Summary & Next Steps

 

Conclusions & take-aways

The main challenge in establishing effective telepresence is that healthcare providers have no clear directions on how to acheive this. Based on the research, three overarching areas should be addressed when striving for this:

  • Interpersonal skills
    • This includes the clinician having a good attitude, and personality traits such as patience, compassion and flexibility (Pellegrino & Kobb, 2005). Building rapport is always important no matter the modality of treatment (Henry, et al., 2016). To assure the sessions remain patient-centered, and everything can be accomplished it is important for clinicians to ask the client clarifying questions and do their best to read visual and other nonverbal cues (Nestel, et al., 2007). These are all ways the clinician can help create a successful telepresence.

 

  • Preparation and Environment
    • These include both technical factors as well as background factors. Being sure the client understands the technology before sessions begin, as to not spend session time on it; research has suggested having a point person for technology questions/difficulties can minimize confusion. Setting clear directives for sessions and standardizing how they run will help the client know what to expect (LeRouge, 2014). Building in time in between meetings, to make sure clients are not waiting for their session to start if the one beforehand runs late, or technology gets in the way. The background environment needs to be private, clinician can wear headphones so no one else can hear and have a non-distracting background so focus can stay on the session (Henry, et al., 2016). These aspects are important to get the most out of clinician-client interactions.

 

  • Technology-related factors
    • Technology is a large part of telemedicine and must be considered in having an effective telepresence. Assuring that both the clinician and client are comfortable with the technology should be one of the first steps. Another first step is making sure that the technology being used is adequate (ie. video, audio) (LeRouge, et al., 2014). If video is not available, and it is appropriate for the nature of the session both parties should be ready to use an audio phone call. HIPAA must continue to be followed through the technology, meaning that the sessions are private and the software being used protects the client's information (Crossen, et al., 2020). Relating back to preparation, the client must be as prepared as possible by the clinician to help with a successful session.

STAKEHOLDERS

  • Each overarching area impacts stakeholders differently, but effective telepresence helps to ensure a productive and positive interaction, most importantly for the patient, but is effective also for the practioner.

 

ETHICS

  • The practices being HIPAA compliant always needs to be considered (Crossen, et al, 2020).
  • The goal is to ensure best practices (evidence based practice) that would be equal to in-person interactions.
  • For SLPs specifically, the American Speech Hearing Association (ASHA) Code of Ethics must be followed (American Speech-Language-Hearing Association, 2016).
  • Each profession has their own set of ethical guidelines that need to be continuously followed via telemedicine.

 

NEXT STEPS

  • As of right now there is no real set of rules/guidelines/regulations for training providers in telehealth to have an effective telepresence.
  • Current research is being done to establish and validate these training protocols for a better overall guideline to an effective telepresence.
  • Authors of this website would recommend and suggest further research in establishing the three identified components (interpersonal skills, preparation and environment, and technology-related factors) as necessary components to effective telepresence. Further research should also aim to determine clear trainings and directives within each component.