O2022: A Roadmap for Developing a School Based Health Clinic Virtual Care Program

Background: Denver Health Pediatrics at Denver Public Schools School-Based Health Centers (SBHCs) provide integrated healthcare services to all Denver Public School (DPS) students via 19 clinics on school campuses. DPS SBHCs are in communities with high health inequities and provide services to over 13,000 students annually. However, over 80,000 DPS students attend schools without a SBHC on campus, and consequently barriers including access to care remain. In 2021, DPS SBHCs started offering virtual services to 19 additional DPS schools lacking a physical SBHC. This grew directly out of the demand from DPS nurses wanting more resources for their students. Virtual visits were facilitated by an on-site DPS school nurse and an off-site SBHC physician or advanced practice provider. The DPS SBHC’s virtual care program is designed to reach a similar demographic virtually as in person. Our goal is to expand the reach of SBHC services by increasing access at additional schools virtually to further ameliorate inequity in access to healthcare and increase educational opportunity. This project aims to describe the series of steps followed to roll out the DPS SBHC’s virtual care program.

Methods: In establishing the DPS SBHC’s virtual care program, several important steps emerged that others could consider when establishing similar programs. These steps included: identify need, secure funding, meet key stakeholders, create EHR platform, pick virtual DPS SBHC’s virtual care sites, identify & order medications, create a staffing plan, train nurses & providers, prepare consent form, recruit parents & students, deliver equipment & medications, launch DPS SBHC’s virtual care, and finally, constant qualitative and quantitative analysis and resulting program evaluation. (Image 1)

Results: In our pilot year, the DPS SBHC’s virtual care has been rolled out to 19 schools. This program expanded access to SBHC services to an additional 8,000 eligible students in 1 year. Of those, 1275 students have been consented. In addition, 23 RN’s have been trained and 62 students have been served by SBHC virtual care. Overall, feedback from nurses, students and parents has been positive.

Conclusion: The development of DPS SBHC’s virtual care program provides a functional roadmap for other SBHCs nationwide. This roadmap can be utilized to expand SBHC's reach. Research continues to understand the impact of this program on increasing educational achievement and decrease health disparities.