School-based health centers pivot to telehealth during pandemic

A qualitative analysis demonstrated that a pivot to telehealth was largely beneficial to school-based health centers during the COVID-19 pandemic, researchers reported.

Anna Goddard, PhD, APRN, CPNP-PC, an assistant professor of nursing at Sacred Heart University, and colleagues assessed the implementation of virtual “Listening and Learning” sessions, which the nonprofit School-Based Health Alliance organized in reaction to national school closures due to COVID-19.

The sessions provided a platform for school-based health center (SBHC) providers, administrators and sponsors around the country to share how they transitioned online to support student health.

“SBHCs deliver comprehensive health care to students who, in many circumstances, would not otherwise receive it,” Goddard and colleagues wrote.

According to their paper, more than 89% of SBHCs provide health care access to vulnerable children attending Title I-designated schools — “those that receive federal financial assistance because of a high percentage of students from low-income families.”

“An average of 70% of the 6.3 million students in the United States with access to an SBHC are eligible for free or reduced cost lunch,” they wrote. “The rapid increase in unemployment and potentially ongoing recession resulting from COVID-19 are likely to dramatically increase the number of students and schools eligible for Title 1 status.”

According to Goddard and colleagues, “Listening and Learning” sessions held between April and May 2020 included three meetings for SBHC clinical providers and three for sponsor and administrating organization staff. Each session focused on telehealth, reentry and mental health.

Before the start of each session, the School-Based Health Alliance emailed session information and registration to 18,142 contacts in its database. Each session was limited to the first 150 registered participants. Participants represented 41 states.

The sessions were hosted over Zoom and lasted between 60 and 90 minutes, according to the authors. Each session included two to three probing questions related to the session topic.

According to Goddard and colleagues, “creative responses that emerged throughout the coronavirus quarantine” allowed SBHCs to remain “a leading resource for students to get patient-centered care directly at home via telehealth.”

“Many SBHC organizations executed immediate shifts in care delivery modalities, largely consisting of reimagining primary and mental health care using telehealth platforms,” they wrote.

They said SBHCs expanded to include acute care, mental health-focused visits with therapists and telepsychiatry, if needed, and primary care visits.

In an effort to minimize in-person exposure time, providers employed telehealth services for “triaging or collecting” medical histories before an in-person visit.

“Lessons learned during the COVID-19 pandemic demonstrate the value of SBHCs, which continue to target barriers to health care access, protect the most vulnerable and decrease the spread of disease,” Goddard said in a news release.

The researchers projected that “highest need for SBHC medical services in the upcoming school year are immunization updates and physical examinations.”

“Social distancing throughout the quarantine created a record-breaking decline in immunizations for U.S. children, with a decrease of more than 2.5 million doses for routine, noninfluenza pediatric recommended vaccinations,” they wrote. “This critical decline leaves unvaccinated children at risk for other serious infectious diseases.”