In years past when District Nurse Becky Droter (’94 Nursing) needed to research complex medical issues that affected her Colville School District students, she’d call the Spokane Educational School District to talk with nurses there. They were helpful but finding resources that fit the particular needs of her rural community remained difficult.

Droter’s students face different challenges than students in urban and suburban places. To start, distance poses a formidable barrier to health care access. If a Colville student needs to see a specialist, they must drive ninety minutes (“on dry roads,” Droter notes) to Spokane or six hours to Seattle. Then there’s the shortage of doctors and nurses that’s endemic to rural Eastern Washington.

“We don’t have a pediatrician in our community,” Droter says. “This creates problems for our kids getting access to care and helping our families understand the importance of seeing a specialist for special needs. And by special needs, I mean something as common as asthma.”

Technology like telemedicine would help ease some cases, but it hasn’t yet been widely implemented.

Fortunately, when it comes to research, Droter’s needs are covered by HEALWA, Washington’s digital library for health care practitioners. Through, Droter can find authoritative clinical research on the conditions and issues that impact her students. She uses that evidence-based information to improve how the district safeguards student health.

For example, thanks to Droter’s efforts, the Colville School District was one of the first districts in the state to make Narcan available at schools. Like many communities nationwide, Colville is no stranger to the opioid crisis. Droter set out to research how other school districts create policies around having this life-saving medicine on hand in case of emergency. Through HEALWA she discovered there wasn’t an example in Washington for her to follow; further searching in HEALWA’s online library yielded resources that helped her make the case to her school board to write a new policy.

The legislature created HEALWA in 2007 to support evidence-based practice in health care. Access to the library of online resources is tied to professional licensure—all nurses, doctors, and 25 other professions licensed in Washington can use HEALWA’s library to find full text articles, point of care references, and patient resources in multiple languages.

“Just last week I spent a bunch of time on HEALWA looking up articles on ‘Do Not Resuscitate’ orders because I have a student I have that order for,” Droter says. “In a small school we’re all completely invested in the 360-degree well-being of our kids. The idea that a student might not go home at the end of the day doesn’t sit well. I really needed HEALWA for looking at best practices and how things are handled from an ethical and cultural perspective elsewhere.”

The small size of her community requires Droter to educate everyone from volunteer emergency responders to the school board. But Colville’s small size also makes that possible: as a rural nurse, Droter can nurture close relationships with all stakeholders. Grounding her efforts in authoritative evidence she found through HEALWA’s website—no more need to call Spokane—helps her educate everyone she works with. In Washington state, equity of access to care may still be a challenge, but thanks to HEALWA, equity of access to evidence-based medical information is already here.


Kate Lebo is the HEALWA outreach coordinator for Eastern Washington, based out of WSU Health Sciences Spokane.