KIT. Keeping in Touch: Speech and Language via Skype

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1 KIT Keeping in Touch: Speech and Language via Skype Helen Poole Reader in Applied Health Psychology Sheena Round Consultant SLT/Network Manager

2 Outline Background to KIT Project Evaluation Implications Recommendations

3 Evaluation: what s already known? Remote delivery of health care increasing Clinical use of Skype reviewed (Armfield et al 2013) In Speech and Language Therapy (SLT) Videoconferencing review (Theodolos & Hill 2002) Range of disorders, e.g. stuttering, dysphagia, Parkinson s disease Variety of purposes, including: screening, assessment, and review. Limited for therapy Predominantly adult populations and case series

4 Evaluation: Rationale & Aims Data on use in UK NHS context sparse Aims To evaluate use of Skype to deliver SLT to children within an NHS context To determine acceptability and engagement To evaluate any resource implications

5 Evaluation: Methods Prospective study using mixed methods Purposive sample 7 Speech and Language Therapists (SLTs) 9 Clients: Children aged between 3 ½ years and 14 years and their parents/carers SLTs and clients provided with Tablets to Skype Variety of session types SLTs and clients completed On device questionnaire (N=49 sessions) Interviews at end of study period (N=11)

6 Evaluation: Findings Sessions and Resources Duration (N=49) between 15 & 45 minutes, Mean=27.8 (SD9.9) Mileage saving per session, mean=8.2 (SD10.1), range 0-50 miles Travel time savings per session M= 26.6 (SD13.2), range minutes Table: Percentage agreement with statements Online questionnaire SLT Client Easy to connect 84% 93% No difficulty with visual display No difficulty with sound 80% 93% 80% 93% Successful interaction 87% 93% Projected Savings Travel ~ 87, 000 DNAs ~

7 Like C says, it is just easier cos she doesn t have to miss any of her lunch hour. Or she doesn t have to miss an art lesson it is very much like, having her [child] sit on the rug. And doing everything As you re having a therapy session in your living room. Evaluation: Clients views Convenience and Satisfaction Acceptability + + Experience - I think the technology She showed us of it is brilliant. It s such an advancement. initially. But To be after able to just that use you a screen didn t and really a call I need any mean help it s really setting come along... it up. Did you? You knew what you were doing When you re on the Skype I think you short sort of sharp I d say bursts are it was all better. good. have everything I wouldn t And she enjoyed say there it. And was ready. You re a little she any could negatives stay focussed. to it... bit more organised I Because think it was only about twenty minutes

8 In their own words video

9 Evaluation summary Findings Positive response to use of Skype Connectivity, need for planning Increased engagement Resource efficient Limitations Sample, potential bias

10 Cost Savings From Time & Travel Skype is Free Increased Productivity RIF study provides an evidence base Equality of Access Patient Centred Low Risk Quality Service Provided Provider Benefits Links with remote mobile working NHS protocol for Skype

11

12 Challenges Confidentiality of data Agreement to implementation for clients Risk assessment in NHS Different way of working for SLTs New processes needed for loan tablets Activity data changes Estate considerations

13 Future Trust Support Trust wide survey based on results of evaluation (staff and service users) Implementation across SLT All therapists a possibility Apps Procurement process, development

14 The KIT team Sheena Round, Helen Poole, Ricky Wallace, Paul Fergus, Carolyn Lees, Ursula McCormick, Catharine Barley, Pam Monti, Louise Simcock, Claire Bimson, Lois Hatfield, Catherine Webb, Claire Hanlon, Chelsea Dobbins, Chris Wright, Caroline Rand Acknowledgements: The participants, LJMU, Liverpool Community Health Trust, NHS NW Innovations Fund

15 References Armfield, N.R., et al. (2012) Clinical use of Skype: a review of the evidence base. Journal of Telemedicine and Telecare, 18(3): Beijer, L., et al. (2010). Evaluating the feasibility and the potential efficacy of e-learning-based speech therapy (EST) as a web application for speech training in dysarthric patients with Parkinson's disease: a case study. Telemedicine Journal and e-health, 16(6): Carey, B., et al. (2010). Randomized controlled non-inferiority trial of a telehealth treatment for chronic stuttering: the Camperdown Program. International Journal of Language & Communication Disorders/ Royal College of Speech & Language Therapists, 45(1): Grogan-Johnson, S., et al. (2010). A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional on-site therapy. Journal of Telemedicine and Telecare, 16(3): Hill, A. and D. Theodoros (2002). Research into telehealth applications in speech-language pathology. Journal of Telemedicine and Telecare, 8(4): Hill, A., et al. (2009) Using telerehabilitation to assess apraxia speech in adults. International Journal of Language Communication Disorders, 44(5): Mashima, P., et al. (1999). Telehealth applications in speech-language pathology. Journal of Healthcare Information Management, 13(4): Sharma, S., et al. (2012). Assessing dysphagia via telerehabilitation: Patient perceptions and satisfaction. International Journal of Speech-language Pathology, 15(2): Sicotte, C., et al. (2003). Feasibility and outcome evaluation of a telemedicine application in speech-language pathology. Journal of Telemedicine and Telecare, 9(5): Styles, V. (2008). Service users' acceptability of videoconferencing as a form of service delivery. Journal of Telemedicine and Telecare 14(8): Theodoros, D. (2012). A new era in speech-language pathology practice: innovation and diversification. International journal of speech-language pathology 14(3): Van den Berg, N., et al. (2012) Telemedicine and telecare for older patients: a systematic review, Maturitas, 73(2): (Williams, P. (2012). Speech and language therapists say yes to bridging barriers with technology. Telerehabilitation, accessed 12/12/12

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