The Use of Telehealth for Disability Evaluations in Medicine and Allied Health Proceedings of a Workshop (2022) / Chapter Skim
Currently Skimming:
4 The Use of Telehealth for Evaluations by Clinical Specialties
4 The Use of Telehealth for Evaluations by Clinical Specialties
Pages 21-32
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 21... ...
The speakers were Ray Dorsey, University of Rochester; Jeffrey Hine, Vanderbilt University and TRIAD Primary Care; Ileana M Howard, Veterans Health Administration and University of Washington; Melissa Ko, Indiana University; Ellen Cohn, University of Pittsburgh; Chad Gladden, Veterans Administration Audiology and Speech Pathology National Program Office; 21
|
From page 22... ...
REMOTE NEUROLOGICAL EVALUATIONS Ray Dorsey, University of Rochester Ray Dorsey, professor of neurology at the University of Rochester Medical Center, discussed challenges people face in accessing neurological care and explored how telehealth can help address these challenges. Dorsey said that many people with disabilities have inadequate access to health care and are underdiagnosed both within neurology and in other medical specialties.
|
From page 23... ...
He noted that there is a slightly stronger literature base for telehealth behavioral interventions, but most ASD assessment tools were designed for use in in-person settings with standardized materials. Hine said two models were typically used for remote assessment before the COVID-19 pandemic: store-and-forward video screening and synchronous video screening (Berger et al., 2022)
|
From page 24... ...
. Researchers developing the tool first used a machine learning algorithm to review more than 700 comprehensive ASD evaluations to identify key social communication behaviors and repetitive behavioral observations that are most predictive of an ASD diagnosis (Corona et al., 2020)
|
From page 25... ...
Teleconferencing software does not have a high enough frames-per-second rate to detect subtle eye movements, though high-quality lighting and cameras can detect some slower eye movements. She noted that for some aspects of the visual exam, digital visual testing apps can help bridge gaps, but very few of these apps have been clinically validated, and most are neither easy for patients to self-administer nor suitable for assessing visual acuity, visual field, or eye motility (Mena-Guevara et al., 2021; Prea et al., 2018; Steren et al., 2021)
|
From page 26... ...
Practitioners focus on functional patient goals that encompass prevention, diagnosis, habilitation, rehabilitation, and enhancement, and they work collaboratively with other health professionals such as audiologists. Cohn said speech-language pathologists use synchronous and asynchronous methods for in-person, remote, or hybrid telepractice visits.
|
From page 27... ...
He said the VA system saw more than 100,000 teleaudiology interactions in 2020, including synchronous videobased visits for diagnostics, fittings, and follow-ups; asynchronous tablet-based hearing tests; online rehabilitation and tinnitus education; and remote programming and fine-tuning of hearing aids and cochlear implants. Gladden described an example of the tools used: specialized workstations for synchronous patient interactions that are equipped with multiple cameras for full diagnostic evaluations within permissible noise standards.
|
From page 28... ...
He noted that common drawbacks include unfamiliarity with the technology required, especially among older users; limited Internet access; and the fact that most diagnoses rely on blood work or endoscopies, which still require a hospital visit. Chowdhry said as technologies improve, it will be important to continue to fund and support telehealth options to give patients with GI conditions a seamless, affordable, and accessible hybrid model for improved care.
|
From page 29... ...
Cyr outlined seven core competencies for quality PT telehealth care: compliance, privacy, safety, technology skills, telehealth delivery skills, assessment and diagnosis, and care planning and management (see Figure 4-1) (Davies et al., FIGURE 4-1 Core competencies for quality care in PT telehealth.
|
From page 30... ...
Cyr posited that telehealth visits generate enough data for International Classification of Functioning assessments. She emphasized evidence-based best practices should reflect the best available research along with clinical expertise, clinician and patient training, technology testing and usability, administrative support, effective resource allocation, and patient choice.
|
From page 31... ...
. English noted that video quality during synchronous virtual appointments must be quite high in order to diagnose and recommend treatment options, and success often depends on the skin condition involved (Kazi et al., 2021)
|
From page 32... ...
Cyr replied that many of the platforms were created before the pandemic and tailored to different HIPAA and documentation standards than those that emerged during the pandemic. Cyr said she is not aware of any specific oversight requirements, though she noted that the companies that develop telehealth platforms are open to feedback.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.