Best Practices for Building Interprofessional Telehealth: Report of a Conference
Keywords:Future implications, Nursing, Occupational therapy, Physical therapy, Speech-language pathology, Telemedicine, Telepractice
The Arizona Biomedical Research Centre (ABRC) has funded a series of workshops and conferences since 2016 to build the capacity of local, tribal, and state agencies, healthcare delivery organizations, and non-governmental organizations to engage in meaningful research related to health disparities. With the COVID-19 pandemic, the use of telehealth has dramatically increased, particularly in nursing, occupational therapy (OT), physical therapy (PT), and speech-language pathology (SLP). The purpose of this paper is to summarize the presentations and discussion from the conference titled “Telerehabilitation and Telepractice: An Interprofessional Conference to Build Connections and Best Practices,” held remotely on March 4-5, 2021. Terminology and concepts from the conference were debated, modified, and refined, based on an interprofessional audience. Presenters at the conference, all leaders in their field, discussed the current status of telehealth in their professions, including best practices, challenges, future trends, and research needs.
Agency for Healthcare Research Quality. (2019, March) About Learning Health Systems. https://www.ahrq.gov/learning-health-systems/about.html
American Academy of Ambulatory Care Nursing (2018). Scope and standards of practice for professional telehealth nursing (6 ed.).
American Nurses Association (2015). Code of ethics with interpretive statements (2nd ed.). https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/coe-view-only/
American Nurses Association (2021). Nursing: Scope and standards of practice (4th ed.).
American Occupational Therapy Association. (2017). The American Occupational Therapy Association Advisory Opinion for the Ethics Commission - Telehealth. https://www.aota.org/-/media/Corporate/Files/Practice/Ethics/Advisory/telehealth-advisory.pdf.
American Occupational Therapy Association. 2018). Telehealth in occupational therapy. American Journal of Occupational Therapy, 72(Supplement_2), 7212410059. https://doi.org/10.5014/ajot.2018.72S219
American Physical Therapy Association. (2020, December 17). APTA Physical Therapy Workforce Analysis. https://www.apta.org/your-career/careers-in-physical-therapy/workforce-data/apta-physical-therapy-workforce-analysis
American Physical Therapy Association. (2019, September 20). Telehealth in practice. Available online: https://www.apta.org/your-practice/practice-models-and-settings/telehealth-practice
American Speech-Language-Hearing Association (n.d.). Telepractice. https://www.asha.org/practice-portal/professional-issues/telepractice/
American Telemedicine Association. (2020). https://www.americantelemed.org/
Brannon, J. A., Cohn, E. R., & Cason, J. (2012). Making the case for uniformity in professional state licensure requirements. International Journal of Telerehabilitation, 4(1), 41-46. https://doi.org/10.5195/ijt.2012.6091
Burns, R. B., Crislip, D., Daviou, P., Temkin, A., Vesmarovich, S., Anshutz, J., Furbish, C., & Jones, M. L. (1998). Using telerehabilitation to support assistive technology. Assistive Technology, 10(2), 126-133. https://doi.org/10.1080/10400435.1998.10131970
Cason, J. (2017). Telehealth is face-to-face service delivery. International Journal of Telerehabilitation, 9(1), 77-78. https://doi.org/10.5195/ijt.2017.6225
Cason, J. & Jacobs, K. (2014, August 18). Snapshots of current telehealth applications in occupational therapy. American Journal of Occupational Therapy. https://www.aota.org/Publications-News/otp/Archive/2014/8-11-14/Telehealth.aspx
Chang, J. E., Lai, A. Y., Gupta, A., Nguyen, A. M., Berry, C. A., & Shelley, D. R. (2021). Rapid transition to telehealth and the digital divide: Implications for primary care access and equity in a post-COVID w. Milbank Quarterly, 99(2), 340-368. https://doi.org/https://doi.org/10.1111/1468-0009.12509
Cherney, L. R., Halper, A. S., Holland, A. L., & Cole, R. (2008, Feb). Computerized script training for aphasia: Preliminary results. American Journal of Speech-Language Pathology, 17(1), 19-34. https://doi.org/10.1044/1058-0360(2008/003)
Cohn, E. R., & Cason, J. (2019). Ethical considerations for client-centered telepractice. Perspectives of the ASHA Special Interest Groups, 4(4), 704-711. https://doi.org/doi:10.1044/2019_PERS-SIG18-2019-0001
Coleman, J. J., Frymark, T., Franceschini, N. M., & Theodoros, D. G. (2015, May). Assessment and treatment of cognition and communication skills in adults with acquired brain injury via telepractice: A systematic review. American Journal of Speech-Language Pathology, 24(2), 295-315. https://doi.org/10.1044/2015_ajslp-14-0028
Cramer, S. C., Dodakian, L., Le, V., See, J., Augsburger, R., McKenzie, A., Zhou, R. J., Chiu, N. L., Heckhausen, J., Cassidy, J. M., Scacchi, W., Smith, M. T., Barrett, A. M., Knutson, J., Edwards, D., Putrino, D., Agrawal, K., Ngo, K., Roth, E. J., Tirschwell, D. L., Woodbury, M. L., Zafonte, R., Zhao, W., Spilker, J., Wolf, S. L., Broderick, J. P., Janis, S., & Investigators, f. t. N. I. o. H. S. T. (2019). Efficacy of home-based telerehabilitation vs in-clinic therapy for adults after stroke: A randomized clinical trial. JAMA Neurology, 76(9), 1079-1087. https://doi.org/10.1001/jamaneurol.2019.1604
Dahl-Popolizio, S., Carpenter, H., Coronado, M., Popolizio, N. J., & Swanson, C. (2020, 12/08). Telehealth for the provision of occupational therapy: Reflections on experiences during the COVID-19 pandemic. International Journal of Telerehabilitation, 12(2), 77-92. https://doi.org/10.5195/ijt.2020.6328
Dirnberger, J., & Waisbren, S. (2020, September). Efficacy of telehealth visits for postoperative care at the Minneapolis VA. American Journal of Surgery, 220(3), 721-724. https://doi.org/10.1016/j.amjsurg.2020.01.015
Douglass, H., Lowman, J. J., & Angadi, V. (2021, 05/18). Defining roles and responsibilities for school-based tele-facilitators: Intraclass correlation coefficient (ICC) ratings of proposed competencies. International Journal of Telerehabilitation, 13(1). https://doi.org/10.5195/ijt.2021.6351
Graham, F., Rodger, S., & Ziviani, J. (2013, Jan-Feb). Effectiveness of occupational performance coaching in improving children's and mothers' performance and mothers' self-competence. American Journal of Occupational Therapy, 67(1), 10-18. https://doi.org/10.5014/ajot.2013.004648
Greenberg, M. E., & Rutenberg, C. (2022). Telehealth nursing and virtual technologies. In D. G. C. Coburn, B.A. Swan (Ed.), Perspectives in Ambulatory Care Nursing (1 ed., pp. 163-183).
Griffin, M., Bentley, J., Shanks, J., & Wood, C. (2018, Apr). The effectiveness of Lee Silverman Voice Treatment therapy issued interactively through an iPad device: A non-inferiority study. Journal of Telemedicine and Telecare, 24(3), 209-215. https://doi.org/10.1177/1357633x17691865
Helm-Estabrooks, N., & Ramsberger, G. (1986). Aphasia treatment delivered by telephone. Archives of Physical Medicine and Rehabilitation, 67(1), 51-53.
Hermann, V. H., Herzog, M., Jordan, R., Hofherr, M., Levine, P., & Page, S. J. (2010). Telerehabilitation and electrical stimulation: An occupation-based, client-centered stroke intervention. American Journal of Occupation Therapy, 64(1), 73-81. https://doi.org/10.5014/ajot.64.1.73
HHS.gov. (2013). Health information privacy. Business Associate contracts. . https://www.hhs.gov/hipaa/for-professionals/covered-entities/sample-business-associate-agreement-provisions/index.html
Hoel, V., von Zweck, C., & Ledgerd, R. (2021). Was a global pandemic needed to adopt the use of telehealth in occupational therapy? Work, 68(1), 13-20. https://doi.org/10.3233/wor-205268
Hung K., G., & Fong, K. N. (2019). Effects of telerehabilitation in occupational therapy practice: A systematic review. Hong Kong Journal of Occupational Therapy, 32(1), 3-21. https://doi.org/10.1177/1569186119849119
Institute of Medicine Committee on Quality of Health Care. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, D.C.: National Academy of Sciences, National Academies Press (US) https://doi.org/10.17226/10027
Institute of Medicine Committee on Health Professions Education. (2003). In A. C. Greiner & E. Knebel (Eds.), Health professions education: A bridge to quality. Washington, D.C.: National Academy of Sciences, National Academies Press (US) https://doi.org/10.17226/10681
Jacobs, K., Cason, J., & McCullough, A. (2015). The process for the formulation of the International Telehealth Position Statement for Occupational Therapy. International Journal of Telerehabilitation, 7(1), 21-32. https://doi.org/10.5195/ijt.2015.6163
Johnston, R. (2019, December 20). Caregiver Perspectives on Telehealth: A Service Delivery for Occupational Therapy. Capstone Project at University of St Augustine for Health Sciences. https://doi.org/10.46409/sr.SMLR2770
Kairy, D., Lehoux, P., Vincent, C., & Visintin, M. (2009). A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation. Disability and Rehabilitation, 31(6), 427-447. https://doi.org/10.1080/09638280802062553
Kruse, C. S., Krowski, N., Rodriguez, B., Tran, L., Vela, J., & Brooks, M. (2017). Telehealth and patient satisfaction: A systematic review and narrative analysis. BMJ Open, 7(8), e016242-e016242. https://doi.org/10.1136/bmjopen-2017-016242
Li, C. T., Hung, G. K., Fong, K. N., Gonzalez, P. C., Wah, S. H., & Tsang, H. W. (2020). Effects of a home-based occupational therapy telerehabilitation via smartphone for outpatients after hip fracture surgery: A feasibility randomised controlled study. Journal of Telemedicine and Telecare, 1357633x20932434. https://doi.org/10.1177/1357633x20932434
Lim, D., & Noble-Jones, R. (2018, September). Interprofessional education (IPE) in clinical practice for pre-registration nursing students: A structured literature review. Nurse Education Today, 68, 218-225. https://doi.org/10.1016/j.nedt.2018.06.020
Maheu, M. M., Drude, K. P., Hertlein, K. M., Lipschutz, R., Wall, K., & Hilty, D. M. (2018). Correction to: An interprofessional framework for telebehavioral health competencies. Journal of Technology in Behavioral Science, 3(2), 108-140. https://doi.org/10.1007/s41347-018-0046-6
Mashima, P. A., Birkmire-Peters, D. P., Syms, M. J., Holtel, M. R., Burgess, L. P., & Peters, L. J. (2003). Telehealth: Voice therapy using telecommunications technology. American Journal of Speech-Language Pathology, 12(4), 432-439. https://doi.org/10.1044/1058-0360(2003/089)
Molini-Avejonas, D. R., Rondon-Melo, S., Amato, C. A., & Samelli, A. G. (2015, Oct). A systematic review of the use of telehealth in speech, language and hearing sciences. Journal of Telemedicine and Telecare, 21(7), 367-376. https://doi.org/10.1177/1357633x15583215
Powell, R. E., Henstenburg, J. M., Cooper, G., Hollander, J. E., & Rising, K. L. (2017). Patient perceptions of telehealth primary care video visits. Annals of Family Medicine, 15(3), 225-229. https://doi.org/10.1370/afm.2095
Prvu Bettger, J., Thoumi, A., Marquevich, V., De Groote, W., Rizzo Battistella, L., Imamura, M., Delgado Ramos, V., Wang, N., Dreinhoefer, K. E., Mangar, A., Ghandi, D. B. C., Ng, Y. S., Lee, K. H., Tan Wei Ming, J., Pua, Y. H., Inzitari, M., Mmbaga, B. T., Shayo, M. J., Brown, D. A., Carvalho, M., Oh-Park, M., & Stein, J. (2020). COVID-19: Maintaining essential rehabilitation services across the care continuum. BMJ Global Health, 5(5), e002670. https://doi.org/10.1136/bmjgh-2020-002670
Reeves, S. (2016). Ideas for the development of the interprofessional education and practice field: An update. Journal of Interprofessional Care, 30(4), 405-407. https://doi.org/10.1080/13561820.2016.1197735
Richardson, J. K. (2000). Tipping the scales of time. Physical Therapy, 80(11), 1121-1124. https://doi.org/10.1093/ptj/80.11.1121
Richmond, T., Peterson, C., Cason, J., Billings, M., Terrell, E. A., Lee, A. C. W., Towey, M., Parmanto, B., Saptano, A., Cohn, E. R., & Brennan, D. (2017). American Telemedicine Association’s principles for delivering telerehabilitation services. International Journal of Telerehabilitation, 9(2), 63-68. https://doi.org/10.5195/ijt.2017.6232
Rutledge, C. M., Gustin, T. (2021, January 31). Preparing nurses for roles in telehealth: Now is the time! The Online Journal of Issues in Nursing, 26(1). https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-26-2021/No1-Jan-2021/Preparing-Nurses-for-Roles-in-Telehealth-Now-is-the-Time.html
Salawu, A., Green, A., Crooks, M. G., Brixey, N., Ross, D. H., & Sivan, M. (2020). A proposal for multidisciplinary tele-rehabilitation in the assessment and rehabilitation of COVID-19 survivors. International Journal of Environmental Research and Public Health, 17(13), 4890. https://doi.org/10.3390/ijerph17134890
Schweickert, P. A. & Rutledge, C.M. (2020). Telehealth essentials for advanced practice nursing. Slack Incorporated. ISBN: 1630916056
Theodoros, D. (2011). Telepractice in speech-language pathology: The evidence, the challenges, and the future. Perspectives on Telepractice, 1(1), 10-21. https://doi.org/doi:10.1044/tele1.1.10
Tindall, L. R., Huebner, R. A., Stemple, J. C., & Kleinert, H. L. (2008). Videophone-delivered voice therapy: A comparative analysis of outcomes to traditional delivery for adults with Parkinson's disease. Telemedicine and e-Health, 14(10), 1070-1077. https://doi.org/10.1089/tmj.2008.0040
Wallisch, A., Little, L., Pope, E., & Dunn, W. (2019). Parent perspectives of an occupational therapy telehealth intervention. International Journal of Telerehabilitation, 11(1), 15-22. https://doi.org/10.5195/ijt.2019.6274
Watzlaf, V. R., & Ondich, B. (2012). VoIP for telerehabilitation: A pilot usability study for HIPAA compliance. International Journal of Telerehabilitation, 4(1), 33-36. https://doi.org/10.5195/ijt.2012.6096
Weidner, K., & Lowman, J. (2020). Telepractice for adult speech-language pathology services: A systematic review. Perspectives of the ASHA Special Interest Groups, 5(1), 326-338. https://doi.org/doi:10.1044/2019_PERSP-19-00146
Wilson, L., Onslow, M., & Lincoln, M. (2004). Telehealth adaptation of the Lidcombe Program of Early Stuttering Intervention: Five case studies. American Journal of Speech Language Pathology, 13(1), 81-93. https://doi.org/10.1044/1058-0360(2004/009)
World Health Organization. (2010). Monitoring the building blocks of health systems: A handbook of indicators and their measurement strategies; World Health Organization, Geneva, Switzerland https://www.who.int/workforcealliance/knowledge/toolkit/26/en
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