North Carolina

Success Stories

In a Pandemic – Poised for Expansion

Ready or Not

Were you ready for the COVID-19 pandemic and its cascading effects on all healthcare?  No one really was – but Amanda Martin, Executive Director of the Center for Rural Health Innovation (CRHI), along with Dr. Steve North and their team, were well poised at the beginning of this pandemic to expand beyond school telehealth care to provide healthcare access for vulnerable detained juveniles, adults and staff in a detention facility. 

Health-e-Schools, a Decade of Development 

For the last 10 years, the Center of Rural Health Innovation (CRHI) led by Amanda K. Martin, MHA, and Dr. Steve North, MD, MPH, have been addressing the healthcare needs in their rural southern Appalachian Community in North Carolina. This area is historically underserved by medical and behavioral healthcare providers. With a grant in 2011, the original pilot to initiate school- based healthcare in three schools called Health-e-Schools, began. 

In this program, students could be assessed and treated via telehealth right in the school, meaning their parent did not need to arrange an appointment, take off work (and often reduce their pay), and drive up and down the curvy mountain roads. For the students, this meant better access to healthcare to address colds and the flu in addition to medication management. 

Now students could not plead they had a sore throat or another aliment to miss a test if telehealth addressed this issue right away in school.  But this did mean more students could spend more time in school, which improved their academic success, leading to some being the first in their family to finish high school. Despite some initial school and community reservations, this program quickly became recognized as an asset and preceding the pandemic they had expanded from the initial 3 to 108 schools. 

A Decade of MATRC Connections  

At the same time, Amanda Martin and Dr. North have been Consultative Service Partners and on the Advisory Board of the Mid-Atlantic Telehealth Resource Center (MATRC). From the early days, this involvement provided them general telehealth information and a broader knowledge of the field and industry through MATRC Summits beginning in 2011.  Amanda Martin and Dr. Steve North quickly became both a regional and national resource for school-based telehealth.

Poised for Health-e-Schools to Health-e-Corrections

All of this lead to Amanda and CRHI being ready for expansion at a pivotal time as the pandemic began. Just as the pandemic initiated in the US in spring 2020, CRHI was asked by the Madison County Sheriff’s Department in Marshall, North Carolina if they could provide healthcare for juvenile inmates. 

And as Amanda describes it, “Thus began the conversation about how telehealth services from an organization like CRHI could bring high quality, timely and responsive care to all the inmates, juvenile and adult, plus the Sheriff’s staff. With a long history of establishing new programs and training non-clinical tele-presenters”, CRHI and key staff like Program Coordinator, Dr. Tonya Shuffler, DNP FNP, “leapt into action to plan and implement a customized service for the Sheriff.”

With an overlap of staff and services, when the schools in North Carolina were closing, Amanda and CRHI began providing healthcare for the Madison County Sheriff’s Department facility. There were different funding sources and documentation but much was the same. 

As Amanda describes, “The Health-e-Corrections program was crafted to reduce transport, increase response time (from inmate request to appointment), enhance chronic disease management, and provide the occasional ‘nurse level’ care that the jail needed but could not afford to staff in-house.”

From schools to detentions centers, access to timely healthcare is still the core. 

Relationships as a Perpetual Resource 

From Amanda’s perspective the team was particularly well poised because of MATRC.  “MATRC is a place where people have long relationships. There are new people, but at the core it builds a network of telehealth people for everyday give-and-take conversations. For example, Dr. North and I would have no reason for connection with Kentucky, but Kentucky and North Carolina are much alike. We have provided them school based telehealth knowledge both formally and informally. So when we needed jail knowledge, we asked them for help and to shed light on some questions.” 

Apparently, supportive collaborative relationships are a perpetual resource and can poise telehealth programs for expansion and success – even during a pandemic.