JCPSLP
Volume 16, Number 3 2014
147
Clinical insight
KEYWORDS
PROFESSIONAL
ISSUES
SPEECH
LANGUAGE
PATHOLOGY
TELEHEALTH
TELEPRACTICE
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
Jodie May (top)
and Shane
Erickson
Telehealth: Why not?
Perspectives of speech-language pathologists not
engaging in telehealth
Jodie May and Shane Erickson
professional health services at a distance by linking clinician
to client, or clinician to clinician for assessment, intervention
and/or consultation” (American Speech & Hearing
Association [ASHA], 2005).
In order to realise the potential of telehealth, SLPs will
need to embrace a range of new technologies and develop
new skills. However, evidence regarding clinician attitudes
to telehealth and potential facilitators to increase uptake is
scarce. Several studies have documented the experiences
of SLPs who use telehealth. A recent survey of SLP
telehealth users in Australia found that the most significant
challenges to using telehealth were: lack of appropriate
technology and telecommunication connections, lack
of appropriate and available telehealth assessment and
therapy resources, access, and information communication
technology (ICT) support (Hill & Miller, 2011). A range of
potential telehealth facilitators were also identified including:
training and demonstrations, access to resources, funding
and a SPA position paper.
There may also be a disparity between SLP attitudes
towards telehealth and those of their clients. Dunkley,
Pattie, Wilson, and McAllister (2010) found that client
attitudes to telehealth were more positive than their SLPs
anticipated them to be and the clients reported better
access to telehealth technology than the SLPs had
perceived.
To date, little is known about the perspectives and
experiences of SLPs who do not use telehealth in clinical
practice. This study seeks to explore this knowledge gap
and inform the broader profession about (a) the existing
barriers to telehealth use and (b) potential facilitators to
support its uptake. Identifying these barriers and facilitators
is a significant step towards broadening the availability of
telehealth and increasing the access, efficiency and cost
effectiveness of SLP services.
Method
Ethics approval was received from the La Trobe University
Human Research Ethics Committee (reference FHEC
13/083) and from the SA Health Human Research Ethics
Committee (reference HREC/13/SAH/60). A qualitative
research design was utilised given the exploratory nature of
the study and scarcity of previous related research.
Participants
The participants were 18 practising SLPs who self-identified
as not using telehealth for clinical service provision (Table 1).
Participants for individual interviews were recruited
Telehealth-delivered speech-language
pathology services can be effective and
improve efficiency and accessibility. However,
uptake of telehealth among Australian
speech-language pathologists (SLPs) is low
and little is known about those who do not
use it. This study aimed to explore the
barriers preventing SLPs from using
telehealth and describe strategies to support
its uptake. Eighteen SLPs participated in
interviews or focus groups. Data were
analysed using thematic analysis. Existing
barriers and potential facilitators were
reflected in the following themes:
information, training, clinician attitudes and
perceptions, and organisational and policy
barriers. Findings suggest that further
research, training, and information are
required to support telehealth use across a
wider range of clinical settings.
D
espite evidence showing that telehealth-delivered
speech-language pathology services can be
effective, efficient and accessible (Reynolds, Vick
& Haak, 2009; Theodoros, 2012), translation into practice
has been limited (Department of Health & Ageing [DoHA],
2011). A recent DoHA survey indicated that only 13%
of Australian allied health professionals use telehealth
(DoHA, 2011). The National eHealth Strategy states that
“the challenges and issues facing the Australian health
care sector will not be solved by doing more of the same,
particularly given the limited nature of available human and
financial resources” (Deloitte, 2008, p. 15). Strategic and
effective use of communication technology is an important
tool to meet growing demand for healthcare services
(DoHA, 2011; Theodoros, 2012).
Inconsistencies regarding telehealth terminology and
definitions confuse both professionals and consumers
(Brennan et al., 2010). In this paper the term telehealth is
used and is consistent with DoHA and Medicare policy
and documentation (however, Speech Pathology Australia
[SPA] has chosen to use “telepractice” in its forthcoming
position statement). Telehealth is “the application of
telecommunications technology to the delivery of
