Telepractice is an Emerging Solution
During 2020 - 2021, the pandemic forced therapists to transition to telepractice service delivery. It didn't take long for the global community to realize that telepractice was an emerging solution for people who are looking for services and for professionals wanting to build a viable practice.
Three Types of Telepractice
The American Speech Language Hearing Association (ASHA) is recommending the term telepractice over other terms such as telehealth, telemedicine, telespeech, and speech teletherapy to avoid the misperception that these services are used only in health care settings.
Common terms describing types of telepractice are as follows:
Synchronous (client interactive): Services are conducted with an interactive audio and video connection in real time to create an in-person experience similar to that achieved in a traditional encounter. Synchronous services may connect a client or group of clients with a clinician, or they may include consultation between a clinician and a specialist.
Asynchronous (store-and-forward): Images or data are captured and transmitted (i.e., stored and forwarded) for viewing or interpretation by a professional. Examples include transmission of voice clips, audiologic testing results, or outcomes of independent client practice.
Hybrid: Applications of telepractice that include combinations of synchronous, asynchronous, and/or in-person services.
Common Fears for Online Therapists
The barriers to telepractice in Canada were reduced during the pandemic because of the urgency of taking care of caseloads. Funders were forced to accept telepractice as a service delivery method. Clients downloaded apps and showed up for sessions.
All therapists had to take risks and learn new skills. Private practice therapists were faced with becoming online entrepreneurs. Here are some common fears expressed by therapists.
- First of all, how do you stay legal? What are your obligations regarding compliance with privacy protection laws and professional conduct? Currently, Canada has vastly different privacy protection laws from province to province. Within provinces, there are variations depending on the place of employment and even the source of the caseload data.
- Secondly, how do you convey competence when the technology keeps changing and the learning curve is so steep?
- Thirdly, how do you compete online to attract your ideal caseload?
- Fourthly, how do you keep your clients committed, paying you well and staying long enough to get clinical outcomes?
Telepractice Service Delivery Solves Problems
In Canada, we have a long history of inequitable access to therapy services for rehab and intervention. During the pandemic, we saw that telepractice service delivery solved some of our intractable problems.
Risk of Spreading Disease
Speech language therapy became a dangerous profession during the pandemic. SLPs could no longer sit close to clients and use the mouth to teach concepts. Some SLPs tried to work behind plexiglass. The acceptance of webcam sessions was rapid because it eliminated the spread of the virus.
Vacancies
Therapy positions in rural communities sometimes stay vacant for a long time while employers try to recruit someone. Experienced therapists tend to be well-established in their careers. They are not interested in moving or even taking short term assignments away from home. Long waiting lists create desperation for people living in those rural communities. They waste their precious funding on fads, unproven therapies and unqualified service providers.
In contrast, telepractice services can be used to address vacancies. Employers can either develop their own telepractice outreach programs or hire private contractors to provide online services.
Demands on Therapists
Even people living in urban centers struggle with finding a therapist who is available at the right time. Many families want a therapist who will come to their home evenings or weekends. Children are in daycare or school all week. Adults can't take time off work.
Private practice therapists can't sustain a caseload that involves giving up evenings and weekends and travelling to homes without being reimbursed.
In contrast, telepractice services allow private practice therapists to build a business that is efficient and profitable. It gives them work-life balance.
Telepractice Service Delivery Offers Benefits
Telepractice gives people access to expert help, so they can make progress on their rehab and intervention. There are benefits for the public, for individual therapists and for the professions.
- The time and expense of travel for clients and therapists is eliminated. Therapists can extend the reach of their practice.
- Telepractice can increase the frequency of contact.
- It is a future-proof way to provide assessment and intervention. The reliance on pen and paper and physical therapy materials is greatly reduced.
- Monitoring can be done asynchronously by viewing data on a server
- Telepractice can turn therapists into leaders in their professional field because therapists can develop a clinical niche.
- Clients with rare and difficult diagnoses can get access to highly effective treatments.
- It can provide new grads with mentoring from confident leaders.
- A more affordable tiered service model is possible because a highly specialized expert can create goals and direct a local team in following a robust therapy protocol.
- Software can be used as curriculum, greatly reducing the need to train paraprofessionals to fidelity.
- The risk of spreading diseases is eliminated.
- Telepractice increases the efficiency and profitability of a therapy practice.
