Austin district shifts to fewer school nurses, more telemedicine


AISD’s addition of telemedicine, used in other districts, aims to increase and quicken access to health care.

The district has 139 health care workers this year, up 19 over last year, but nine fewer nurses.

AISD for 2017-18 has budgeted for student health care services $7.1 million, up $2 million over last year.

The Austin district this year is launching virtual health care throughout its schools, though skeptics question whether the move, while it promises to be more quick and convenient, is better for kids.

The telemedicine will increase and quicken access to health care during school hours, district officials say, but it also means fewer registered nurses who help oversee the district’s youngest students.

Every elementary school is assigned a full-time health assistant, who must have served for six months in a medical clinic, doctor’s office or similar setting. Registered nurses oversee five or six campuses, up from two or three last year.

Overall, the district has 139 health care workers, 19 more than last year, but 56 registered nurses, nine fewer than last year. That means the nurses spend less time on campuses, have less direct supervision of the health assistants and less time getting to know the students.

District officials said the change offers more health care, not less, to students.

BACK TO SCHOOL TIPS: Be healthy this year

The health assistants assigned to the elementary schools now have the option to consult with the overseeing nurse, via a secure web cam. The nurse is able to view the student on a screen and ask the health assistant and student questions.

The addition of the virtual health care is more efficient than the previous method of explaining injuries or ailments to the nurse over the phone and cuts down on travel time for the overseeing nurse, district officials say.

“The quality of care will be as high as it always has across all of our schools with our nurses and our health assistants,” said Tracy Spinner, the district’s assistant director of health services. “Every school in AISD will have nurses and health assistants to provide care, either face to face or virtually, through a webcam.”

Austin joins a growing number of districts across the country, including the Dallas school district, that have embraced telemedicine on campus.

The Austin district more than 20 years ago eliminated registered nurses from every elementary campus to save money. The district has since contracted with Seton Healthcare Family to provide the nurses and health assistants for the schools. But some hours of the day weren’t staffed at the elementaries, district officials said, and a school employee designated by the principal would fill in.

“We can enhance care and provide better access and more services by using technology,” said Mark Steiger, Seton Healthcare Family director of virtual care. “Not replacing people, but by using technology to leverage the ability to collaborate … in a way that they were either constrained before by virtue of the fact they weren’t in the same place or by just using verbal communication.”

All secondary schools will continue to have a registered nurse onsite at their campuses. The district, however, is piloting digital clinics at three high schools.

In addition to being able to connect to virtual nurses, Crockett, Eastside Memorial and McCallum high schools this year also will have access to “digital clinics” for students to get consults with nurse practitioners or pediatricians. For ailments that would require a physician, the onsite nurse at the three schools can patch a student in to a virtual doctor, with parental consent. The parent also can join the conversation through a free phone app. The digital care is billed to the student’s insurance or covered by Medicaid.

The district expects to pay $7.1 million to Seton for student health services, which includes mental health services. The amount is up $2 million over last year, partly because of the virtual care additions.

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