JCPSLP Vol 16 no 3 2014_FINAL_WEB

Table 3. Open codes, subthemes and overarching themes Examples of open codes Subthemes

Overarching themes

I’ve heard very little about it. I don’t know exactly what it is.

Awareness Knowledge Terminology

Information

Evidence Research

I want to see it being done. I need practical training.

Professional development

Training

Mentoring

Preference for face to face.

Fear of technology Resistance to change Clinician preference

Clinician attitudes & perceptions

Clients couldn’t do it.

Wouldn’t suit my caseload. I don’t have time to set it up.

Client issues

What are the benefits?

Time

Is it cost effective? I don’t have access to the equipment. Who would fund these sessions?

ICT

Organisational & policy barriers

Funding

We can’t use Skype.

Access Confidentiality Policy & procedures

including telephone, Polycom, Skype, and video- teleconferencing; however, there was broad confusion about what constituted telehealth. I really don’t know much about it … I am still not 100% sure what telehealth is …. I just don’t know. What I am thinking, is it similar to Polycom? (Maria) SLPs were aware that telehealth is used clinically by GPs, medical specialists and allied health professionals. The Lidcombe Program for paediatric stuttering (Lewis, Packman, Onslow, Simpson, & Jones, 2008) was the most frequently identified SLP intervention able to be delivered via telehealth. Five participants had learnt about it from journal articles, conferences or other colleagues. The participants reported that while learning about telehealth research was exciting, they did not feel equipped to deliver services in this way and needed more guidance. Potential facilitators to improve dissemination of telehealth information included a SPA position paper, practice guidelines, ICT minimum requirements and technical instructions, and trouble- shooting guidelines. Additionally, all participants identified the need for further evidence, particularly cost-benefit analyses. Theme 2: Training A lack of training was also identified as a major barrier. None of the participants were aware of current telehealth education opportunities and none had attended formal training. A trial-and-error approach and incorporating information from colleagues were identified as likely learning strategies for those considering telehealth in the future. Participants reported that accessing training and education programs which included demonstrations would be most beneficial. Part of the reason I’ve never done it is that I’ve never seen anybody do it. I would want to see people doing it. (Jacinta) Theme 3: Clinician attitudes and perceptions Metropolitan SLPs commonly reported that telehealth is a rural and remote issue. Conversely, SLPs in rural and remote areas indicated that the successful uptake of

themes. Written notes were compared with the audio- recordings to ensure accuracy of transcription and to preserve the context of the dialogue. Discussion occurred between the researchers throughout the data collection and analysis phases. Differences in interpretation were discussed until consensus was reached. During data collection accuracy was checked with participants by reviewing major points and clarifying information. Following transcription participants were offered (via email) the opportunity to review their transcript to verify accuracy. Four participants (22%) reviewed their transcripts: three made no amendments and one requested a minor addition. Results The participants demonstrated varied knowledge about telehealth. Those who demonstrated the greatest insight, including providing a definition consistent with ASHA’s definition (2005), clinical anecdotes and research awareness were in senior SLP roles with more than 15 years’ experience. Participants who reported little knowledge had largely only heard about telehealth in the context of services offered by rural and remote GPs and medical specialists. All participants were aware of the potential use of ICT for staff meetings or professional development. Despite not using telehealth for clinical service delivery, all participants identified a range of potential benefits including: reduced travel time, efficiency and improved access for clients. Five participants in the private or disability sectors stated that they intended to trial telehealth service delivery in the future due to these perceived benefits. Data analysis identified existing barriers and potential facilitators across four major themes: information, training, clinician attitudes and perceptions, and organisational and policy barriers. Theme 1: Information Lack of information about the use of telehealth was reported to be a significant barrier. Knowledge of the potential use of telehealth for clinical service provision was highest amongst more experienced SLPs in the disability and private sectors, and in rural and remote areas. Participants reported awareness of a range of systems

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JCPSLP Volume 16, Number 3 2014

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