The benefits of using telehealth for speech therapy

Like other areas of healthcare, speech therapy services are expected to grow exponentially over the next decade. One estimate suggests the US speech therapy market will grow from $4.10 billion in 2021 to $6.08 billion in 2028 at a CAGR (Compound annual growth rate) of 5.8%, though statistics aren't available to show the prevalence of virtual compared to in-person.

One example of the success of speech teletherapy occurred at Therapy Solutions Inc. in July 2020. The service provider hosted a virtual camp at the Philadelphia Zoo, where it offered therapy sessions for its young patients. They were eager to participate because of the location of their therapy provider and the fun, lively atmosphere they had.

Hosting such camps by speech therapists and medical associations led to medical professionals seeing their patients in a new way. The popularity of teletherapy led to the American Speech-Language-Hearing Association publishing an official statement on teletherapy use. With telehealth, speech therapy can be provided in various ways. It can be provided via real-time visits through video, audio, or both. Many medical associations have seen telehealth prove effective for patients with aphasia, articulation disorders, dysarthria, and more.

"Working via telehealth took a couple of months to get used to," says Allie Gallinger, M.Cl.Sc., a speech language pathologist in Toronto. "However, I have found it to be exceptionally beneficial and successful. My clients have continued to make significant gains with all of the skills we have been working on. While there are some clients that benefit from in-person services (younger children, children with complex needs, etc.), there is always a workaround such as providing parent coaching or observing parents' interactions with the children and guiding them that way."

COVID-19 Healthcare Coalition conducted a study among speech therapists regarding their experience with telehealth during the pandemic. The study showed that most speech therapists were happy using telehealth to interact with patients.

• 60% of speech therapists mentioned that telehealth is easy to use and can be used across rural, urban, and suburban locations.
• 50% of speech therapists mentioned that they could maintain a work-life balance, increasing satisfaction with their work.
• 68% of speech therapists mentioned that they would be using telehealth in the future.

Just as all rules and regulations must be followed during in-person appointments, all rules and regulations must also be followed while providing teletherapy services.

Some of the benefits of using telehealth in speech therapy are:

• It saves time and money and requires no commute.
• It requires taking less time off work.
• Providers don't have to make special travel arrangements to see their patients.
• It provides greater flexibility when the services can be offered (for example, offering sessions before kids go to school).
• Telehealth technologies pave the way for new creative ideas and ways of interacting and working with patients.

It expands the potential to monitor different standards of care and service user outcomes.

Speech therapists have been using Zoom and other online videoconferencing tools, including specialized speech therapy solutions, to provide teletherapy to their patients during the pandemic. These make it incredibly easy to connect with patients using audio/video features. Tools like Zoom provide the ability to share screens, and the whiteboard feature allows participants to write/draw quickly and easily, making the whole process engaging.

Multiple sources predict that telehealth will remain important for speech therapy, even as in-person visits open up. Most likely, speech therapists will adopt a hybrid model of teletherapy and in-person services.

Speech therapists have recognized five models for virtual or virtual-enabled non-acute care and evaluated the overall possibility of healthcare services that can be used to deliver these models. These virtual care models have high requirements to employ a broader range of the healthcare delivery system, from providing one-off urgent visits to developing different omnichannel care models to using virtual services in-home care models. These models include:

• On-demand virtual care in place of urgent care visits, after-hours consultations, and emergency room (ER) visits. On-demand virtual care is one of the most common uses for teletherapy. It allows a patient to consult a speech therapist on-demand to address problems that occur unexpectedly (such as acute sinusitis). Moreover, it helps the patient to avoid unnecessary trips to the service provider's office. This kind of model can be further scaled to handle large amounts of low acuity visits, which was commonly seen in ER's in the U.S.
• Omnichannel care consisting of a mix of virtual and in-person visits, with a consistent set of speech therapists. This model provides a patient with convenience, reliable access, and ongoing care. Virtual office visits can consist of specialty care (including virtual cardiac rehabilitation), behavioral health (for example, virtual psychotherapy sessions), and primary care. With a combination of digital coaching, speech therapeutics, and patient monitoring, speech therapists can provide better overall care to their patients.
• Administrating home medication through tech-enabled devices. Here, patients are allowed to receive injectable and infusible drugs from the clinic to their homes. This model can be adopted by using remote monitoring devices to monitor a patient's symptoms. The devices can contain self-service tools for patient education (such as training for self-administration), providing telehealth surveillance of staff, and doing home-delivery of medicines.
• Virtual office visits combined with "near home sites" for testing and immunizations but retail and worksite clinics, wherever necessary.
• Virtual home health services that contain remote monitoring, digital engagement tools, and virtual visits. Digital engagement tools include providing patient and caregiver education, treatment evaluation, occupational therapy, speech therapy, and physical therapy. Direct services such as assisting with daily living routines and wound care will still happen in-person, but offering virtual home health services can enrich everyone's experience, improve connectivity with the healthcare team and extend the reach of home health service providers.

The aim is to provide a seamless telehealth experience to both caregivers and patients. As technologies continue to improve and grow, progress in infrastructure and software will lead to more secure connections from patient's homes. Still, proper research is needed to define specific standards for clinical protocols with equipment specifications to assist therapeutic and diagnostic goals and procedures.