OMAHA, Neb. -- It takes less than a minute for health assistant Nancy Yount to power up the computer and activate the videoconference.
The screen fills with an image of a doctor's office 85 miles away in Norfolk. In the bottom right corner, a smaller box shows Yount in her office at Westside Community Schools, a student at her side cooperating with a demonstration.
A nurse enters the televised picture.
Yount picks up a high-resolution videocamera connected to the computer and trains it on the student's "imagined" injury. The nurse gets a closer look at the student while talking to Yount.
High-resolution cameras and speedy Internet connections to the clinic in Norfolk are helping some cash-strapped schools provide nursing services to schools without nurses and ones in rural areas. Yount has used the telemedicine service several times, including to help verify that a student had shingles and determine the best way to treat it.
Through the Internet connections, American Educational Telecommunications LLC provides advice to schools from nurses -- and doctors, if necessary -- on hard-to-diagnose cases. Health assistants can receive information on several illnesses, among them asthma, diabetes and adolescent development.
"It's a nice tool to have," Yount said.
Dr. Keith Vrbicky, an obstetrician-gynecologist, started the company in 1997 to focus on international telemedicine and distance education. When business slowed after the Sept. 11, 2001, terrorist attacks, he turned to helping schools in his own state.
"It is a good way to level the playing field for rural areas in getting good health care," he said.
Westside signed up its 10 elementary schools for the 2002-2003 academic year after Douglas County cut funding for a visiting nurses program.
At first offered as a free service to schools during the 2001-2002 year, American Educational began charging for the program last year, and it is starting a pilot program for businesses. The company hopes to turn a profit this year.
The schools' costs are based, in part, on the number of students served.
Westside is paying $60,000 for its 2,800 students. American Educational, based in St. Louis, also is compiling medical records for each student and sending three to five nurses to Westside schools to help with health exams.
Putting nurses into each of Westside's schools was not feasible at $25,000 to $40,000 a position, and American Educational was a viable alternative, said Ken Baldwin, director of building services at Westside.
Westside has not decided whether to renew its one-year contract. Baldwin said the district's other options include hiring two nurses or contracting with another health group.
Vrbicky hopes the program helps alleviate problems caused by a nationwide nursing shortage and school budget cuts.
"It's very beneficial to schools that don't have a nurse, and our experiences with them were very good," said Larry Ferguson, superintendent of Leigh Community Schools, whose elementary and high schools received the program last year at no charge.
American Educational may be the only company providing this kind of service to public schools, although some universities and medical colleges have undertaken similar projects, said Jonathan Linkous, executive director of the non-profit American Telemedicine Association. The Washington-based organization advocates medical care using telecommunications technology.
Outside Nebraska, 21 schools in southeast Kansas receive the service, and American Educational recently signed a contract with the Universidad Autonoma de Guadalajara's School of Medicine in Guadalajara, Mexico. The university will use the network to help provide clinical care in Mexico and elsewhere.
The Southeast Kansas Education Service Center, known as Greenbush, used a grant to install cameras in 21 rural school buildings. Some of the schools had been doing without a nurse; others had shared a nurse among six buildings.
The service is more personal than a telephone consultation and it can be applied to special needs students who might require daily monitoring, medication or other consistent medical help, said Kristy McKechnie, spokeswoman for the service center.
"The benefit is the nurse actually seeing the child," she said. "If there is a cut or an abrasion, the nurse can see the problem. Or if the student is having trouble breathing, the nurse can watch the chest and hear the wheezing."
The service center paid $52,986 for the program.
On the Net:
American Educational Telecommunications: http://www.aetmedical.com
American Telemedicine Association: http://www.americantelemed.org
Southeast Kansas Education Service Center: http://www.greenbush.org
Nursing survey: http://bhpr.hrsa.gov/healthworkforce/rnsurvey/
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