%0 Journal Article
%T Evaluation of a Clinical Service Model for Dysphagia Assessment via Telerehabilitation
%A Elizabeth C. Ward
%A Clare L. Burns
%A Deborah G. Theodoros
%A Trevor G. Russell
%J International Journal of Telemedicine and Applications
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/918526
%X Emerging research supports the feasibility and viability of conducting clinical swallow examinations (CSE) for patients with dysphagia via telerehabilitation. However, minimal data has been reported to date regarding the implementation of such services within the clinical setting or the user perceptions of this type of clinical service. A mixed methods study design was employed to examine the outcomes of a weekly dysphagia assessment clinic conducted via telerehabilitation and examine issues relating to service delivery and user perceptions. Data was collected across a total of 100 patient assessments. Information relating to primary patient outcomes, session statistics, patient perceptions, and clinician perceptions was examined. Results revealed that session durations averaged 45 minutes, there was minimal technical difficulty experienced, and clinical decisions made regarding primary patient outcomes were comparable between the online and face to face clinicians. Patient satisfaction was high and clinicians felt that they developed good rapport, found the system easy to use, and were satisfied with the service in over 90% of the assessments conducted. Key factors relating to screening patient suitability, having good general organization, and skilled staff were identified as facilitators for the service. This trial has highlighted important issues for consideration when planning or implementing a telerehabilitation service for dysphagia management. 1. Introduction There is a small but emerging evidence base supporting the use of telerehabilitation to improve access to both clinical and instrumental dysphagia assessment services [1¨C8]. However, while the research conducted to date has focused on the evaluation of different types of system architecture [1, 4, 6], early feasibility data [1, 4, 7, 8], and the validity and reliability of online clinical decisions [2, 3, 5, 7, 8], no studies have examined the service characteristics (session durations, session complication rates, and equipment issues) associated with implementing a telerehabilitation clinical service. There is also limited information regarding potential facilitators and barriers to implementing a successful and time efficient telerehabilitation dysphagia service. Only one paper to date has discussed issues noted during the assessment of a small set of patients where certain patient factors (e.g., hearing impairment, movement disorders) made the assessment process less efficient [9]. That paper highlighted important service considerations including the need for careful patient and
%U http://www.hindawi.com/journals/ijta/2013/918526/