Authors (including presenting author) :
Yiu OY (1), Chan CSS (1), Tsui SY (2)
Affiliation :
(1) Speech Therapy Unit, Hong Kong Children’s Hospital, (2) Department of Paediatric Surgery, Hong Kong Children’s Hospital.
Introduction :
Telepractice is the utilization of telecommunication technologies to deliver health care services where there is physical separation between service provider and patients. It is recognized in the field of speech language pathology to be effective in delivering services across a spectrum of disorders, including childhood speech and language disorders, fluency disorders, neurogenic communication disorders, and dysphagia. However, telepractice has not been widely used in Hong Kong given the limited accessibility concern in this small city. With the outbreak of coronavirus disease 2019 (COVID-19) in the region in January 2020, service provision in public hospitals has been affected and medical appointments have to be postponed. Telepractice has been implemented as an option to continue speech therapy provision in various hospitals including Hong Kong Children’s Hospital (HKCH).
Objectives :
This study aims to evaluate the service outcome of this new delivery modality in speech therapy to patients with cleft palate at HKCH.
Methodology :
A review was done on the telepractice delivered by two speech therapists to patients with cleft palate at HKCH from February to December in 2020. Information of the telepractice sessions was retrieved from progress notes on the clinical management system, including number of sessions, mode of delivery, duration and the disorder(s) therapists were working on. A satisfaction survey which consisted of statement rating with 5-point scale (1=very dissatisfied; 5=very satisfied), questions as well as comment section, was disseminated to parents whose child had at least two telepractice sessions to understand their telepractice experience.
Result & Outcome :
One hundred and thirteen telepractice sessions were done for 56 cleft palate patients, with the therapy focused on cleft speech (58%), dysphagia or feeding problem (23%), cleft speech and language impairment (13%), and language impairment (5%). Duration of the sessions ranged from < 15 minutes (18%), 15-30 minutes (53%) and >30 minutes (29%), with synchronous means by audio over the phone (29%) and videoconferencing over Zoom (64%), or store-and-forward approach by sending videos over Whatsapp (7%). Questionnaires were distributed to 34 patients who had at least two telepractice sessions, with a return rate of 100%. There was overall high satisfaction towards the telepractice sessions with average ratings above 4.2 in terms of clinician’s knowledge and expertise, treatment, materials provided, duration, and convenience of using the service. More than half of the parents (56%) considered telepractice better or the same as traditional face-to-face follow up, while other parents prefer the traditional modality because of the patient's engagement and concentration level, accuracy of speech sound perception, as well as immediate and physical facilitation or demonstration by the therapist. Yet, 91% of them indicated that they would use telepractice again particularly under the pandemic, and would recommend this service modality to others. Parents also provided additional constructive comments specific to disorders for service improvement.
The results of this study indicate overall high levels of satisfaction and support telepractice as a viable solution for accessing speech therapy in time of COVID-19. Findings can be a guide for setting up telepractice in speech therapy in hospital settings, while more attention and further investigation are warranted for improving current telepractice service to the level of traditional face-to-face follow up.
