School-based telemedicine: using technology to bring health care to inner-city children

In the USA, children in low-income, medically understaffed areas have diffi culty accessing health care. A pilot telemedicine service was established i n Kansas, linking four elementary schools with a local hospital at 128 kbit /s. PC-based videoconferencing systems, a stethoscope, an otoscope and fax machine were installed for each school's nurse. During the first three mont hs of operation, 187 consultations were conducted by a hospital physician o ver the video-link. Ear, nose and throat problems were the most common reas on for referral (29%), followed by dermatological problems (20%) and mandat ory school physicals (20%). Prescriptions were issued in 67% of cases. Eigh teen per cent of children required referrals for specialist care. The pilot service successfully enabled medically disadvantaged children to receive h ealth care and prompted four additional schools to join the project.