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TELEHEALTH BASICS AND PURDUE SLHSCLINICS ADAPTATION DURING COVID-19PresentersGeorgia A. Malandraki, Ph.D., CCC-SLP, BCS-SChristi Masters, MS, CCC-SLPShannon Van Hyfte, AuD, CCC-AModeratorJennifer Simpson, AuD, CCC-A
CEU RequirementsTo receive ASHA CEUs, there are two things we will need you to do in order tocollect the full .10 amount. Please note there will not be any partial credit givenfor this course.1. The first component is to attend this webinar in its entirety tonight.a. Your attendance will be tracked through the system and only those whoare present through the whole webinar, will be eligible for credit.b. The moderator will designate the end of the webinar.2. Secondly, we will need you to fill out a Learning Outcome Assessment form.a. This electronic form/questionnaire will be emailed to you the day afterthe webinar event.b. You will need to submit your form questionnaire, within the softwaresystem, no later than 15 calendar days after this event which will beSaturday November 14th.A confirmation email will be sent to you once we have verified your attendanceand received your form.If you have any questions about your CEU redemption, please contact ouradministrator Teasha McKinley at teasha@purdue.edu.2
DisclosuresFinancialNon-Financial MalandrakiPurdue University: salaryCurasis, LLC (acting CEO) MastersPurdue University: salary Van HyftePurdue University: salary SimpsonPurdue University: salary MalandrakiDysphagia Research Society, BoardMember; ASHA, Member; ISHA,Co-Chair Telehealth Taskforce MastersASHA, member Van HyfteASHA, Member SimpsonASHA, Member3
Chicago, ILWEST LAFAYETTE, IN4
PURDUE SPEECH, LANGUAGE,& HEARING SCIENCEShttps://www.purdue.edu/hhs/slhs/5
Purdue Speech, Language, & Hearing Sciences Founded in 1935 Ranked #3 program inSpeech LanguageDept. Head: Preeti Sivasankar, PhD, CCC-SLPPathology and #9 inAudiology Largest # of academicand clinical faculty One of the top HHS unitsin NIH funding6https://www.purdue.edu/hhs/slhs/
M.D. STEER SLHS CLINICS 20 clinical specialtyprograms School–based andmedical programs Birth to 100 3000 patientappointments in 2019 In person ANDtelehealthClinic Directors:Christi Masters & Shannon Van h language/programs.html7
Outline Basics of telehealth Definitions Motivation Models and Applications Legal and Practical Considerations Adaptation to telehealth for Speech & Language Clinic Adaptation to telehealth for Audiology Clinic8
Definitions - Telehealth“The use of electronic information andtelecommunications technologies to supportlong-distance clinical health care, patient andprofessional health-related education, publichealth and health administration.”Health Resources and Systems Administration, US Dept of Health andHuman Services ---- http://www.hrsa.gov/ruralhealth/about/telehealth/9
OTHER TERMSDISCIPLINE SPECIFIC Tele – [discipline] Tele-dermatology Tele-stroke care Tele-speech Tele-audiologyTelepractice Tele-rehabilitation Tele-care Tele-medicine10
MOTIVATION FOR TELEHEALTH PRIOR ANDDURING THE PANDEMICPrior to pandemic Motivation: Reducedistance and increaseaccess of careNow Motivation: Increasedistance and maintainaccess of carePrior to pandemic Restrictions: legal(privacy), licensure,reimbursementNow Restrictions: Lifted!11
TELEHEALTH TYPES Synchronous (live videoconferencing) Asynchronous (store and forward) Remote Patient Monitoring (RPM) Mobile Health (mHealth) Hybrid approaches12
Most Common Models of Telehealth Center/clinic/base tosatellite clinic Center/clinic to client home Clinician home to remotecenter/clinic Clinician home to clienthome (common duringpandemic)13
MAIN PRINCIPLE INTELEHEALTH NO regulatory distinction between a service delivered viatelehealth and a service delivered in personASHA Telepractice Portal, n.d.; ATA, 2014; Burns & Hill, 2014; HRSA, n.d. American Speech-Language-Hearing Association (ASHA): “Theuse of telepractice does not remove any existing responsibilities indelivering services, including adherence to the Code of Ethics,Scope of Practice in Audiology and Speech-Language Pathology,state and federal laws and ASHA policy.”ASHA Telepractice Portal, n.d.14
Legal Considerations (summary)Examples Compliance with laws andregulations (federal/state/facility) HIPAA; FERPA BAA agreements Licensure Securenetwork/platform/storage covid-19/Gough et al., 2015; Richmond et al., 2017; Turvey et al., 2013; Verduzco‐Gutierrez et al., 2020;15Malandraki et al., accepted
Practical Considerations (summary) Infrastructure Technology available Internet Connectivity Quality & security ofinformation Patient Candidacy Facilitators EnvironmentGough et al., 2015; Richmond et al., 2017; Turvey et al., 2013; Verduzco‐Gutierrez et al.,2020; Malandraki et al., accepted16
CLINICADAPTATIONS Prior Telehealth Experience Timeline – sent home 3/16/20 Challenge – be up andrunning ASAP, but by summerclinic session at a minimum17
CLINIC ADAPTATIONS BAA in place for WebEx HIPAA/Docusign for patient consent to telehealthdeveloped Developed, approved, and implemented within the firstfew days18
WebEx InstructionsYou can join a meeting from your computer, mobile device, phone, or a videosystem. Pick the one that works best for you. Join from your mobile device - If you're on the go, you can join yourmeeting from your Apple or Android phone, tablet or Apple watch usingWebEx mobile app.You'll be able to use video, chat with other participants, and sharecontent.Troubleshooting:Why is there no audio? The speaker or microphone volume may be low. Adjust yourspeaker and microphone settings. Low bandwidth can also cause poor quality audio. Check audio andvideo bandwidth. Consider dialing into your meeting for audio.Can I test my audio before a meeting? Join a test meeting to make sure your audio and video devices workas expected before your meeting. Join from the browser - Use the WebEx web app to join a meeting fromyour browser. This works best if you don't want to install anything or areusing a Chromebook or a Linux computer.You'll be able to connect using computer audio and video, chat withparticipants, and share content. Join from your desktop computer - Use the WebEx desktop app to joinyour meeting from your Windows or Mac computer.You'll be able to connect using computer audio and video, switchlayouts between grid and active speaker views, chat, and share content. When you join a test meeting, it automatically downloads the WebExMeetings app - so it's easier to join your next meeting.How do I download the app? When you click the join link in your email invite, the WebEx Meetingsapp automatically downloads. You can also download it fromwebex.com. Download now19
CLINIC ADAPTATIONS Student component - Supervision Preparation beforehand Process of including/supervising during appointment Conference afterwards20
SUPERVISION CFCC allowing graduate student clinicians to engage in servicedelivery through telepractice as outlined below until June 30, 2021.--COVID-19: Guidance for Graduate Programs, Students, and Clinical FellowsFrom the Council for Clinical Certification in Audiology and Speech-LanguagePathology Guidance-From-CFCC/21
SLP CLINIC Determine appropriate clinics and patients for telepractice Utilize and obtain resources Q-global from Pearson ASHA Practice Portal ASHA Telepractice Evidence Maps22
SLP CLINIC Established a virtual screening clinic for pediatrics andadults; continued with therapy services for appropriatepatients Approval to provide free screenings for anyone in the state ofIndiana Flyer developed and distributed widely Completed approximately 50 screenings23
AUDIOLOGYSPECIFIC EFFORTS Prepare clinical faculty Google doc with process,flow, Q&A Online training with hearingaid manufacturers Tech troubleshooting foreach individual to ensureability to remote in24This Photo by Unknown Author is licensed under CC BY
AUDIOLOGY CLINIC PROTOCOL Identify eligible patients AR, HAC, Remote HA adjustments/fittings, CIconsultation, Early Intervention consultation Advertised this via social media/flyer Schedule/patient prep Follow-up documentationThis Photo by UnknownAuthor is licensed under CC25BY-NC-ND
OPPORTUNITIESSLP ClinicAUD ClinicConsistent services for patients –very few no shows!See patients in their ownenvironmentCaregiver involvementTrue simulation of difficult listeningsituationsClinical educationPatients had our full face visible forspeechreading26
CHALLENGESSLP ClinicAUD ClinicTechnology – webcams needed;sound challengesTechnology – connectivity issueswith hearing aidsOnline therapy materialsLimited pediatricsLack of recording features withWebExNo diagnostics27
FUTURE OF TELEHEALTH FOROUR CLINICS Reach rural patients Reduced travel and exposure times for all Great option for time management in theclinics Forward thinking for our students28
Contact ue UniversitySpeech, Language, andHearing Sciences@PurdueSLHS@purdueslhs29
NEXT FREE SLHS /news/telehealth/Webinar2.html30
x Join from your desktop computer - Use the WebEx desktop app to join your meeting from your Windows or Mac computer. You'll be able to connect using computer audio and video, switch layouts between grid and active speaker views, chat, and share content. x Join from your mobile device - If you're on the go, you can join your
