Atrium addresses pediatrician shortage in North Carolina with in-school virtual clinics

A county in North Carolina with a child-to-physician ratio of 2,490 to 1 has become part of a growing testing ground for school-based interventions.

Starting with the beginning of the school year this week, pediatricians will be able to diagnose and develop treatment plans for students within two school-based virtual clinics in the town of Lincolnton, North Carolina. The program is part of a partnership between Atrium Health and the Levine Children's Hospital's pediatric practice. 

With help from a $150,000 grant from retail chain Kohl’s, officials said pediatricians will be able to open up access to healthcare in a region where access to pediatricians is severely limited. 

The virtual care program is a partnership between Atrium Health Levine Children’s Shelby Children’s Clinic, Atrium Health’s Community Health Division, Cleveland Country Public Health Center and Cleveland County Schools. With the new additions in Lincoln Country, the program is now in 12 elementary schools around the state.

The program follows the success of a similar school-based virtual clinic launched in Cleveland in 2017.

Within the first year of launch, officials say, the virtual clinic reduced emergency department visits from students by 55.6%, reduced early dismissal by 33.3% compared to the previous year and established medical care for the 21% of students with no primary care provider.

“We were intentional about implementing a program that increased access to care, reduced non-emergent emergency department visits, and provided the opportunity to connect patients with a primary care medical home,” Patricia Grinton, M.D., director of Atrium Health Levine Children’s virtual clinic, told FierceHealthcare.

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How it works

Using technology, students—with the consent of a parent—will be evaluated by a pediatrician located at Levine Children’s Shelby Children’s Clinic. During the visit, parents are invited to join via audio, video or in person.

Via video, the pediatrician is able to:

  • Listen to the student’s heart and lungs with a stethoscope, which streams the sounds of the heart and lungs in real-time
  • Use an otoscope to create a real-time video of the student’s eardrum, which is transmitted to the pediatrician. The ear canals and eardrums are evaluated for infection. 
  • Evaluate the student's eyes, nose, throat and skin through a high-resolution camera
  • Evaluate common conditions such as rashes, sore throats, common colds, ear pain, asthma flares, cough and pink eye

So who pays for these virtual health visits?

Currently, government and private insurers do not cover visits of this nature. Grinton says that Atrium Health relies upon internal resources and community partners for support. 

“Given our size and scope, we were able to initiate a first-of-its-kind pilot in this area,” she said. “The investment and level of support needed to make the pilot successful provided both short-term, and ultimately long-term, benefits to this community." 

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The program is supported, in part, through funding from Kohl’s, which has donated more than $3.5 million to Atrium Health and the Kohl’s Cares program to support the Levine Children’s Hospital. Recently, Blue Cross and Blue Shield of North Carolina made a pledge of $750,000 to fund a similar program in Cleveland County, North Carolina, via Atrium Health.

Beyond funding, Grinton notes that the in-school virtual program has its challenges, specifically when it comes to collaboration. School leadership, the board of education, the local health department and Atrium must all work together.

Still, Grinton notes that adoption throughout other communities has been met with great enthusiasm. 

“The school staff and leadership in Lincoln County have embraced the virtual clinic model and have been very helpful in providing education and enthusiasm about our program’s potential,” she said.