In 2015 when Howard County became the first school system in Maryland to launch a telemedicine program, the lead agencies – the Howard County Department of Health and the Howard County Public School System – contracted CHHCS to develop an initial evaluation plan to formally assess the progress of the program. At the time, because of the early stage of the Howard County School-Based Wellness Telemedicine Program, the focus of the evaluation plan was on implementation-related processes, specifically increasing program utilization and improving service delivery. Drawing on an extensive history of work with SBHCs, CHHCS was able to connect with four experts in the field who are adopting telemedicine in school settings across the country. Key informant interviews with these experts gleaned insights on best practices and metrics currently used, or in development, for evaluating telemedicine programs. In addition, qualitative structured interviews with school nurses were conducted from each of the five participating telemedicine sites in Howard County in order to elucidate any challenges or barriers associated with operating the telemedicine program, as well as stories of success. Finally, multiple tools were developed or modified to improve data collection and build a foundation for later outcome/impact evaluation efforts.
CHHCS conducted an outcome evaluation to illuminate what kind of change has occurred following an intervention, and an impact evaluation that points to how an intervention may be affecting outcomes and why similar results might be expected if the intervention were replicated in other settings or communities. We answered these questions and collected other relevant data to inform program development in Howard County Public Schools.