A Systematic Review of the Use of Telehealth in Speech, Language and Hearing Sciences

Journal of Telemedicine and Telecare

Molini-Avejonas, D. R., Rondon-Melo, S., et al. (2015).

Journal of Telemedicine and Telecare, 21(7), 367-376.

This systematic review investigates the benefits and barriers of providing speech, language, and hearing assessment and treatment via telehealth to a variety of populations (e.g., hearing, language, speech, voice, swallowing, orofacial myology and reading/writing disorders).

No funding received

Up to August 2014

Published, peer-reviewed English- or Portuguese-language studies (not further specified)

103

Out of thirty-three studies investigating the benefits of telehealth to identify the presence of hearing loss in individuals, 93.9% reported improved access to care and 21.2% reported cost-effectiveness.

Only one study was located regarding videoconferencing  administration of a children's literacy assessment. Positive results were noted. Further research was suggested to address technology issues with the audio and an overall paucity of research.

For individuals receiving speech-language pathology or audiology services via telepractice, "telehealth activities demonstrated mainly advantages over the alternative non-telehealth approaches" (p. 6). Benefits of telepractice were improved access to care, cost-effectiveness, and patient/caregiver satisfaction. Possible barriers to telepractice included internet speed and technological limitations, lack of acceptance for telepractice, and the need for more data on the efficacy of interventions provided. Additional research on the use of telepractice for providing audiology or speech-language pathology services is warranted.

Nine studies examined use of telehealth in voice disorders. Most addressed assessment and screening of voice, and "results showed that remote voice assessment was considered reliable and viable" (p. 19). One study compared face-to-face intervention with intervention via real-time remote videoconferencing, and found no significant differences in outcomes (perception of voice quality, acoustic changes, patient satisfaction, laryngeal changes). Access to services and cost-effectiveness were mentioned as benefits of telehealth. Barriers included internet/computer access, internet speed, and individual skills in using telehealth.

Three studies supported the cost-effectiveness and viability of using telehealth for assessment, diagnosis, and telemonitoring of voice disorders in individuals with Parkinson's disease.

Six papers were found comparing telepractice to face-to-face assessment for dysphagia. Most of the studies reported both improved access to and quality of care. Early diagnosis and treatment for dysphagia was emphasized. Barriers to implementation included internet speed, individual computer skills, and accessing patient health data. It should be noted that of the studies included, <ul> <li>four were authored by the same or similar group of individuals, and two of those studies appear to share at least some portion of participants; and</li> <li>two are pilot studies, one of which used simulated patients.</li> </ul>