Virtual, school-based care programs in rural communities experienced implementation successes and challenges, as described by providers.

Background

Children living in rural areas often face limited access to health care services due to provider shortages. School-based health centers can help address this gap by offering primary and dental care services, as well as behavioral health care, via telehealth. This study used interviews to identify opportunities and challenges for effectively implementing this virtual care model in rural schools.

Findings

This qualitative study drew on semi-structured interviews with 50 key informants, across multiple states, involved in school-based telehealth programs. Thematic analysis was used to highlight facilitators and barriers for implementing virtual-based care in rural areas. Commonly cited barriers were broadband access, having no available Medicaid reimbursement mechanism, and varying levels of support for telehealth within school communities. Participants also identified several facilitators and action steps for successful program implementation, including marketing and outreach, technology training and support, and integrating telehealth into existing school health programs.

Program/Policy Takeaways

Telehealth can expand provider reach and access to care in underserved school settings. Providers and school leaders in rural communities can consider developing similar programs for students who may benefit from accessing health care services during the school day, with attention paid to training, integration with school workflows, community engagement, and sustainable reimbursement for long-term success.