Telehealth and Assistive Technology

What is Telehealth?

Technology has become a widespread resource that has dramatically increased over the years. Technology is present in everyone’s life, and it presents itself in many forms. This prevalent use of technology has altered the way in which individuals communicate with others, the way in which tasks are completed, and more importantly, it has become the new normal in today’s society. Telehealth is considered an ‘umbrella term’ for healthcare, providing and delivering services to an individual through the use of electronic communication and remote methods (Li, 2012). Telehealth has become a promising service delivery alternative for face-to-face visits in various health-related fields as it improves access to and the overall quality of care. Some of the services provided under telehealth in various disciplines include telerehabilitation, telemedicine, and teletherapy.

Telehealth can take the form of scheduled check-ins with health care providers, online charts for prescriptions and refills, monitoring technologies to help healthcare industries stay up-to-date on patient health, remote therapy sessions for various disciplines, and fitness tracking devices.

What is Assistive Technology?

Some individuals who receive services through telehealth also rely on tools necessary for communication and completion of everyday tasks. These tools are often referred to as assistive technology (AT). AT is important in the field of health and human services because many individuals throughout the lifespan use AT to complete activities of daily living (ADL). The population of interest includes the users of AT which can range vastly across the lifespan. This population may also include individuals who advocate for AT devices, including the professionals who educate and provide services related to the technology, such as speech-language pathologists, occupational therapists, physical therapists, nurses, doctors, psychologists, etc. The community connected to this topic includes individuals, whether they be family members or unfamiliar faces, or businesses in which these individuals live in and interact with. Therefore, it is important to highlight how community plays a huge role. Individuals often need these devices to navigate through their communities and communicate amongst peers and individuals they come in contact with. There needs to be accessibility options for the various devices, as well as opportunities in the community for individuals to be able to successfully utilize their devices. No matter the mode of therapy related to AT, individuals need to learn realistic ways in which these devices can be used, to generalize skills not only in their homes, but within the community as well.

Stakeholders Involved in AT

Stakeholders are involved in AT and telehealth due to the fact that insurance companies are often the decision makers for whom is granted AT technology cost-free, and who is not. Even if doctors and specialists prescribe or recommend an AT device, insurance has the final say. AT devices can be made low-cost, but many are very expensive due to advancements in technology, thus creating financial barriers for many individuals and families who truly need these devices to be successful in their ADLs. For some, an AT device is what can permit individuals to keep a higher level of independence, rather than having another individual complete functional tasks for them. It is safe to assume that the majority of individuals want to feel a sense of independence and purpose, essentially feeling that they have control over some and/or most aspects of their lives. According to the Assistive Technology Act of 1998, AT is considered equipment, devices, or products that are used to accommodate individual needs and improve daily functioning and independence of skills (Schmeler et al., 2009). AT can be recognized in both low-tech and high-tech forms. Examples of low-tech AT devices may include cardboard communication devices and sticky notes. Examples of high-tech AT devices include electronic pill dispensers, applications on iPads, and smart home devices. When modes of service delivery change from the standard healthcare model to telehealth, clinicians must find ways to modify treatment to continue incorporating AT in telehealth appointments. AT devices are an important tool that many individuals depend on, thus making it an essential aspect of telehealth care for those who use them.

Use of Assistive Technology 

 

Similar to telehealth, assistive technology (AT) is considered an umbrella term, as AT devices exist in many forms to provide a wide range of support across activities. Upon searching the literature, a unique tool surfaced involving the management of AT in telehealth. The E-servant is a system that can be programmed to assist individuals with their AT devices and help problem-solve for their everyday, functional needs (Picking et al., 2014). This system is individualized based on people’s needs, functioning levels, behaviors, and contexts within the home environment. It can be programmed to monitor appliances around the house and it has enough functionality to alert the user of problems or emergency situations that may occur in the home to ensure safety (Picking at al., 2014). Overall, the E-servant has been considered a useful interface between assistive technology and telehealth (Picking et al., 2014). The E-servant is just one generalized AT option for greater independence of ADLs, but other various options are described throughout the literature. 

Li (2012) emphasized the role of AT in telepractice focusing on individuals in the aging population. The article discussed broad technologies that can be used in telehealth that lead to emergency management in the home for elderly individuals to ensure safety and adequate care. Technology is chosen through a client-centered approach to target their needs based on individualized home settings. This may include pressure sensors and location tracking devices as well as health-related services to ensure adequate safety, access to healthcare, and support aging in place (Li, 2012). AT devices do not serve just one sole purpose, as they provide a vast range of benefits for individuals across the lifespan. These devices are known to greatly impact the older population who want to retain independence for a greater period of time. Although AT devices can serve multiple functions such as communication and motor assistance, they can also support ADLs and greatly increase individuals’ quality of life.

Can Caretakers Benefit from the use of AT?

Other AT devices focus mainly on the caretaker’s role in providing support for individuals. Bossen et al. (2015) discussed the usage of assistive technology through telehealth for caretakers of individuals with dementia. Dementia is a general term for a group of symptoms that impacts an individual’s overall daily functioning due to progressive memory and cognitive deficits (Bossen et al., 2015). A majority of individuals living at home with dementia are reliant on caretakers for ADLs. Bossen et al. (2015) discussed technology-based interventions that are designed for the caretakers of individuals with dementia, and how they can improve the overall process of providing care. The technology-based interventions ranged from simplicity of information on the internet and support groups, to robotic features on smartphones and other technology used to report symptoms, movement, and behaviors of the individual in which they are caring for. Unlike recent literature that focuses on how technology can be utilized by the person with dementia (Doughty et al., 2007), Bossen et al. (2015) takes the perspective of a caretaker's use of technology to support the person with dementia. Although assistive devices range in purpose, their function can also be determined by the specific field in which they are being used.