Many of our parents have received a letter from AISD with information on a new program that provides telemedicine services in the school nurse office with a third party service (Virtual Care for Kids).  Our patients deserve to know that we have very serious reservations about this program.  Here are some highlights, and then we’ll share some philosophy with you.  This is DIFFERENT than the telemedicine program that is being developed by Dell Children’s Hospital; you may be asked to consent to this separately, and we DO SUPPORT THIS initiative.

• This program was brought in by a for-profit corporation without the consultation of the pediatric community of Austin.  This pediatric community is pretty tight and we are proud members of many collaborative groups including The Greater Austin Pediatric Society (GAPS) and the Central Texas Primary Care Alliance (CTPCA), and we have seats on the board of the Dell Children’s Health Alliance.  None of these groups support the AISD telemedicine initiative through this for-profit third party corporation.
• NO meaningful collaboration with the pediatric community has been held about this initiative.  GAPS members were allowed to give testimony in a few 2 minute increments at Board meeting when the third-party corporation was given unlimited time.  We are aware that the testimony of the third-party corporation did not reflect the opinion of pediatricians in other markets where they have worked – serious concerns have been raised, and these were NOT addressed.
• We are very disheartened that AISD proceeded with the program despite our vigorous objection and the fact that Dell Children’s Hospital, who has provided school nurses through a state-of-the-art collaboration, refused to allow their nurses to take part in it.
• The American Academy of Pediatrics (AAP), the Texas Pediatric Society and the Texas Medical Association have long supported the concept of the pediatric medical home as the optimal setting for providing children with holistic, coordinated, and timely health care. Developing a trusting partnership with families is essential to the provision of pediatric care.
• We have no guarantees that the care providers that the third-party company will employ are Board-certified, experienced, or qualified.  We have no insight on their quality assurance programs.
• The American Academy of Pediatrics applauds expansion of telemedicine, but only through the medical home.  That means – where your child is known, where their medical records are complete, and the whole child is considered in making medical decisions.
• Studies have indicated that retail and virtual care models consistently result in overprescribing of antibiotics and other medications, can not possibly take into consideration the past medical history and chronic conditions of a child as well as their primary provider, and lack continuity.
• Texas has introduced “telemedicine parity,” which means that telemedicine visits are going to produce revenue similar to that of a face-to-face doctor visit.  There is now the potential for significant PROFIT for these virtual companies.  This motive must be considered.

Now, the philosophy:

We recognize that not everybody in Austin has access to a pediatrician that knows them by name.  We recognize that AISD is trying to provide medical care to its students, and that they are not trying to hurt our kids.  We recognize the demands of working parents just trying to get through the day, and they need access as on-demand as possible.  However, we also recognize the value of the medical home.

This is our promise to you – that we will do our best to know YOUR child and YOUR family well enough that we can make informed, collaborative decisions together.  We offer extended hours 6 days a week and are expanding creatively to make our doctor-patient relationship even more available – but in the context of GOOD care in YOUR child’s medical HOME.  We are exploring options like telemedicine, which is finally becoming capable of providing good care in the right circumstances.  Outside the medical home, virtual care has the potential to be fragmented and unsafe.

To our AISD families, please contact us FIRST if you think your child would benefit from a telemedicine visit through the AISD third-party corporation.   Please let your principals and school nurses know that your child’s doctor has serious reservations about this program and want to make sure it is safe and used appropriately.  Call US first if you are offered a virtual visit at school.  We can usually provide advice that will get you through to a visit, and often save you a visit to begin with.  We promise to make your child the center of their medical home, because we’re with you, every step of the way. 

This link contains a letter to GAPS, of which we are a member, sent to the Student Health Advisory Committee of AISD with even more details.