P1022 - School based telemedicine as a novel solution to improving student chronic absenteeism in California

Title:
School based telemedicine as a novel solution to improving student chronic absenteeism in California

Background:
Chronic absenteeism is defined as students missing 10% or more of enrolled school days. Acute medical conditions have been shown to significantly contribute to school absences. Students who are chronically absent test lower and are at higher risk of not completing high school.

Purpose:
Provide medical care access with telemedicine for acute visits to the school health clinic and conduct health screens to identify risk factors for chronic absenteeism.


Methods:
Appropriate consent (Health Insurance Portability and Accountability Act (HIPAA) and Federal Educational Rights and Privacy Act (FERPA) compliant) was obtained for participating students. 22 schools were enrolled over 17 months. Acute medical visits and health screens were selected by the school health staff once their training was completed. Vital signs were obtained at the clinic. Students were assessed via video by licensed health care professionals. Care and disposition (home, school or other clinic) was determined by the health care professional. Over the counter medication, that was approved by parents in consent, was administered at the discretion of the provider. Follow up (primary care provider or school resources) were determined by provider and in concordance to the school district health policy. Chronic absenteeism data in California was obtained from the state dashboard web site (high school students were excluded from this data). We compared the percent of chronic absent students (excluding high school students) in California schools who did not have this service to the elementary and middle schools that enrolled in this telemedicine program. We compared rates of chronic absenteeism in 3 categories: one full year and less, just one full year and 2 years of service.

Results:
Schools that had access to telemedicine services for 1 full year or less experienced a reduction in chronic absenteeism by 0.7% [15.3% to 14.6%] while the control group experienced an increase in chronic absenteeism by 1.1% [9% to 10.1%]

Schools that had access to telemedicine services for 1 full year reduced chronic absenteeism by 1.5% [12.6% to 11.1%] while the control group experienced an increase in chronic absenteeism by 1.1% [9% to 10.1%]

Schools that had access to telemedicine services for 2 years experienced a reduction in chronic absenteeism by 2.4% [11.6% to 9.2%] while the control group experienced an increase in absenteeism by 1.4% [8.7% to 10.1%].

Conclusion:
Chronic absenteeism decreased in schools that provided urgent care telemedicine compared to the rest of California. Reducing barriers to access, by providing telemedicine service, and has a chance to improve students’ quality of life.