Multidisciplinary Care of International Patients With Cleft Palate Using Telemedicine

Glazer, Chad A.; Bailey, Patti J.; Icaza, Ivette L.; Valladares, Socorro J.; Steere, Katherine A.; Rosenblatt, Elizabeth; Byrne, Patrick J.

doi:10.1001/archfacial.2011.72

Cited by 17 publications

(14 citation statements)

References 6 publications

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“…While some programs have implemented interdisciplinary, comprehensive services for cleft patients in LMICs [64], for instance by using telemedicine to provide speech therapy [47, 65, 66], this type of care depends on broad manpower and healthcare structure capabilities, neither of which is the focus of a vertical model. By reinforcing the importance of surgical care, a particular strength of the vertical approach, while simultaneously building capacity for other necessary CLP services, the diagonal model has the potential to improve the outcomes of patients in LMICs.…”

Section: Building Capacity While Addressing Specific Needs: a Diagmentioning

confidence: 99%

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

Patel

Hoyler

Maine

et al. 2012

Plastic Surgery International

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Global cleft surgery missions have provided much-needed care to millions of poor patients worldwide. Still, surgical capacity in low- and middle-income countries is generally inadequate. Through surgical missions, global cleft care has largely ascribed to a vertical model of healthcare delivery, which is disease specific, and tends to deliver services parallel to, but not necessarily within, the local healthcare system. The vertical model has been used to address infectious diseases as well as humanitarian emergencies. By contrast, a horizontal model for healthcare delivery tends to focus on long-term investments in public health infrastructure and human capital and has less often been implemented by humanitarian groups for a variety of reasons. As surgical care is an integral component of basic healthcare, the plastic surgery community must challenge itself to address the burden of specific disease entities, such as cleft lip and palate, in a way that sustainably expands and enriches global surgical care as a whole. In this paper, we describe a diagonal care delivery model, whereby cleft missions can enrich surgical capacity through integration into sustainable, local care delivery systems. Furthermore, we examine the applications of diagonal development to cleft care specifically and global surgical care more broadly.

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Section: Building Capacity While Addressing Specific Needs: a Diagmentioning

confidence: 99%

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

Patel

Hoyler

Maine

et al. 2012

Plastic Surgery International

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“…Although a few studies exist on speech and language therapy, little has been reported on the application of telemedicine to models of cleft care. [1][2][3] The Shriners Hospital for Children (SHC) is a national provider of cleft care whose mission is to provide free care for children with orthopedic and plastic surgery related acquired and congenital deformities. The Shriners Hospital for Children Los Angeles (SHCLA) is a regional pediatric plastic surgery referral center that serves the Southwestern United States and Northern half of Mexico, an area comprising more than 700,000 square miles.…”

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confidence: 99%

Telemedicine in Cleft Care

Costa

Yao

Gillenwater

et al. 2015

Journal of Craniofacial Surgery

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“…Some children will present with normal skills, and will not require a comprehensive assessment. This may improve efficiency and save costs for the service provider (32 Telepractice also offers the opportunity for local SLPs to access educational and mentoring opportunities (131,(138)(139)(140). Telemedicine studies have reported improved communication between local doctors and paediatric subspecialists (138,139,141), with subsequent improvements in the quality and continuity of care (138,139,(141)(142)(143)(144)(145).…”

Section: Figure 6 Possible Telepractice Screening Pathwaymentioning

confidence: 99%

“…However, there is limited evidence to support telepractice for speech pathology management of complex paediatric patients. A literature search (see Chapter 4) found only seven studies that investigated the effectiveness of telepractice for speech pathology service delivery to CMC (33,139,140,(171)(172)(173). None of these studies investigated language screening or assessment, and only three studies examined the use of telepractice for assessment of speech production.…”

Section: Efficacy and Adoption Of Speech Pathology Telepracticementioning

confidence: 99%

“…None of these studies investigated language screening or assessment, and only three studies examined the use of telepractice for assessment of speech production. These three studies all described the use of telepractice for assessment or treatment of speech impairment among international patients with cleft lip and palate (33,140,171 with patients) (178), thus adoption is likely to be low. However, this study did not include remote patient monitoring via telephone or email within their definition of "telepractice", which may account in part for these low rates of adoption.…”

Section: Efficacy and Adoption Of Speech Pathology Telepracticementioning

confidence: 99%

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Speech and language screening for children with medical complexity: A comparison of telepractice and in-person methods

Taylor¹

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Effective communication is vital for healthy development and successful educational and vocational outcomes. For children with medical complexity (CMC), the interaction between medical complexity and a speech and language impairment may put them at particular risk for adverse effects. It is important that these children are promptly assessed and diagnosed so that intervention can be started early. Medical complexity is rare in childhood, thus CMC usually access speech pathology services through tertiary facilities where staff have specialist experience and resources, and work as part of a coordinated tertiary team. Unfortunately these facilities are typically located in metropolitan centres, which may compromise service accessibility for CMC living in rural and remote locations.A potential solution to improve service accessibility is remote speech and language screening using telepractice. Telepractice screening allows the speech-language pathologist (SLP) to distinguish those children who need further assessment at the tertiary hospital from those with normal speech and language. This model is increasingly used for the delivery of tertiary medical services, however, there is little research to support the use of telepractice for paediatric speech and language screening, and very few studies have included CMC. Thus, the overall purpose of this research project was to investigate the role of telepractice for remote speech and language screening of CMC. To achieve this aim, two studies were carried out.The first study was an international survey of tertiary SLPs that aimed to describe access difficulties experienced by CMC, and to investigate the rate of telepractice adoption among SLPs who work with CMC. The survey was administered in 2011 (n = 46) and repeated in 2015 (n = 47). This survey identified widespread access difficulties experienced by CMC, highlighting a need for alternative service delivery models such as telepractice. Telepractice adoption among tertiary SLPs more than doubled between 2011 and 2015 (p < 0.05), and in 2015 the rates of telepractice adoption were higher (40%) than previously reported for the general speech pathology profession. Tertiary SLPs were willing to use telepractice with their CMC patients, and considered a wide range of patient groups and service types to be appropriate for telepractice delivery. However, some SLPs were reluctant to use telepractice for direct services such as screening, and a number of barriers to telepractice adoption were identified, including inability poor audio and image quality, lack of experience with telepractice, concerns about behaviour management and use of hands-on techniques, and concerns about the caregiver's inability to assist during telepractice sessions.ii The second study was an exploratory method comparison study that aimed to investigate the feasibility, validity, and acceptability of speech and language screening via telepractice for CMC.This study compared in-person speech and language screening with two telepractice screening ...

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Multidisciplinary Care of International Patients With Cleft Palate Using Telemedicine

Cited by 17 publications

References 6 publications

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

Telemedicine in Cleft Care

Speech and language screening for children with medical complexity: A comparison of telepractice and in-person methods

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