In view of the urgent needs of children living in rural areas who suffer from developmental and behavioral concerns, Healthy People 2020, Rural Healthy People, and the Patient Protection and Affordable Care Act call for new approaches incorporating technology. The project has very high potential impact as a new service delivery model to address health disparities faced by rural children. As supported in just released American Academy of Pediatrics telemedicine guidelines (2015) and many other leaders in child health, the innovation lies in linking primary care/patient-centered medical homes with telecommunications technologies to support health care coordination and other health home principles. The innovation is not the technology per se, but rather using the technology as a tool to increase communication and collaboration and in turn support quality care. Child telemental health serves as an ideal beginning for this model, but the telemedicine-supported medical home has great potential to impact access and outcome across the needs of rural children living in poverty. Until recently, the irony of telemedicine was that it was uniquely designed to deliver specialized care to remote areas but lacked the infrastructure to do so. Now, all counties in Kansas have access to high speed internet access, making this an opportune time to test the effects of telemedicine in rural primary care in order to reach children in a trusted care environment and provide a potentially cost-saving means of care coordination.
The purpose of the study is to augment and expand successful validated telemedicine approaches for the assessment and treatment of children developmental and behavioral concerns over telemedicine. Over the last decade, our multi-specialty team has worked hand-in-hand with primary care and school-based sites to develop an integrated telehealth approach. Driven by community-identified needs, the multi-system model has focused on developmental and autism assessment over televideo as well as behavioral assessment and treatment over televideo.
In view of the urgent needs of children living in rural areas who suffer from behavioral concerns as well as those who struggle with obesity, Healthy People 2020, Rural Healthy People, and the Patient Protection and Affordable Care Act call for new approaches incorporating technology. Most recently, a presidential-appointed task force and President Obama have endorsed the need for increased mental healthcare in schools (Office of the White House 2013). The project has very high potential impact as a new service delivery model to address health disparities faced by rural children. As supported in just released American Academy of Pediatrics telemedicine guidelines (2015) and many other leaders in child health, the innovation lies in using technology to link school-based health centers and other school-based health professionals to specialist teams to support a systems approach and promote care coordination. The innovation is not the technology per se, but rather using the technology as a tool to increase communication and collaboration and, in turn, support quality care. Schools offer many unique advantages for telemental health (Steffan et al., 2016; Nelson & Patton, 2016; Grady et al., 2011), including increasing access in a nonstigmatizing, natural, supportive environment and supporting a team-based approach that addresses psychological, emotional, social, and academic/learning concerns concurrently (Comer & Barlow, 2014).
The project will pair the Department of Pediatrics along with the University of Kansas Center for Telemedicine and Telehealth (KUCTT) with rural school-based health centers and other school sites to increase access for the poorest rural area of Kansas, southeast and south central regions. Telehealth ROCKS Schools uses a range of telemedicine technologies to partner with the Community Health Center of Southeast Kansas’s (CHCSEK) rural school-based health centers and rural school districts served by the South Central Kansas Special Education Cooperative (SCKSEC). By collaborating with families and child-serving systems (healthcare, education, behavioral health, social service agencies, advocacy groups, others), the Telehealth ROCKS Schools project anticipates a strong impact for the child and family, the primary care/medical home practices, and the broader communities. We also partner with our Heartland Telehealth Resource Center to extend school-based telemedicine lessons learned
Telehealth ROCKS Schools aims to empower rural communities to meet the Surgeon General’s charge to create a “new normal”, with an emphasis on achieving an optimal level of health and well-being for rural children and their families. Our team aims to support rural children and families where they “live, labor, learn, play, and pray” and work together to decrease the negative impact of behavioral health concerns and pediatric obesity.
Telehealth ROCKS Schools includes ECHO which promotes collaborative approaches to better meet student needs.
ECHO uses telementoring to bridge the gap between healthcare knowledge and practice using established adult learning principles and practice change strategies. This is a guided practice model where the rural provider/team manages the patient/student and gains skills to manage other students with similar concerns. The approach will support effective triaging of students who are able to managed by the school-based health center team or who are in need of additional telemental health services, thus maximizing both services through both the school-based setting and the specialist behavioral health team.
Telehealth ROCKS Schools includes ECHO "telementoring" to assist local medical, mental health, and school providers in developing expertise in developmental and behavioral disorders to increase their capacity to identify and treat these disorders in local settings. The ECHO telementoring model bridges the gap between healthcare knowledge and local health care providers using established adult learning principles and practice change strategies. This is not telemedicine where the specialist assumes the care of the patients and families; instead, it is a guided practice model where the primary care provider manages the patient and gains skills to manage many more patients. Thus, Project ECHO participants learn by doing, learn from each other, and learn from specialist teams.
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3901 Rainbow Blvd.
Kansas City, KS 66160