JCPSLP
Volume 16, Number 3 2014
149
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
Table 3. Open codes, subthemes and overarching themes
Examples of open codes
Subthemes
Overarching themes
I’ve heard very little about it.
Awareness
Information
I don’t know exactly what it is.
Knowledge
Terminology
Evidence
Research
I want to see it being done.
Professional development
Training
I need practical training.
Mentoring
Preference for face to face.
Fear of technology
Clinician attitudes & perceptions
Clients couldn’t do it.
Resistance to change
Wouldn’t suit my caseload.
Clinician preference
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.
ICT
Organisational & policy barriers
Who would fund these sessions?
Funding
We can’t use Skype.
Access
Confidentiality
Policy & procedures
