Case Study | School-Based Telemedicine Program Expands Access to Care for Students and Teachers

The Problem

During the 2009-10 academic year, the nursing teams at Bradley County Schools and Cleveland City Schools — two school districts in Bradley County, Tennessee — observed a steady increase in student health challenges. Chronic absenteeism became more common, acute illnesses went untreated, and many families struggled to find time or transportation to take their children to a doctor. These barriers kept students out of the classroom and added stress for both parents and teachers.

In response, the districts partnered with a local hospital to provide access to the Ronald McDonald Caremobile, a mobile health clinic that offered limited services to three of their 27 schools. But the situation became more urgent in 2020 when the Caremobile was retired. Without that resource, the district lacked a reliable method to address the rising demand for accessible healthcare.

School leaders recognized the broader impact of reduced access to healthcare services. Lost school days adversely affected academic progress and attendance-related funding, while teacher medical absences disrupted instruction and increased costs. These pressures highlighted the need for a sustainable solution that could keep students healthy, engaged in school, and ready to learn.

The Solution

The team learned of and applied for an annual grant offered by the United Way of the Ocoee Region. With support from this grant and assistance from their districts, they were able to increase access to care beyond the limited reach of the retired Caremobile. The school-based telemedicine program, powered by Eko Telehealth, started in just a few locations but has now expanded into a district-wide initiative covering all 27 schools.

Eko’s digital stethoscopes equipped with the Eko Telehealth solution allow school nurses to connect students with local nurse practitioners in real time via secure Zoom links. This enables the provider to listen to heart and lung sounds, conduct ear exams, and perform a more comprehensive virtual assessment, all while the students remain on campus. Parents are engaged throughout the process with digital consent and follow-up communication, and prescriptions are sent directly to local pharmacies for same-day access.

A significant aspect of the program is its ability to eliminate financial barriers. Thanks to funding from the United Way grant, uninsured students can receive medical visits and prescriptions at no cost, while insured families are billed later, rather than required to pay upfront. This approach ensures that no student is turned away due to financial constraints.

The technology itself has also proven easy to adopt. Nurses who are already managing busy clinics find Eko’s tools intuitive and straightforward to use alongside their daily workflow.

“It's a seamless piece of technology because it's a couple of clicks and then you're connected. It’s very clear and user-friendly. Our nurses are extremely busy, especially when they're trying to multitask with a visit, so the simplicity of the equipment has been a huge benefit.”  

Tabitha Payne, BSN, RN
Telemedicine Coordinator for Bradley County and Cleveland City Schools

The program has also proven valuable for teachers. With telemedicine available on campus, teachers can receive care during the school day without leaving their classrooms, reducing disruptions for students and lowering costs associated with substitutes. Together, these features have made Eko Telehealth a practical, sustainable solution for the entire school community.

The Outcome

Today, Bradley County and Cleveland City Schools provide services with Eko Telehealth in all 27 sites, ensuring students and teachers can access timely, high-quality care on campus.

By integrating Eko’s technology, the districts have:

• Expanded access to care for students and staff, with visits increasing from just 43 in the 2020–21 academic year to more than 630 in 2022–23 academic year.
• Reduced absenteeism, as students are often seen within 5-15 minutes and return to class the same day, depending on the outcome of the visit.
• Minimized the need for substitute teachers to cover for full-time staff during medical appointments.
• Lowered costs for families by reducing transportation challenges, missed wages, and up-front medical expenses.
• Provided continuity of care, with local providers establishing medical homes for students who previously lacked them.
• Built community trust and adoption, with families learning about the service through school events, social media, and word of mouth.

The program's growth has been driven by strong leadership, consistent funding from United Way and district contributions, and a dedication to having a nurse in every school, which surpasses state requirements. With telemedicine now firmly established, the districts are planning for the future by expanding into new schools, exploring the integration of mental health services, and preparing the next generation of providers through partnerships with local colleges.

“This is my 38th year in education, and I'm still so proud of our school system because when we go to state conferences, we're leading the pack when it comes to telemedicine. We get to share our stories, and that’s going to get more people on board to do this so that more students across the nation can get help. Other districts can see this is doable, and that it can help all of our students.”  

Karen Saffles-Slater
School Health Coordinator for Bradley County Schools

Bradley County’s telemedicine program is more than a healthcare service; it is a lifeline that keeps students learning, families working, and communities thriving. This program also provides a model that other school systems nationwide can replicate to improve access to care.