practitioner located at a different school uses a computer to examine and talk to the patient.
“The stethoscope (connected to the computer) actually picks up better heart sounds than the stethoscope I have (with me) because it magnifies it,” said Holbrook. “You could hear a cricket in that corner if I turn the volume up loud enough. That is how sensitive it is. It picks up everything.”
A medical assistant can take photographs of a patient’s throat and the practitioner can examine it on his computer and then erase the image after the examination is finished.
“Anything I need to see, I can see,” said Holbrook. “Just because I’m not there, doesn’t mean I can’t fix it.”
Holbrook said telemedicine will help keep children in school and keep sicknesses down.
Advanced practice registered nurse (APRN) Lora Cook is stationed at Letcher County Central High School. Ashley Sumpter, APRN, serves Arlie Boggs, Cowan and Martha Jane Potter elementary schools, Fleming- Neon Middle School and Jenkins Independent Schools. Holbrook works at Cowan, Letcher and West Whitesburg elementaries and Whitesburg Middle School.
“(Holbrook) is there a few hours a day, but not at every school each day,” said Breeding. “With this system, we’ll be able to put Matt in any of those schools and then we’d have a medical assistant go to the other schools with a similar piece of equipment.”
Holbrook could be at Letcher while treating a child at Cowan, said Breeding.
“That way he is able to provide a service to children in three or four schools instead of one school,” said Breeding.
Caudill said telemedicine helps to even out workloads at different schools and cut down wait time for students.
In addition to MCHC providing the telemedicine equipment, Caudill told the board MCHC will place a medical assistant (MA) in each school.
“ You’ve got nurses in some of them,” said Caudill. “We want to work with them. The ones you don’t have you are going to have an MA in the school that can be seeing your students with what we always refer to as Band-Aid and aspirin-type complaints.”
The board gave MCHC permission to test telemedicine in schools and demonstrate the equipment to parents and school staff during open houses.
“We don’t just want to say here it is and we’re going to use it,” said Caudill. “We want to make sure every parent has an opportunity to say I want my child to use this or not.”
Caudill is projecting that telemedicine equipment will be in every Letcher County school by fall of next school year.