May 27, 2021

getty When the Covid-19 crisis abruptly shut down schools across the country in March 2020, it became clear to the general public what members of those school communities already knew: schools provide students and their families with a lot more than classroom instruction. Along with academic growth and social engagement, students lost access to basic resources such as food and mental health support during the pandemic. A year later, one school district leaned into an expanded role when it reopened to in-person education this spring. Earlier this month, the  Baltimore City Public Schools  announced a partnership with  K Health , a primary care mobile app with five million users nationwide. K Health now provides 80,000 Baltimore City students and their families customized health information and access to doctors if needed—for free. Based on detailed questionnaires and artificial intelligence, the app helps users understand their symptoms and when to connect a doctor. Normally, consultations with a K Health doctor cost $19. Ron Shaul, K Health cofounder and chief product officer, said that the company was trying to find ways to help communities in need when they hit upon the opportunity to support Baltimore’s school reopening. “We got a lot of excitement from the faculty because they were dealing the idea of convincing people that it’s a good idea to go back to school, that it’s going to work,” Shaul said. The app became a pillar of Baltimore’s reopening plans, alongside masking, health screening, testing, air ventilation, and other Covid-19 mitigation strategies, according to  Alison Perkins-Cohen , chief of staff at Baltimore City Public Schools. MORE FOR YOU “The idea that through a school system you can get these kinds of resources has been really welcomed by the community,” Perkins-Cohen said. “We feel like [it is] such a victory for our families.” Schools have long provided health services through school nurses and on-site clinics, and in recent years  school-based telehealth has expanded . But when Covid-19 struck, school-based healthcare went from innovative to essential. “When Covid happened, our schools were asked not only to immediately build models for remote learning, but also to become public health experts,” said Josh Golomb, CEO of  Hazel Health , a school-based telehealth company that has set up virtual health clinics in school districts representing more than 1.5 million students across ten states. According to Golomb, educators found themselves having to fill in healthcare access gaps. Despite deep expertise from existing school nursing programs, schools needed more support to handle new demands. That’s where telehealth and other health apps could help. “If we can partner with school nurses with the right tools and access to great doctors, we can improve families’ healthcare access and enable the educators to focus on what they do best—educating our kids,” Golomb said. Baltimore City had already been providing social services and other resources as a  Community Schools district, which means 130 Baltimore schools have a full-time coordinator responsible for connecting families with resources. Perkins-Cohen said the coordinators have been ecstatic to have the K Health resource for worried parents—whether they’re worried about Covid-19 or another health issue. Nationwide,  20 million —or more than one in four—children lacked adequate access to essential healthcare before the pandemic. These barriers only got worse as a result of the economic downturn. In Baltimore, the number of people without health insurance grew an  estimated 5%  as a result of widespread unemployment, which peaked in the Baltimore metropolitan area at  9.2%  in May 2020. “The parents in Baltimore are just like every other parent in the nation feeling stress of having their kids at home and working from home or being without a job,” said Dr. Chelsea Johnson, a pediatrician with K Health. Reopening schools added a new dimension to that stress. Despite evidence that schools have been  relatively safe  when mitigation protocols are followed, many parents feared exposure to Covid-19. According to Johnson, the app has helped ease these concerns for many families she has met through the app, which has had hundreds of downloads in the initial weeks following the launch. Many families have also told her they couldn’t afford to see a doctor without the app. “It’s so much a lifeline for many and it’s great, convenient care for others,” Johnson said. One surprise for Perkins-Cohen from the initial response has been how much use the app has gotten from adults about their own health. “Sometimes our health programs support students but they don’t as often support the adult, and that’s a really important need,” she said. “For our school community, we need parents to have access to the supports they need in order to be able to support their students, too.” Hazel Health’s Golomb agrees that schools can be a conduit to serving whole families. Adults, he said, don’t always prioritize their own health, but most will do anything for their kids. “Sometimes the best way to reach the family members is to do something through the school because they’re such hubs,” Golomb said. That insight may point to the real value of school-based digital health: enabling broader access to primary care. Though most Americans may have a primary care provider on paper, Shaul thinks as many as half lack adequate access to primary care because of long waits for appointments, lack of transportation, or inconvenient hours. “Coming out of the pandemic, [we] realize that you can use a lot of automation, a lot of data, [and a] virtual component to get people to access that important primary care layer that later on determines [their] long-term health,” Shaul said. Golomb also sees the potential for digital health services to have long-term positive impacts. “Nothing is more important than kids being healthy and in school,” Golomb said. “If we can create a great experience for them as kids, we can … create a positive engagement with their own health throughout their lives.”