Telehealth for Dysphagia Across the Life Span: Using Contemporary Evidence and Expertise to Guide Clinical Practice During and After COVID-19

Abstract

Purpose Our aim was to critically review recent literature on the use of telehealth for dysphagia during the COVID-19 pandemic and enhance this information in order to provide evidence- and practice-based clinical guidance during and after the pandemic. Method We conducted a rapid systematized review to identify telehealth adaptations during COVID-19, according to peer-reviewed articles published from January to August 2020. Of the 40 articles identified, 11 met the inclusion criteria. Full-text reviews were completed by three raters, followed by qualitative synthesis of the results and description of practical recommendations for the use of telehealth for dysphagia. Results Seven articles were guidelines articles, three were editorials, and one was a narrative review. One article focused on telehealth and dysphagia during COVID-19. The remaining 10 mentioned telehealth in varying degrees while focusing on dysphagia management during the pandemic. No articles discussed pediatrics in depth. The most common procedure for which telehealth was recommended was the clinical swallowing assessment (8/11), followed by therapy (7/11). Six articles characterized telehealth as a second-tier service delivery option. Only one article included brief guidance on telehealth-specific factors, such as legal safeguards, safety, privacy, infrastructure, and facilitators. Conclusions Literature published during the pandemic on telehealth for dysphagia is extremely limited and guarded in endorsing telehealth as an equivalent service delivery model. We have presented prepandemic and emerging current evidence for the safety and reliability of dysphagia telemanagement, in combination with practical guidelines to facilitate the safe adoption of telehealth during and after the pandemic.

Autism assessment via telehealth during the Covid 19 pandemic: Experiences and perspectives of autistic adults, parents/carers and clinicians

“…They felt that they needed to adapt their practices for tele-assessments, including less reliance on their own observations and heavier reliance on supplementary sources of information and parents for child assessments. Research has consistently shown that adaptations of clinical practices are required to support clients or patients via telehealth ( Malandraki, Arkenberg, Mitchell, & Malandraki, 2021 ; Waller et al, 2021 ), and assessments for some conditions such as chronic pain require additional involvement from the clients or patients (e.g., Perez, Niburski, Stoopler, & Ingelmo, 2021 ). A number of specific challenges related to telehealth delivery for autism assessments were identified by clinicians, including administration difficulties with eye contact being most challenging to assess.…”

COVID-19 pandemic experiences of parents caring for children with oesophageal atresia/tracheo-oesophageal fistula

“…Service providers must now actively engage with the rapidly evolving technology, such as use of remote stethoscopes, 23 understand barriers and support access to technology, 21 and develop appointment-specific telehealth guidance to optimise use of telehealth. 24 Parents described the impact that delays and cancellations had to their child's health and developmental progress, with access to community care particularly problematic. A number of parents highlighted the distress caused by feelings of being abandoned by healthcare services.…”

“…Service providers must now actively engage with the rapidly evolving technology, such as use of remote stethoscopes, 23 understand barriers and support access to technology, 21 and develop appointment-specific telehealth guidance to optimise use of telehealth. 24 …”

Development of a Remote Examination of Deglutition Based on Consensus Surveys of Clinicians (Part I): Selection of Examination Items

“…Malandraki et al [ 21 ] stated that in remote training, the viscosity and amount of food to be tried needs to be carefully selected. Since assessments are performed on patients of various severities and diseases, it is necessary to obtain consensus among experts who are candidates for telemedicine on the amount and viscosity of food and water when conducting assessments remotely.…”