Implementation of speech pathology telepractice services for clinical swallowing assessment: An evaluation of service outcomes, costs and consumer satisfaction

Abstract

Introduction Timely assessment of swallowing disorders (dysphagia) by speech pathologists helps minimise patient risk, optimise quality of life, and limit healthcare costs. This study involved a multi-site implementation of a validated model for conducting adult clinical swallowing assessments via telepractice and examined its service outcomes, costs and consumer satisfaction. Methods Five hub-spoke telepractice services, encompassing 18 facilities were established across a public health service. Service implementation support, including training of the telepractice speech pathologists (T-SP) and healthcare support workers in each site, was facilitated by an experienced project officer. New referrals from spoke sites were managed by the hub T-SP as per published protocols for dysphagia assessments via telepractice. Data was collected on existing service models prior to implementation, and then patient demographics, referral information, session outcomes, costs and patient and T-SP satisfaction when using telepractice. Results The first 50 sessions were analysed. Referrals were predominantly for inpatients at spoke sites. Telepractice assessments were completed successfully, with only minor technical issues. Changes to patient management (i.e. food/fluid changes post assessment) to optimise safety or progress oral intake, was required for 64% of patients. Service and cost efficiencies were achieved with an average 2-day reduction in waiting time and an average cost benefit of $218 per session when using the telepractice service over standard care. High clinician and patient satisfaction was reported. Conclusion Telepractice services were successfully introduced across multiple sites, and achieved service and cost benefits with high consumer satisfaction.

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.…”

“…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. Regarding assessments, both tele-clinical (bedside) and tele-videofluoroscopic swallowing assessments conducted remotely have been repeatedly shown to be safe, valid, and reliable when compared to traditional in-person swallowing evaluations [70][71][72][73][74][75][76][77][78][79][80]. In the last few years, we have also seen emerging positive research evidence for the use of telehealth for dysphagia treatment [81][82][83].…”

Conducting community rehabilitation review sessions via videoconference: A feasibility study

“…However, use of videoconferencing for swallow assessments has been applied elsewhere successfully. 4 This is encouraging to consider in further expanding the use of telerehabilitation in CRP. Clients participating in dietetics sessions received education and advice in regard to either treatment of malnutrition, or strategies to improve healthy lifestyle and prevent weight gain.…”

“…There is literature to suggest that rehabilitation provided via videoconference (telerehabilitation) is a cost-effective and time efficient alternative to providing face-to-face visits. 1,[3][4][5][6][7] Not only this, the added benefit is that telerehabilitation is proposed by clients and clinicians to be just as effective as face-to-face sessions. 1,8 However, many studies assessing the effect of videoconferencing on client outcomes have provided clients and clinicians with the appropriate technology to use in trials.…”

Management of Dysphagia During COVID-19 Pandemic: Gazi University Faculty of Medicine ENT Clinical Experience

“…[19][20][21] Benzer şekilde, literatür incelendiğinde farklı hasta gruplarında klinik yutma değerlendirmesi için de telesağlık sisteminin kullanıldığı, bu yöntemin etkili ve güvenilir olduğu belirtilmiştir. [22][23][24][25] Eğer hastanın durumu müsaade ediyor ise uzaktan iletişime geçilmeli ve ilk değerlendirmesi telesağlık şeklinde planlanmalıdır. Bu doğrultuda, mevcut durumu uygun olan COVID-19 tanılı hastaların klinik yutma değerlendirmelerinde telesağlık sisteminin kullanılabilmesi için uygun şartların sağlanması ve hazırlanması gerekir.…”