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Broca's aphasia

Article Review 3

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Telehealth Improves Access to Care

 

The telehealth program has made it possible for SLP’s to decrease their weekly visits to patients while allowing the patients to continue receiving frequency of visits optimal for their progress. The program gives patients access to an SLP and allows the SLP to deliver therapy in an efficient manner. The program improves productivity and increases the capacity of the field SLP who serves a large number of patients in home care who have aphasia secondary to stroke who come to clinics in the acute stage when they need intensive therapy. With telehealth services, the SLP is able to increase the number of visits to meet the needs of the patients who suffer from expressive speech disabilities.

 

The way it works is the speech pathologist and the patient are connected by a small video screen, camera and speaker which are placed in the home of the patient. This equipment is given to the patient at no cost to them. The SLP places a phone call to the patient and within 1 minute after pressing a button, the patient and SLP see and hear each other through the video screen and speakerphone. The patient is still treated at least once a week at the clinic or home and the telehealth services are used as a supplement to those sessions.

 

A 30 minute therapy session may include oral motor exercises, articulation drills for speech intelligibility, language stimulation activities, swallowing exercises and support for the patient and caregiver.

 

To determine if a patient will benefit from this type of therapy, the SLP looks at the cognitive abilities and receptive and information processing deficits that may make this delivery inappropriate for them. For instance, patients suffering from Wernicke’s aphasia may need a one-to-one, face-to-face interaction in order to make gains on their speech goals. Telehealth also may not be utilized at the beginning of the home treatment program. It may be implemented after the SLP has established routines and techniques with the patient and the program is used for carry-over skills.

 

It’s important for the SLP’s and the telehealth staff to have weekly consultations and provide data and summaries of what they have been working on and achieved. The program should be discussed and changes made as needed. It is also important to continue to get feedback on patient satisfaction and outcomes.

 

The latest patient satisfaction survey revealed positive replies. On a 5 point scale, the services scored 4.2 to 4.8 in every category. The categories included: ease of the use of the equipment, training in the use of the equipment, and whether clinicians were able to help patients reach their communication goals.

 

Telehealth is an interesting concept that needs further trials. In addition to benefiting adults with disabilities, it shows a potential for reaching children with communication disabilities as well. The benefits of home practice, reinforcement in between the therapy sessions and carry over skills are an exciting positive outcome for this program. 

 

Keefe, S. (2005). Telehealth Improves Access to Care. Advance for Speech Language Pathologists and Audiologists. November 14, 2005.

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