Evaluation of a Clinical Service Model for Dysphagia Assessment via Telerehabilitation

Abstract

Emerging research supports the feasibility and viability of conducting clinical swallow examinations (CSE) for patients with dysphagia via telerehabilitation. However, minimal data has been reported to date regarding the implementation of such services within the clinical setting or the user perceptions of this type of clinical service. A mixed methods study design was employed to examine the outcomes of a weekly dysphagia assessment clinic conducted via telerehabilitation and examine issues relating to service delivery and user perceptions. Data was collected across a total of 100 patient assessments. Information relating to primary patient outcomes, session statistics, patient perceptions, and clinician perceptions was examined. Results revealed that session durations averaged 45 minutes, there was minimal technical difficulty experienced, and clinical decisions made regarding primary patient outcomes were comparable between the online and face to face clinicians. Patient satisfaction was high and clinicians felt that they developed good rapport, found the system easy to use, and were satisfied with the service in over 90% of the assessments conducted. Key factors relating to screening patient suitability, having good general organization, and skilled staff were identified as facilitators for the service. This trial has highlighted important issues for consideration when planning or implementing a telerehabilitation service for dysphagia management.

Dysphagia Care Across the Continuum: A Multidisciplinary Dysphagia Research Society Taskforce Report of Service-Delivery During the COVID-19 Global Pandemic

“…Telehealth, or the use of telecommunications technologies to support long-distance clinical health care, is a model that has been used in prior public health emergencies and disasters [69], and has been implemented as part of standard care in several countries and healthcare systems prior to the current global health crisis. Indeed, prior to this pandemic, telehealth had gained momentum in a variety of disciplines, including the management of dysphagia in research and in clinical practice particularly in countries with rural and remote populations (for example, Australia) [70][71][72][73][74][75][76][77][78][79][80][81][82][83]. A growing body of literature has provided overall positive research evidence for the use of both synchronous (live interaction) and asynchronous (store and forward) telehealth to assess and treat dysphagia, mainly in adults but in some pediatric populations as well.…”

Quality of life of head and neck cancer patients in urban and regional areas: An Australian perspective

“…There is growing interest in telehealth as a model of service delivery in oncology. Telehealth has been used in HNC care to conduct remote diagnostic assessment, deliver rehabilitation support and screening programs . The benefits of receiving specialist support remotely include improved patient satisfaction with care and a reduction in the economic, health and environmental impact of travelling for ongoing care .…”

“…Telehealth has been used in HNC care to conduct remote diagnostic assessment, deliver rehabilitation support and screening programs . The benefits of receiving specialist support remotely include improved patient satisfaction with care and a reduction in the economic, health and environmental impact of travelling for ongoing care . There is scope for future research to investigate the potential of integrated multidisciplinary care, delivered through a telehealth model, to improve QoL outcomes and enhance access to specialised care for HNC patients living in regional areas.…”

Dysphagia Practice in 2035: Beyond Fluorography, Thickener, and Electrical Stimulation

“…Since the early 2000s, evidence has accumulated supporting both feasibility and reliability of teledynamic clinical swallowing assessments and telefluoroscopic swallow studies. [169][170][171][172][173][174][175][176][177] Regarding dysphagia teletreatment, evidence is scarce including case studies or small-scale satisfaction surveys on the use of dysphagia apps. [178][179][180] An additional promising area of telehealth includes wearable technology and devices.…”