Helping to keep kids in class: Telehealth in Guilford County Schools

Image © Cone Health

Healthcare doesn’t usually begin in a classroom – but for many working families in Guilford County, North Carolina, when it does, that’s where it often ends. This is thanks to a telehealth programme in Guilford County Schools, which is designed to improve access to on-demand healthcare for children.

Established in 2021, the telehealth programme enables students who feel sick during school time to visit an on-site medical assistant who determines their needs. For simple concerns, like a headache, the medical assistant cares for the child as needed. For other issues such as earaches, minor injuries, or colds, the medical assistant connects the student to an online call with a healthcare provider. To support the healthcare provider to remotely check the child’s vital signs, the medical assistant is equipped with standard medical devices like a stethoscope and a blood pressure cuff. The computer platform and equipment used in a telehealth visit are designed specifically for virtual exams.  Using this special equipment, the medical assistant can give the provider views of the ear, nose, and throat of the child, just as if they were at the healthcare provider’s office. The telehealth programme also allows the medical assistant to dial in a parent or even provide language translation services if needed.

Before this programme was implemented, many Guilford County schools shared a school nurse who rotated among two or more campuses, meaning that when students fell sick at school, it was often not possible to treat them, even for minor conditions. As a result, they had to be picked up and taken home, causing parents to miss work and students to miss class for the rest of the day. Now, students return to class and can continue learning. “Using the telehealth system has allowed my child to have much less learning loss,” says one parent.[1]

During the 2024-2025 school year, with just 26 clinic sites, the programme conducted over 10,000 visits, of which 3,206 were telehealth visits. For the 2025-2026 school year, the programme has expanded to 32 schools in Guilford County. This has had a positive impact on the children’s attendance records and wellbeing. For example, before the programme was implemented, 25 per cent of children in Guilford County high poverty elementary schools were absent more than 19 days per year, with the primary reason being sickness or health concerns.[2] Sometimes, students were missing school for something as simple and treatable as a sore throat or allergies. This compounded with other social and financial issues that families in the community face. Lacking routine access to healthcare, parents would often take their children to the emergency room for minor conditions, straining the overall health system and their families’ finances.

Children who participate in the telehealth programme have higher rates of attendance and better learning outcomes, including greater reading proficiency and improved math test scores. There was significant impact on overall wellbeing as well, with participating schools experiencing fewer discipline referrals for behavioural problems when compared to the year before.[3]

“Our telehealth programme is a game-changer,” says Dr Johnita Readus, Principal of Bluford Elementary School during the 2024-25 school year. “By connecting students with medical professionals in real time, we help ensure that minor health concerns are addressed promptly, reducing absences, and keeping students engaged in learning.”

Building on the programme’s success, the team is expanding its services to include behavioural health support. Children and adolescents experiencing anxiety, depression, or behavioural disorders will soon have access to tele-behavioural health sessions with licensed mental health professionals. As with the medical programme, this mental health component will combine remote care with in-person support: community care health workers will work directly with schools to support students and equip teachers with practical tools. For example, teachers may be trained to guide students through deep-breathing exercises when they are experiencing anxiety.

“I grew up in this neighbourhood, and I know the unique needs in this community,” says Dr Jonathan Brooks, former Principal of Bessemer Elementary School. “Having this telehealth programme is a unique advantage here. We have healthy students, we have happy students, and a by-product of that is that we have successful students.”[4]

Oak Foundation supports Guilford Education Alliance through our Special Interest Programme. Driven by the interests and passions of Oak’s Trustees, the programme provides the space and flexibility to make grants outside of Oak’s other programme strategies. You can learn more about Guilford County’s Telehealth Programme by watching these videos here and here.

[1] Cone Health, School-Based Telehealth: Keeping Our Kids Healthy and In School (YouTube 21 March 2023), <https://youtu.be/L5qXiFC5uR8?si=6fo6gc1bjurEkELp>.
[2] Johns Hopkins Bloomberg School of Public Health, All in for Attendance: Education and Public Health Leaders Release Framework to Address Chronic Absence from Schools (10 June 2025), <https://publichealth.jhu.edu/2025/all-in-for-attendance-education-and-public-health-leaders-release-framework-to-address-chronic-absence-from-schools>. [publichealth.jhu.edu]
[3] Guilford County Schools, School-Based Telehealth Services Lead to Better Education & Health Outcomes for Students, <https://resources.finalsite.net/images/v1749741550/gcsnccom/mx4pzce80oerlmfpsgsu/TelehealthDataHighlightsv22925.pdf>.
[4] Cone Health, School-Based Telehealth: Keeping Our Kids Healthy and In School (YouTube 21 March 2023), <https://youtu.be/L5qXiFC5uR8?si=6fo6gc1bjurEkELp>.