KIT
Keeping in Touch: Speech and Language via Skype
Helen Poole Sheena Round
Outline
• Background to KIT Project
• Evaluation
• Implications
Evaluation: what’s already known?
• ‘Remote’ delivery of health care increasing
• Clinical use of Skype reviewed
(Armfield et al 2013)
• In Speech and Language Therapy (SLT)
– Videoconferencing review
(Theodolos & Hill 2002)
– Range of disorders, e.g. stuttering, dysphagia,
Parkinson’s disease
– Variety of purposes, including: screening,
assessment, and review. Limited for therapy
Evaluation: Rationale & Aims
• Data on use in UK NHS context sparse
Aims
• To evaluate use of Skype to deliver SLT to
children within an NHS context
• To determine acceptability and engagement
• To evaluate any resource implications
Evaluation: Methods
• Prospective study using mixed methods
• Purposive sample
– 7 Speech and Language Therapists (SLTs)
– 9 Clients: Children aged between 3 ½ years and 14 years
and their parents/carers
• SLTs and clients provided with Tablets to Skype
• Variety of session types
• SLTs and clients completed
– On device questionnaire (N=49 sessions)
– Interviews at end of study period (N=11)
Evaluation: Findings
Online questionnaire
SLT
Client
Easy to connect
84%
93%
No difficulty with
visual display
80%
93%
No difficulty with
sound
80%
93%
Successful interaction
87%
93%
Sessions and Resources
• Duration (N=49) between
15 & 45 minutes,
Mean=27.8 (SD9.9)
• Mileage saving per
session, mean=8.2
(SD10.1), range 0-50
miles
• Travel time savings per
session M= 26.6 (SD13.2),
range 15-60 minutes
Table: Percentage agreement with statements
Projected Savings
Travel ~ £87, 000
DNAs ~ £27.000
+
+
Experience
-Convenience
and
Satisfaction
Acceptability
Evaluation: Clients views
“I think the technology
of it is brilliant. It’s such an
advancement. To be able to
just use a screen and a
call…I mean it’s really
come along...”
She showed us
initially. But after
that you didn’t really
need any help setting
it up. Did you? You
knew what you were
doing
I think short
sharp bursts…are better.
And she enjoyed it. And
she could stay focussed.
Because it was only about
twenty minutes
Like ‘C’ says,
it…is just easier ‘cos
she doesn’t have to
miss any of her lunch
hour. Or she doesn’t
have to miss an art
lesson…
…it is very much
like, having her [child]
sit on the rug. And doing
everything…As you’re
having a therapy session
in your living room.
I’d say it was all good.
I wouldn’t say there was
any negatives to it...
When you’re on the
Skype you sort of
have everything
ready. You’re a little
bit more organised I
In their own words
Evaluation summary
Findings
• Positive response to use of Skype
• Connectivity, need for planning
• Increased engagement
• Resource efficient
Limitations
Quality
Service
Provided
Low Risk
Equality
of Access
Cost Savings From Time & TravelSkype is
Free
IncreasedProductivity RIF study provides an evidence base
Patient
Centred
Links with remote mobile workingNHS
protocol
for Skype
Provider
Benefits
Challenges
• Confidentiality of data
– Agreement to implementation for clients
– Risk assessment in NHS
– Different way of working for SLTs
• New processes needed for loan tablets
• Activity data changes
Future
• Trust Support
– Trust wide survey based on results of evaluation
(staff and service users)
• Implementation across SLT
– All therapists a possibility
• Apps
Sheena Round, Helen Poole, Ricky Wallace, Paul Fergus,
Carolyn Lees, Ursula McCormick, Catharine Barley, Pam
Monti, Louise Simcock, Claire Bimson, Lois Hatfield,
Catherine Webb, Claire Hanlon, Chelsea Dobbins, Chris
Wright, Caroline Rand
Acknowledgements: The participants, LJMU, Liverpool
Community Health Trust, NHS NW Innovations Fund
References
Armfield, N.R., et al. (2012) Clinical use of Skype: a review of the evidence base. Journal of Telemedicine and Telecare, 18(3): 125-7.
Beijer, L., et al. (2010). Evaluating the feasibility and the potential efficacy of e-learning-based speech therapy (EST) as a web application for speech training in dysarthric patients with Parkinson's disease: a case study. Telemedicine Journal and e-health, 16(6): 732-738.
Carey, B., et al. (2010). Randomized controlled non-inferiority trial of a telehealth treatment for chronic stuttering: the Camperdown Program. International Journal of Language & Communication Disorders/ Royal College of Speech & Language Therapists, 45(1): 108-120.
Grogan-Johnson, S., et al. (2010). A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional on-site therapy. Journal of Telemedicine and Telecare, 16(3): 134-139.
Hill, A. and D. Theodoros (2002). Research into telehealth applications in speech-language pathology. Journal of Telemedicine and Telecare, 8(4): 187-196.
Hill, A., et al. (2009) Using telerehabilitation to assess apraxia speech in adults. International Journal of Language Communication Disorders, 44(5): 731-47.
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Sharma, S., et al. (2012). Assessing dysphagia via telerehabilitation: Patient perceptions and satisfaction. International Journal of Speech-language Pathology, 15(2):176-83
Sicotte, C., et al. (2003). Feasibility and outcome evaluation of a telemedicine application in speech-language pathology. Journal of Telemedicine and Telecare, 9(5): 253-258.
Styles, V. (2008). Service users' acceptability of videoconferencing as a form of service delivery. Journal of Telemedicine and Telecare 14(8): 415-420.
Theodoros, D. (2012). A new era in speech-language pathology practice: innovation and diversification. International journal of speech-language pathology 14(3): 189-199.
Van den Berg, N., et al. (2012) Telemedicine and telecare for older patients: a systematic review, Maturitas, 73(2): 94-114 (Williams, P. (2012). Speech and language therapists say ‘yes’ to bridging barriers with technology. Telerehabilitation, accessed 12/12/12 http://www.ithealthboard.health.nz/sites/all/files/Telerehabilitation%20Flyer%20v2.pdf