SP 2030 Report

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Using telepractice to enhance delivery of adult dysphagia and head and neck cancer services Speech pathologists at the Royal Brisbane and Women’s Hospital

highlighted as an additional benefit of the service. Evaluation of the telepractice service compared to standard care (i.e. email/phone support or face-to-face appointments at RBWH) has confirmed significant service and cost efficiencies along with high consumer and clinician satisfaction when using telepractice. These telepractice models improve access to speech pathology services by providing care at the patient’s local health facility. This reduces travel and costs for the patient and health service, contributes to reducing patient risk, optimises patient outcomes, improves speech pathology service efficiency, and provides greater opportunities for workforce training/mentoring for clinicians. Additional projects by this team are underway, including exploring application of telepractice to support remote delivery of instrumental swallowing assessments such as videofluoroscopic swallow studies and fibreoptic endoscopic evaluation of swallowing, as well as home based intervention for head and neck cancer patient care.

Queensland (AHPOQ) is currently supporting the clinical implementation of this new model of care through the development of statewide implementation and training packages, and the evaluation of newly- established telepractice service across 19 sites within Queensland Health. A multisite hub-spoke telepractice service has been established to enhance speech pathology services for patients with head and neck cancer within non-metropolitan areas in Queensland Health. Using a share- care approach, specialist clinical support is provided by the RBWH (hub site) during live clinical telepractice consultations with the patient and their local speech pathologist at Nambour, Hervey Bay or Rockhampton Hospital sites (spoke sites). A purpose built telepractice unit incorporating a medical camera system transmits fine detailed images to support all aspects of speech pathology assessment and management (e.g. voice prosthesis sizing and insertion). Patients have also been supported by multidisciplinary consultations with a dietitian or physiotherapist. Online workforce training has been

(RBWH) in collaboration with researchers from the Centre for Functioning and Health Research, Queensland Health, and the Centre for Research in Telerehabilitation, The University of Queensland, have developed and implemented new telepractice models of care to enhance delivery of speech pathology services for adults with dysphagia and head and neck cancer. The application of telepractice in adult clinical swallowing assessments was initially examined in a series of studies, which confirmed that the new telepractice model was both safe and valid as per face-to-face care. In this service model, the telepractice speech pathologist (at a hub site) directs the patient, supported by a trained health care support worker (at a spoke site), to complete the required assessment tasks. Enhanced technical features such as remote camera zoom and a lapel microphone enables the telepractice system to transmit the necessary audio-visual information for the assessment. Funding from Allied Health Professions’ Office of

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