Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training

Authors

  • James Coyle Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh

DOI:

https://doi.org/10.5195/ijt.2012.6093

Abstract

Many patients survive severe stroke because of aggressive management in intensive care units.  However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP), a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians.  Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas.  Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year.  Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

  

Author Biography

James Coyle, Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh

James Coyle is an Assistant Professor of Communication Science and Disorders Department at the University of Pittsburgh, with a principal clinical and research interest in oropharyngeal dysphagia, its assessment and management, biomechanical analysis of swallowing physiology, and medical sequelae caused by dysphagia. He is a Board Recognized Specialist in Swallowing Disorders, and a member of the Specialty Recognition Board. He served in the Communication Sciences and Disorders Clinical Trials Research Group (CSDRG) as a Regional Principal Investigator for Protocol 201, a multi-site randomized clinical trial investigating the effects of dysphagia treatments on pneumonia outcomes among aspirating adults. He has authored or co-authored peer reviewed scientific and review articles and chapters in the field of motor speech and swallowing disorders, and served as a reviewer for Dysphagia and other peer reviewed journals.

References

Baine, W.B., Yu, W., & Summe, J.P. (2001). Epidemiologic trends in the hospitalization of elderly Medicare patients for pneumonia, 1991-1998. American Journal of Public Health,91,1121-1123.

Centers for Disease Control and Prevention, (2009), Retrieved from: http://www.cdc.gov/nchs/data/dvs/deaths_2009_release.pdf.

Hilker, R., Poetter, C., Findeisen, N., Sobesky, J., Jacobs, A., Neveling, M., & Heiss, W.D. (2003). Nosocomial pneumonia after acute stroke: Implications for neurological intensive care medicine. Stroke, 34,975-81.

Katzan, I.L., Cebul, R.D., Husak, S.H., Dawson, N.V., & Baker, D.W. (2003). The effect of pneumonia on mortality among patients hospitalized for acute stroke. Neurology, 60,620-625.

Malandraki, G.A., McCullough, G., He, X., McWeeny, E., & Perlman, A.L. (2011). Teledynamic evaluation of oropharyngeal swallowing. Journal of Speech, Language, and Hearing Research, 54,1497-505

Niederman, M.S., McCombs, J.S., Unger, A.N., Kumar, A., & Popovian, R. (1998). The cost of treating community-acquired pneumonia. Clinical Therapeutics, 20,820-837.

Perlman, A. L., & Witthawaskul, W. (2002). Real-time remote telefluoroscopic assessment of patients with dysphagia. Dysphagia, 17, 162-167.

Downloads

Published

2012-06-06

How to Cite

Coyle, J. (2012). Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training. International Journal of Telerehabilitation, 4(1), 41–46. https://doi.org/10.5195/ijt.2012.6093

Issue

Vol.4, No.1, Spring 2012

Section

Brief Communications

License

Authors who publish with this journal agree to the following terms:

  1. The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
  2. Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
  3. The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
    1. Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
    with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
  4. The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
  5. Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
  6. Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
  7. The Author represents and warrants that:
    1. the Work is the Author’s original work;
    2. the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
    3. the Work is not pending review or under consideration by another publisher;
    4. the Work has not previously been published;
    5. the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
    6. the Work contains no libel, invasion of privacy, or other unlawful matter.
  8. The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.

Revised 7/16/2018. Revision Description: Removed outdated link.