The Effect of Telerehabilitation on Missed Appointment Rates

Authors

  • Lyn T. Covert Department of Veterans Affairs Medical Center, Lexington, KY University of Kentucky, Lexington, KY Eastern Kentucky University, Richmond, KY
  • John T. Slevin Department of Neurology, college of Medicine, University of Kentucky Department of Veterans Affaris Medical Center, Lexington, KY
  • Jessica Hatterman Department of Veterans Affairs Medical Center, Lexington, KY

DOI:

https://doi.org/10.5195/ijt.2018.6258

Abstract

The purpose of this study was to examine the effect of telerehabilitation on missed appointment rates in a rehabilitation clinic.  Clients fail to attend scheduled appointments for a variety of reasons.  Unmet appointments represent a loss of financial support as well as diminished efficiency and capacity to provide services. Speech therapy utilizing multiple appointments is most difficult to maintain during a treatment regimen. This may cause individuals to miss appointments and therefore not achieve desired results.  For this study, researchers utilized an intense speech therapy technique, the Lee Silverman Voice Treatment (LSVT®) to measure compliance with scheduled appointments. Participants were randomized to either in-person treatment or telerehabilitation treatment at a site distant from the speech-language pathologist. Participants in the telerehabilitation (TR) condition completed significantly more appointments than participants in the in-person (IP) condition. When comparing results of treatment for each condition, there were no significant differences in outcome whether treated in the IP or TR condition of the study for monologue and picture description tasks, which are closely associated with conversational speech.  There was a difference in the reading task with participants demonstrating significantly better post treatment results in the IP condition.  The reason for this disparity is unclear and warrants further study.

  

Author Biography

Lyn T. Covert, Department of Veterans Affairs Medical Center, Lexington, KY University of Kentucky, Lexington, KY Eastern Kentucky University, Richmond, KY

Lyn Covert is currently assigned to the Research Service at the Department of Veterans Affairs Medical Center in Lexington, KY as a researcher.  She is also an adjunct instructor at the University of Kentucky and a university supervisor at Eastern Kentucky University.

References

American Telemedicine Association (2017). Principles for delivering telerehabilitation services. Retrieved from http://www.americantelemed.org/main/membership/ata-members/ata-sigs/telerehabilitation-sig

Berg, B.P., Murr, M., Chermak, D., Woodall, J., Pignone, M., Sandler, R.S., & Denton, B. L. (2013). Estimating the cost of no-shows and the effects of mitigation strategies. Medical Decision Making, 33, 976-985. doi: 10.1177/0272989X13478194

Critchley, E. (1981). Speech disorders of Parkinsonism: A review. Journal of Neurology, Neurosurgery & Psychiatry, 44, 751-758. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC491132/

Darley, F., Aronson, A., & Brown, J. (1969a). Differential diagnostic patterns of dysarthria. Journal of Speech and Hearing Research, 12, 246-269. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/5808852

Darley, F., Aronson, A., & Brown, J. (1969b). Clusters of deviant speech dimensions in the dysarthrias. Journal of Speech and Hearing Research, 12, 462-469. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/5811846

DuMontier, C., Rindfleisch, K., Pruszynski, J., & Frey III, J. (2013). A multi-method intervention to reduce no-shows in an urban residency clinic. Family Medicine, 45, 634–641. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24136694

Fahn, S., Marsden, G., Goldstein, M., & Caline, D. (1987). Recent developments in Parkinson’s disease (Vol 2). Florham Park, NJ: Macmillian Healthcare Information. Retrieved from http://www.scip.org/(Si43dyn45teexjx455qlt3d2q))/reference/ReferencesPapers.aspx?ReferenceID=1365499

Fox, C., Ebersbach, G., Ramig, L. & Sapir, S. (2012). LSVT® LOUD and LSVT® BIG: Behavioral treatment programs for speech and body movement in Parkinson disease. Parkinson’s Disease, 1-13. doi:10.1155/2012/391946. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3316992/

Georgeadis A, Brennan D., Barker L, & Baron C. (2004). Telerehabilitation and its effect on story retelling by adults with neurogenic communication disorders. Aphasiology, 18, 639–652. doi:10.1080/02687030444000075

Hill, A., Theodoros, D., Russell, T., Cahill, L., Ward, E., & Clark, K. (2006). An Internet-based telerehabilitation system for the assessment of motor speech disorders. A pilot study. American Journal of Speech-Language Pathology, 15, 45-56. doi: 10.1044/1058-0360(2006/006)

Keck, C. & Doarn, C. (2014).Telehealth technology applications in speech-language pathology. Telemedicine Journal & eHealth, 20, 635-639. doi: 10.1089/tmj.2013.0295

Kully D. (2000). Telehealth in speech patholgoy: Applications to the treatment of stuttering. Journal of Telemedicine and Telecare, 6(Suppl 2), 39–41. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10975096

Lemaire E, Boudrias Y, & Greene G. (2001).Low-bandwidth, Internet-based videoconferencing for physical rehabilitation consultations. Journal of Telemedicine and Telecare, 7, 82–89. Retrieved from https://pdfs.semanticscholar.org/8054/ab225a1e71fd167a16b5596fe733cda27291.pdf

OpenDataNetwork.(2016). Retrieved from https://www.opendatanetwork.com/entity/0400000US21/Kentucky/geographic.population.density?year=2016

Paulson, H., & Stern, M.B. (1997). Clinical manifestations of Parkinson’s disease. In R. Watt & Koller (Eds.) Movement Disorders: Neurological Principles and Practice. (pp.183-197). New York: McGraw-Hill.

Ramig, L.O., Countryman, S., Thompson, L.L., & Horii Y. (1995). Comparison of two forms of intensive speech treatment for Parkinson disease. Journal of Speech and Hearing Research, 38, 1232–1251. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/8747817

Ramig, L., Sapir, S., Fox, C., & Countryman, S. (2001). Changes in vocal intensity following intensive voice treatment (LSVT®) in individuals with Parkinson disease: A comparison with untreated patients and normal age-matched controls. Movement Disorders, 16, 79-83.

Scheideman-Miller C., Clark P., Smeltzer, S., Cloud, A., Carpenter, J., Hodge, B., & Prouty, D. (2002). Two year results of a pilot study delivering speech therapy to students in a rural Oklahoma school via telemedicine. In Proceedings of the 35th Hawaii International Conference on System Sciences.

Sicotte, C., Lehoux, P., Fortier-Blanc, J., & Leblanc, Y. (2003). Feasibility and outcome evaluation of a telemedicine application in speech-language pathology. Journal of Telemedicine and Telecare, 9, 253–258. doi: 10.1258/135763303769211256

Spielman, J., Ramig, L., Halpern, A., & Gavin, W. (2007). Effects of an extended version of Lee Silverman Voice Treatment on voice and speech in Parkinson’s disease. American Journal of Speech-Language Pathology, 16, 96-107. doi: 10.1044/1058- 0360(2007/014)

Stroud, A., & Belin, G. (2004, November). Effects of intensive voice treatment (LSVT®) on ataxic and hypokinetic dysarthria: A condition case study. Poster presented at the Annual Convention of the American Speech-Language-Hearing Association, Philadelphia, PA.

Theodoros, D.G., Constantinescu, G., Russell, T., Ward, E.C., Wilson, S.J., & Wootton, R. (2009). Treating the speech disorder in Parkinson’s disease online. Journal of Telemedicine and Telecare, 12(Suppl 3), 88–91. doi: 10.1258/jtt.2009.090306

Theodoros, D., Hill, A., & Russell, T. (2016).Clinical and quality of life outcomes of speech treatment for Parkinson’s disease delivered to the home via telerehabilitation: A noninferiority randomized controlled trial. American Journal of Speech-Language Pathology, 25, 214-232. doi: 10.1044/2015_AJSLP-15-0005

Tindall, L. & Huebner, R. (2009).The impact of an application of telerehabilitation technology on caregiver burden. International Journal of Telerehabilitation, 1(1), 3-7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296779/

Tindall, L., Huebner, R., Stemple, J., & Kleinert, H. (2008).Videophone-delivered voice therapy: A comparative analysis of outcomes to traditional delivery for adults with Parkinson’s disease. Telemedicine Journal & eHealth, 14, 1070-1077. doi: 10.1089/tmj.2008.0040.

Van Den Eeden, S.,Tanner, C., Bernstein, A., Fross, R., Leimpeter, A., Bloch, D., Nelson, L.M. (2003). Incidence of Parkinson’s disease: Variation by age, gender, and race/ethnicity. American Journal of Epidemiology, 157, 1015-1022. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12777365

Wikimedia Commons. (2010). https://commons.wikimedia.org/wiki/File:Kentucky_population_map.png

Wohlert, A. (2004). Service delivery variables and outcomes of treatment for hypokinetic dysarthria in Parkinson’s disease. Movement Disorders, 12, 235-239. Retrieved from https://www.e-jmd.org/

Downloads

Published

2018-12-11

How to Cite

Covert, L. T., Slevin, J. T., & Hatterman, J. (2018). The Effect of Telerehabilitation on Missed Appointment Rates. International Journal of Telerehabilitation, 10(2), 65–72. https://doi.org/10.5195/ijt.2018.6258

Issue

Vol. 10 No. 2 (2018)

Section

Clinical Applications

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.