A breath of relief

A breath of relief: How MUSC telehealth helps kids breathe easier at school

Before Makenzi Garland knew what asthma was, she knew how it felt – when her chest got tight and she couldn’t catch her breath.

By age 9, her visits to the school nurse in Sumter, South Carolina, had become more frequent.

“She’d come in holding her chest, wheezing – especially after recess,” said school nurse Tiffany Davis, R.N.

Eventually, Makenzi was diagnosed with asthma. She’s one of more than 60,000 children in South Carolina living with the condition – that’s more than 5% of the population under the age of 18. But as Davis knows, diagnosis is just the beginning. Managing chronic conditions like asthma takes education, support and access – something too many rural families lack.

Meeting families where they are

For many of her students, getting to a doctor isn’t simple. Davis says some are being raised by grandparents or other relatives while their parents serve in the military. Others face daily challenges that make traditional appointments hard to manage.

“Some families are just trying to put food on the table,” Davis said. “A doctor’s visit for a sore throat can feel like a luxury.”

The solution? Virtual doctor’s visits, also known as telehealth.

Through the MUSC Health Center for Telehealth, students can be evaluated for common issues like asthma, sore throats, earaches, ADHD and more without ever leaving school. This growing initiative – supported by The Duke Endowment – brings care directly to students who need it most.

“I definitely wanted Makenzi referred to telehealth,” Davis said. “She and her mom needed help understanding why her treatments matter – and how to use them consistently.”

How telehealth reaches kids at school

Enter Lorrie Smart, LPN, a former school nurse and now telepresenter for the center.

A telepresenter is essentially the hands of a doctor on the other end of a video call. With a parent’s consent, Smart works alongside the school nurse to guide the child through a remote exam.

“We can listen to their heart, check their throat, even run a strep test,” Smart explained. “Everything I see and hear, the provider sees too – I just carry out the physical part.”

Once a diagnosis is made, the provider can prescribe medication or recommend follow-up care. With philanthropic support, MUSC’s school-based telehealth program is removing major barriers to care for many families: lack of transportation, limited time off work or no primary care provider.

“It’s a huge help,” Davis said. “Students get care quickly. Parents don’t miss work. Kids miss less school. We’re all working together for the child.”

Empowering healthy communities, one child at a time

MUSC’s school-based telehealth program is just one part of its statewide commitment to empowering healthy communities. From stroke care to mental health counseling to OB/GYN and urgent care, the MUSC Health Center for Telehealth is working to bring high-quality care to patients across South Carolina – no matter where they live.

The center also serves as the headquarters of the South Carolina Telehealth Alliance, a statewide network of hospitals, providers, schools and agencies collaborating to remove barriers to care.

“The whole landscape of how we access care has changed,” said James McElligott, M.D., executive medical director for telehealth at the Medical University of South Carolina. “We started with three schools and thought we were doing good. Now we’re in the hundreds.”

From struggle to strength

As a telepresenter, Smart manages care across 18 schools – eight in Sumter County and 10 in Williamsburg – traveling between sites equipped with telehealth technology to facilitate virtual appointments between students and physicians.

Smart remembers what it was like when Makenzi’s care began.

“She was so used to struggling. That was her normal,” Smart said. “She couldn’t run at recess. She couldn’t keep up with her friends.”

With Smart’s support, Makenzi regularly met virtually with a physician from a small room just off the nurse’s office. She learned how to manage her asthma, started a treatment plan and began using an inhaler.

Then one day, something clicked.

“I’ll never forget when she came in and said, ‘I can breathe! I can feel it,’” said Smart. “Now she only visits the nurse to get her controller medication. No more emergency visits. That’s a huge shift.”

A new normal

Makenzi’s life today is full of movement – and joy. She loves to cheer, play soccer, sing in the church choir, and race her friends at recess. Her mom, Thomasina Garland, calls the change “tremendous.”

“We used to get so nervous during her asthma attacks,” she said. “We didn’t know how to help. Now she sleeps better. She’s active again. It’s been a blessing for our whole family.”

Makenzi is still learning to manage her asthma and stops in to see Davis twice a day to use her inhaler. But what really helps, she says, is knowing she’s not the only one.

“Sometimes I come into the nurse’s office and see other kids taking their medicine,” she said. “It reminds me I’m not alone. And Ms. Davis helps me remember – because some days, I forget.”

“She told me she can run with her friends again,” Smart said. “That’s why I do this. Once I see your child, they’re my child too. And I’ll fight to make sure they can breathe – literally and figuratively.”

Contributing Author
Kristin Lee