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A brief overview of key points that apply to most new services

The type of service and staff will influence technology selection, workflows, and regulatory requirements.

School-based Telehealth service ideas may include:

Acute medical care for illness and injury
Behavioral health services including therapy
Medication management
Sports medicine consults for athletic injuries
Group therapy
Nutrition counseling
Pre-Participation (Sports, Camp or School) Physicals
Oral health screenings

Service Setting Options: school nurse office, dedicated space in the school, school-based health center, and mobile vans or buses.

Care options: Live, synchronous two-way video with peripheral cameras and stethoscope or ‘store & forward’ exams to be reviewed later by a provider.

Funding

The funding source can open new options or force artificial restrictions. The most common funding sources are third-party reimbursements (Private health insurances & Medicaid) federal or state grants, local grants, and cost reductions generated through the use of school-based telehealth.

It is important to diversify and find more than one funding source. A consultant or mentor can help guide you on different funding sources.

Best Practices

Clinical Best Practices:

Provider Training
Security and Privacy of data
HIPAA security of technology/software
Practicing only where licensed
Collaboration with Primary Care Provider
Evaluate the suitability of the patient/client
Remote emergency procedures
Inform consents specific to telehealth
Back up communication plans
Publicly displayed credentials
Patient/client age and identity verification
Psychological safety verification
Identify the local emergency service provider close to the client/patient
Provide viable referrals

Technology Best Practices

HIPAA-Security
Management oversight opportunity
Workflows
Referral management – incoming/outgoing
Interoperability with other electronic health records
Signed Business Associate Agreement from vendors consistent with HHS Sample BAA.

Selecting Technology and Software

Technology is constantly evolving and with that, comes the need to ensure that your technology and software are operating at a high level of performance. Below are a few things to keep in mind when deciding on what is best for your preferred service setting and overall use:

Consider requirements for both ends of the video calling
It is better to integrate with existing systems when possible
EMR Interoperability (Electronic Medical Records)
Bandwidth and hardware needs
Videos and workflows must be HIPAA-secure
Choose technology with flexibility for growth
Affordability and sustainability should be key deciding factors
Select non-labor-intensive options

Planning, Preparation, Implementation

Preparation: Seek out mentorship and training to learn and understand the industry
Make a business plan: Start with small achievable goals and layer new ones as you succeed at each iteration. Plan a pilot project. When successful, scale up the program. Clearly define the cost and return on investment (ROI) to share with your leadership and collaborative partners. Consider that there are many types of behavioral health services, but few that are profitable as a stand-alone service. Carefully select the pilot staff to help you resolve any unforeseen implementation obstacles. Consider the option of outsourcing medical and school-based telehealth services to an existing company to obtain these services more quickly.
Leadership buy-in: Ensure your organization’s leadership understands the program, the pathway and the benefits at each stage of program development.
Community buy in: Ensure that the school system leadership, the area primary care providers and the community’s elected leadership understand the program, the pathway and the benefits at each stage of program development.

Resources

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