Telehealth Delphi

Wu, C. (2019). Utilization Efficacy Perceptions of Telepractice for Speech-Language Pathologists and University Faculty Administrators: A Qualitative Delphi Study (Doctoral Dissertation

Utilization Efficacy Perceptions of Telepractice for Speech-Language Pathologists and University Faculty and Administrators:  A Qualitative Delphi Study. Cybele Wu, 2019: Applied Dissertation, Nova Southeastern University, Abraham S. Fischler College of Education and School of Criminal Justice. Keywords: Delphi Method, Speech-Language Pathology, telepractice, reimbursement barriers, technology acceptance, licensing barriers, HIPAA compliance, technology use

Telepractice (or telehealth, teletherapy, tele-rehabilitation) is becoming more common. Speech-language pathology entered the world of telemedicine later than other fields of medicine. With the increasing size of the aging population with the baby boomers, the need for speech-language pathology can be achieved through practitioners using telepractice. Despite the need, barriers such as reimbursement, licensing, privacy and confidentiality, technology and technology acceptance are hindering the adoption of telepractice. This study uses the Delphi methodology with qualitative data collection and analysis to come to a consensus on how to best regulate and operate telepractice with speech-language pathology so that it is more readily adopted.

The panel of 11 experts were identified and organized into three groups: 6 speechlanguage pathologists working with adult and geriatric patients, 2 regulatory experts, and 3 university speech-language pathology program faculty and administrators. The Delphi method was used in multiple rounds to collect data on the barriers to telepractice, as well as potential solutions.  

Rounds included: individual semi-structured interviews (barriers, training and curriculum, technology acceptance and use, HIPAA compliance), statements from data collected in previous rounds, where participants made additional comments and voted, and final presentation of results to participants. During this final round results and solutions were presented, , as well as suggestions for technology training options to speech-language pathologists.

Research Subquestions

1. How do telepractice regulations limit the use of telepractice by speech-language pathologists in clinical, private practice, and home-health settings?

2. How does the availability of HIPAA compliant technologies limit the use of telepractice by speech-language pathologists in clinical, private practice, and home-health settings with adult and geriatric patients?

3. What do university masters-level speech-language programs teach about the use of telepractice, telepractice regulations, and HIPAA compliant technologies in their curricula? ​

Research Themes

Theme 1. The lack of a commonly agreed upon name for remote therapy has 79 caused problems in licensing and reimbursement, particularly for adult and geriatric patients. 

Theme 2. SLPs conducting Telepractice are not reimbursed at the same rate as therapy provided in person.

Theme 3. Because there is a shortage of SLPs, the lack of multi-state licensing for SLPs caused by licensing boards has restricted patients’ access to care. 

Theme 4. Although technology is readily available, HIPAA has affected the cost of doing business

Theme 5. SLP programs are not universal in teaching about telepractice.