How a remote Maine school union uses telehealth for a variety of needs

Speech therapy, occupational therapy, psychology and counseling – all are handled at a distance for School Union 93 by a teletherapy service provider.
By Bill Siwicki
11:40 AM

Telehealth in action at the School Union 93 in Maine

Photo: School Union 93 in Maine

Dr. Karen Watts, director of special services at School Union 93 in Maine, lives and works in quintessential, rural Maine.

THE PROBLEM

"The advantages are the clean air, verdant hills and meadows, outstanding wildlife, clean air, the crystal clear water of Penobscot Bay that surrounds the Blue Hill Peninsula, peace and quiet, and our friendly communities," she said. 

"Being positioned to hire exceptional therapists, psychologists and counselors for our students, however, is not in the list of advantages. There is a dearth of highly qualified, experienced clinicians in our school union geographic area."

As a special services administrator, Watts spent countless hours searching for possible clinicians to support her students, to no avail. As a last resort, she reached out to special education directors – her Canadian neighbors in the Maritime Provinces – asking for leads. The Canadians recommended Dotcom Therapy.

"As soon as I made the call and provided preliminary information about what we so urgently needed, I was told I would receive a follow-up call within the same week," she recalled. "Happily, I soon heard from the customer success manager for our area, and I knew we were off and running to find the right solutions for our students."

PROPOSAL

DotCom Therapy is a pediatric teletherapy provider for healthcare and educational organizations. It recently was named No. 80 on Inc.'s Top 250 fastest-growing private companies in the Midwest.

"Without the vendor, we would have contracted outside, waiting an average of two to four months for initial contact with the student and family."

Dr. Karen Watts, School Union 93 in Maine

In the inaugural year of telemedicine, School Union 93 in Maine began by contracting a skilled and experienced speech-language pathologist (SLP) for one of its five elementary schools. The prep for remote speech services becoming a reality, Watts explained, included:

  • Careful consideration of the caseload in terms of need and recommended frequency/duration of services.
  • In-depth onboarding sessions with the principal, special education office assistant and special services administrator following a carefully constructed Dotcom Therapy protocol and data collection form, along with discussion time for any potential idiosyncratic issues at the school.
  • Assigning an SLP/e-helper and sharing the Dotcom Therapy job specifications for the position.
  • An SLP resources and remote learning demonstration from the vendor for members of the town's school board, special education teachers, principal and special services administrator.
  • An introductory Q&A session for parents during the school's opening parent night with the Dotcom Therapy customer success manager and the school's new SLP.
  • A consultation with the IT coordinator to ensure there was a good fit between the tech requirements and the school's tech set-up.
  • A remote "meet and greet" between the vendor's speech language pathologist and the first general staff meeting of the school year.
  • Information sharing during the school's initial staff meeting regarding the process of remote instruction and the imminent use of laptops whenever communicating with the newly assigned speech language pathologist, the intention being to normalize the communication process within the school.

MARKETPLACE

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MEETING THE CHALLENGE

School Union 93 in Maine's central office IT coordinator made connections with both Dotcom Therapy and the school-based IT integration specialist to ensure the school had what was needed to provide successful technology integration across the school year.

Contact information was exchanged in case there was a need to problem-solve any glitch that may surprise staff during the first run of the vendor's speech services at the largest school in the union.

"Special education teachers and the e-helper understood that technology would serve as the glue for our interactive process," Watts noted. "The e-helper was provided with a laptop dedicated to SLP therapy sessions, IEP participation and weekly consultations, as required.

"Our school evolved into a 'school without walls' when teachers and e-helpers were seen chatting with the SLP while walking down the corridor, en route to a pending meeting," she continued. "Students quickly learned this was how we connected with our Dotcom speech therapist and responded to others' questioning expressions by quietly saying, 'She's talking with our speech therapist; it's normal. And she's really nice.'"

RESULTS

Over the past four years, School Union 93 in Maine has gradually augmented its DotCom Therapy contracted providers to cover four schools in the union and one private Waldorf Education school in the union's catchment area.

"Last year we expanded our reach to span across speech and language therapy, occupational therapy, school psychology, and counseling with a first-rate LCSW with elementary school experience," Watts said. "Without a doubt, it would not have been possible to provide timely onset and provision of required services had it not been for our collaborative and nurturing relationship with Dotcom Therapy.

"Evaluation requests were responded to by our school psychologist, who provided the telephone consultation with teachers and parents, administered the evaluations, completed the school psychology evaluation report, presented at IEP meetings, and followed up as required," she continued. "Without the vendor, we would have contracted outside, waiting an average of two to four months for initial contact with the student and family."

Further, parents and team members would have had an average one-hour commute to and from the school psychologist's office, she added.

Watts summarizes the success of the telemedicine program as follows:

  • Overall parent, teacher, administrator and student reports indicate an appreciation for consistently high clinical standards and rapport.
  • For the first time in the area, Waldorf school parents have embraced technology as an integral aspect of their child's support programming.
  • Quarterly reports issued from Dotcom Therapy indicate the ongoing progress of students in their therapeutic support.
  • Colleagues within the county, learning from the School Union 93 experience, have reached out to Dotcom Therapy and reported similar positive experiences for their constituents.
  • Proactive and preventative problem/process resolution has been appreciated by teams, in large part due to the highly effective clinical supervision of Dotcom providers.
  • The reciprocal transparency of the intake process has facilitated the development of contracts and the clarity of invoices, and has substantially helped to prepare budget projections for the upcoming school year.

ADVICE FOR OTHERS

"Looking toward the uncertainty of the status of the virus, we have the assurance of being able to continue the first-rate work we began remotely four years ago," Watts said. "Not surprisingly, we have decided to incrementally increase our remote staff each passing year.

"Whenever we administrators are in the position of recruiting therapists and school psychologists for our students, we want the very best," she continued. "Living in geographically remote areas, the odds are typically not in our favor to find what we are looking for – even over the course of an entire school year."

Watts' advice to other organizations is very straightforward: Follow your intuition to reach outside of your immediate reality and find a solution for students that has already passed the litmus test in effectively supporting and engaging students with the assistance of technology.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

Topics: 
Telehealth
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