Telepractice/telehealth and speech pathology
The use of Telepractice (Telehealth) has increased since the outbreak of COVID-19.
The following FAQs are intended to provide guidance and resources to members of the general public for understanding and successfully participating in Telepractice services for speech pathology.
If you have further questions in relation to this document, please do not hesitate to contact us [link].
What is telehealth? Is it different than telepractice?
Telehealth means that a health service is provided using telecommunication technology. Telehealth allows the healthcare provider and you, the client, to be in two different locations.
Speech pathologists often use the term telepractice as well as telehealth. Telepractice reflects the different settings where speech pathologists work, including hospitals, private practice, schools, community health, etc.
When a speech pathologist provides services through telepractice, they must provide the same quality of services that you would receive in person. Telepractice speech pathology services are subject to the same rules, regulations, and Code of Ethics as onsite services.
How does telepractice work?
Most telepractice services happen through a live, videoconference meeting with your speech pathologist.
Your speech pathologist may use different tools to make the service look and feel as close to an onsite service as possible. A few things you may experience are:
- Use of video and audio for the therapist to model and observe speech and language.
- Screen share, which lets the therapist share items on their computer with you, you can often interact with screen shared items as if they were on your own computer.
- Drawing and Typing functions, which let you interact with screen shared materials.
- Webcams, which let the therapist show you and observe physical materials.
At times, Telepractice may also include sharing recorded information. This may help speech pathologists observe and analyse information about a communication or swallowing issue.
What do I need to do to make telepractice work?
This will depend on your individual circumstances. You should speak with your speech pathologist to work out what you need. Below are some things that may help make Telepractice successful:
A device: This is what you will use to communicate with the speech pathologist. Many people use desktop computers, laptop computers, and even tablets. In some instances, you may communicate using a videoconference app on a mobile device or speak over the phone. However, for many speech pathology services, a phone would not offer the audio or video quality required. Speak with your speech pathologist about the devices you have available and which may be appropriate for your circumstances.
An internet connection: You should have access to a reliable internet connection. Your internet speed and bandwidth should allow a clear audio and video signal. Your plan should include enough data to allow videoconference sessions. Your network should be secure and prevent others from being able access your data. Do not engage in telepractice using public or unsecured networks.
A secure location: You should be in a location that is quiet, well-lit, and free from distractions. Only permit people in the location who would typically be included in an in-person session. You should not participate in Telepractice where unknown people might intentionally or accidentally observe the session.
A support person: It’s often best to have someone with the person who is receiving services. The support person can work with the speech pathologist to:
- resolve technical issues
- manage materials
- position equipment or the client
- help the client interact with the technology
- manage the environment
- support the speech pathologist’s observations.
Speak with your speech pathologist to identify an appropriate support person and to discuss their role.
Is telepractice secure?
When speech pathologists and clients take appropriate actions, telepractice can be a secure way to receive services. There are risks to privacy and security that you and your speech pathologist should be aware of. Here are a few areas to discuss with your speech pathologist:
Videoconference platforms: Your speech pathologist might use any number of videoconference platforms. Each has unique security features. Many people use free or low-cost videoconference platforms to communicate with friends and family. However, these may not have features required to keep your telepractice session private. If a platform is not secure others may be able to access or view your session, obtain private information about you, or put malware onto your computer. Discuss the features of the platform you will use with the speech pathologist. Have a plan and procedures for using these features. Discuss how audio, video, screenshare, and other data are secured when it is
transmitted between your device and the speech pathologist’s. You can often find information about a platform’s security features on their website.
Communication: Discuss how you and your speech pathologist will communicate and schedule meetings. Where meeting or private client information will be shared, make sure that it is through a secure method such as a phone number or email that only you have access to.
Internet connection: Use a private, secured network to prevent others from gaining access to your data. Do not use public or unknown networks for Telepractice sessions, to schedule meetings, or to share private client information.
Recordings: You and your speech pathologist should only record meetings when you have both agreed:
- That there is a good reason to do so
-
That you consent to the recording
- Who will record the meeting
- For what purposes the recording will be used
- How the recording will be stored
- Who may have access to the recording.
Session recordings generally form part of a client’s record. It can be a serious breach of privacy regulations for recordings to be shared with others.
Environment: Only people who would typically take part in an in-person session should be in the location where you hold the Telepractice session. Consider whether others will be able to see or hear the session either intentionally or accidentally.
Is telepractice effective?
There is growing evidence that, when speech pathologists and clients use good practices, many Telepractice services can be as effective as in-person services. You can learn more about current research in Telepractice and speech pathology from the following sources:
Depending on your individual circumstances, telepractice may not be the best fit for you. This is true with any clinical setting and is not unique to telepractice. Research has not determined that there are specific clinical needs that may not be addressed through telepractice. However, in some clinical areas there is very little research in telepractice. Discuss your situation with your speech pathologist to determine if telepractice may be an effective option for you. Areas that may pose additional challenges include:
- sensory characteristics: e.g., hearing or vision issues
- physical characteristics: e.g., motor skills need to access technology
- behavioural or motivational characteristics: e.g., difficulty sitting in front of a device or focusing on the computer
- cognitive characteristics: e.g, whether it might be confusing or upsetting to see someone through the computer
- communication characteristics: e.g., how a communication disability may impact telecommunication; how to help clients who speak a language that is not spoken by the speech pathologist; deciding if a translator might be needed.
Challenges with any of these characteristics does not necessarily mean that Telepractice isn’t an appropriate solution for you. Speak with your speech pathologist to understand how you might address these characteristics.
What if I’m not comfortable being seen by telepractice?
Discuss any concerns that you have with your speech pathologist. They may be able to share information or change procedures that address your concerns.
If you still do not feel comfortable, you can decide not to participate in a session or specific activities that occur during the session. You can change your mind, even in the middle of a session. You can tell your speech pathologist that you no longer wish to participate in writing or verbally.
You may request to receive services in-person. In the context of COVID-19 and depending on the individual circumstance, in-person services may or may not be possible with your current speech pathologist. Speak with your speech pathologist about whether that is a possibility, the risks involved, and what precautions will need to be in place if you do agree to in-person services. If your current speech pathologist is not able to offer in-person services, discuss other options with them. They may refer you to another speech pathologist who can provide those services.
Can NDIS funds be used for telepractice services for speech pathology?
Yes. Speak with your speech pathologist or your Local Area Coordinator (LAC), or support coordinator for details.
Do Medicare rebates apply to telepractice services for speech pathology?
The Department of Health has announced new temporary MBS telehealth allied health items (including speech pathology) for clients who have a valid referral for period 13 March 2020 to 30 September 2020 (inclusive). For details, speak with your speech pathologist or see the information on the MBS Online webpage.
Will my private health fund cover telepractice services for speech pathology?
An increasing number of private health funds do permit customers who have the appropriate extras cover to claim for speech pathology services delivered through telepractice. Check with your provider to ask about coverage.