Referral to specialty telemedicine can increase timely follow up for hearing loss identified through school screenings.

Background

Rural areas often face barriers to accessing specialty health services, such as provider shortages and long travel times. Telehealth, in coordination with schools, is one strategy for enhancing access to care for children. This study evaluated the impact of referring students in rural Alaska to community-based specialty telehealth following preschool hearing screenings, compared to standard referrals.

Findings

Fourteen rural Alaska communities with preschools were randomized to the specialty telehealth referral intervention versus standard care (8 randomized to telehealth referral, 6 to primary care referral). The study assessed 153 children screened for hearing loss between 2018 and 2019. Thirty-nine children were ultimately referred for telehealth follow up and 32 for primary care follow up. Telemedicine referral was associated with increased follow-up rates within nine months (76.9% for children receiving telehealth referral compared to 50% control group) and reduced time to follow up (median follow up time of 28 days for children receiving telehealth follow up versus 85 days for children receiving standard follow up).

Program/Policy Takeaways

Specialist telehealth referrals can support timely follow up after positive school-based hearing screenings. While this study focused on interventions related to hearing loss, there may be opportunity to pilot a similar model for other conditions. Additionally, school-based telehealth interventions tend to focus on telehealth directly provided in schools; this intervention is an example of how schools can coordinate with community-based telehealth providers as another strategy for enhancing access to care.