R-2 District implements ‘Nurse in a Box’

CoxHealth virtual office located at BES

By Roxie Murphy, Staff Writer
Posted 10/30/19

Rebecca Strode introduced the implemented CoxHealth virtual urgent care program “Nurse in a Box” at the Oct. 24 Maries R-2 Board of Education meeting.

“I do the virtual clinic …

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R-2 District implements ‘Nurse in a Box’

CoxHealth virtual office located at BES

Posted

Rebecca Strode introduced the implemented CoxHealth virtual urgent care program “Nurse in a Box” at the Oct. 24 Maries R-2 Board of Education meeting.

“I do the virtual clinic for half the day and the other half, if they need me to substitute teach, I will,” Strode said.

Strode said she wanted to update the board and help address any unknowns or questions the they or parents may have.

“I want you to see this like an urgent care. There are a lot of words like ‘virtual health and telehealth’ — but it is basically an urgent care. We facetime with the provider, a doctor or nurse practitioner,” Strode said. “All I do is registration. If the nurse sees someone sick and they want to be seen by a provider, I get their insurance, get their co-pay and put them in the system and we hop on with them.”

Thus far, 455 consent forms have been sent and 358 have been returned, signed “yes,” and agreed to participate in the program.

“We had our first successful visit three days ago. It is being used, we just have to get the word out,” Strode said.

The process begins when a child sees the nurse, and lets them know there is a program available. They notify the parents and if they parents want to proceed, they are transferred to Strode.

“The parent must be there in person or can join us via video capability — smartphone or laptop,” Strode said. “Their consent forms may add someone, like grandma, can come in. But someone has to be there because they are minors.”

After the appointment, if a prescription is recommended, it can be sent to a pharmacy of the parent’s choice.

Frequently asked questions include if a child can see their primary care physician via the program.

“We are not a primary care clinic,” Strode said. “We are an acute, short illnesses — strep throat, pink eye, that sort of thing.”

Parents have to be present in person or video form.

“Another question — will more parents send their kids to school sick? Will that increase? Well that is already happening,” she said. “It usually takes them three or four days to get into the doctor’s office. If they are at work, this is a great way to get the student ready to go, and the provider will let us know if the student needs to stay in school or go home.”

Cost is also a big question.

“This is like a normal doctor’s visit,” Strode said. “If you are in network, it is a normal co-pay. If you are out-of-network, there is an upfront discount. If you are Medicaid, which most of our district is, it is a co-pay of zero.”

The CoxHealth virtual care program is a three year grant that former superintendent Dr. Patrick Call and former secretary Peggy Terrill applied for last school year, and began the process of implementing this summer. The program was delayed at the beginning of the 2019-20 school year, as the healthcare provider had yet to find someone to take responsibility for it at the school. Strode was hired and trained so that the program can now be implemented.

“After, what I have been told, is we can keep the equipment if we see so many people,” Strode said. “Based on number of visits, Cox Health will determine if they can keep an employee on. If they don’t have an employee, if a nurse or anyone in the district would be willing, there is a lot shorter of a process that they can hop on and do the visit as well.”

Strode added that future goals are hopefully the school will be able to keep the program if it is beneficial to the community.

“This is not just for students,” she said. “It’s for staff — everyone — janitors, cooks, teachers, admin; everyone.”

Superintendent Dr. Lenice Basham said she thinks it is great for the staff to not have to take half a day to go to a doctor’s appointment.

“They can come in, be seen, get their prescription, move on, and come back to class if they can,” Basham said. “It does take a couple of days sometimes, if you call in today and want to be back in the classroom tomorrow. This can really help with that.”

Strode they can also handle filling refills for 14 days, for normal medications such as blood pressure medicine.

“We have two offices, one at the elementary and one at the middle school and we are recruiting,” Basham said. “I think they are just walking by waiting to see someone (who is sick).”

The CoxHealth “Nurse in a Box” program is a co-sponsored telemedicine clinic.

“They are going to provide a television kind of thing (for kids to see the doctor,” said Basham.

The program had only been in place for about a year — since 2017, through the efforts of the TKD Foundation and Children’s Miracle Network Hospitals at CoxHealth. The first year, six districts participated. Now the program has grown, and more than quadrupled it’s numbers. Participants benefit from the on-site clinic by seeing a physician without having to wait.

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