Imagine what it would be like if medical providers didn’t just see their pediatric patients a couple of times a year, but got to observe them every day. Knowing these children so well, it would seem, could only have a positive impact on their physical, mental and emotional health.
This is what occurs at the high school and middle school in Ossining and the elementary, middle and high schools in Port Chester, with Open Door Family Medical Center’s School-Based Health Centers, an innovative program that places a medical team at each school, with dental care offered through a high-tech dental van.
The program integrates a nurse practitioner and medical assistants, working in collaboration with a physician, into each school community. The Open Door medical providers work closely with a school nurse to provide such services as annual and sports physicals, immunizations, first aid/sick care, laboratory tests, health education, behavioral health screening, referrals to specialists, and chronic disease management (e.g. asthma), with the ability to e-prescribe medications.
“We get to see the students in their own environment – in class, at lunch, and on the playground,” said Sara Hodgdon, associate director of Open Door’s SBHC program. “We know what students eat for lunch and how they interact with their peers. We see them during the stressful times at school. Being physically in the school makes a world of difference in terms of our ability to provide effective care.”
The program is also exceedingly nimble when it comes to getting ailing children treated quickly to minimize lost time. In the case of students in the Ossining and Port Chester school systems, many children are back in class 24 hours after being sent home due to illness.
“A child suspected of strep, who has a fever, for example, is sent to the School-Based Health Center, where our nurse practitioner diagnoses the illness and, if necessary, sends an e-prescription to the pharmacy so the parent can pick up the medicine immediately,” said Hodgdon. “This way, the child begins to heal quickly and can return to school much earlier.”
The Open Door SBHC program was the 2019 recipient of a national award for its evidence-based work, with its asthma-based management program earning the HIMSS Nicholas E. Davies Award of Excellence. The award recognizes the “thoughtful application of health information and technology to substantially improve clinical care delivery, patient outcomes and population health.”
In order to address the management and control of asthma within its school-based health program, Open Door set goals to improve asthma classification, treatment and clinician education, and to increase the use of asthma action plans. In addition to reducing missed school days, this has given patients and their parents the day-to-day skills to better manage the condition. The reduction in missed days for students with asthma at Port Chester elementary schools was nothing short of dramatic – from a high of 376 days in 2014, to 28 days in 2017.
The program also supports families that are new to the country and whose children require vaccines in order to be enrolled immediately into the school system. “Immediate access to the School-Based Health Centers is the fastest way for a child that has newly arrived in one of our districts to begin attending school,” said Hodgdon.
There are no out-of-pocket costs to children or their parents and no co-pays. A parent or legal guardian must consent for a child to be enrolled in the program.
