Miss Louise Cleary1, Ms Rebecca Kingston1, Ms Rose Findlater1, Dr Sarah D'Souza1, Mr Jesse Kirwan-William4, Mrs Asher Verheggen1, Mrs Robyn Trzaskowski1, Miss Sophie Maines2, Ms Katherine Lamont3, Ms Nicole Jeffree3, Mrs Kate Valmadre3, Mr Josh Linsson3, Mr Sujay Sadanandan3, Mrs Trish Chivilo2, Ms Tania Orr4, Mr Andrew Poustie2, Mr Thomas Brodie2, Mr Bill Wear2, Ms Suzanne Spitz2, Ms Michelle Jacobs3, Mrs Victoria Bycroft3, Mrs Mary Lynas2
1Sir Charles Gairdner Osborne Park Health Care Group (SCGOPHCG), Stirling, Australia, 2Geraldton Regional Hospital – WA Country Health Service, Geraldton, Australia, 3WA Country Health Service (WACHS) Clinical Telehealth Development, Shenton Park, Australia, 4North Metropolitan Health Service Virtual Care Team, Mount Claremont, Australia
Biography:
Louise Cleary is a Senior Speech Pathologist with 13 years’ experience in tertiary acute and rehabilitations hospitals. Her passion is stroke rehabilitation and implementation of innovative approaches to improve service delivery. Louise is an early career researcher and an advanced scope clinician who supports local and rural staff in complex swallow management.
Louise Cleary is the lead investigator on this project who conceptualised the project idea, led overall project development and team coordination, completed data collection and contributed to data analysis. Louise received the Allied Health New Investigator Award from the Charlies Research Foundation for her work on this project.
Abstract:
Background:
Videofluoroscopy Swallowing Study (VFSS) is best practice in the management of swallowing difficulties (dysphagia). Geraldton Regional Hospital (GRH), located in a large rural town (MM3), has VFSS equipment, but no VFSS trained speech pathologists. Telepractice VFSS (TeleVFSS) may increase capacity to deliver safe, high-quality VFSS services and workforce competency for GRH. The study explored the feasibility of conducting VFSS with a concurrent livestream to an onsite and an external computer (TeleVFSS) between Osborne Park hospital (OPH), a metropolitan hospital, and GRH.
Method:
Feasibility study exploring if TeleVFSS, via concurrent livestream, can: i) achieve a score of 4/5 (livestream available with mostly adequate quality, brief occasions of poor-quality, scores not impacted) or better on a TeleVFSS image rating scale; and ii) be attributed a Penetration Aspiration Scale (PAS) score on 80% of VFSS swallows. Phase 1 was conducted onsite at OPH, with three telehealth platforms trialled. Phase 2 was conducted during a VFSS clinic at GHS and live streamed to OPH.
Results:
In Phase 1 (n=10) one platform, Healthdirect achieved: i) 100% (5/5) scored a 4 or greater on the image rating scale; and ii) 100% (5/5) were attributed a PAS score on 80% or more. Phase 2 (n=5) achieved 100% (5/5) in both objectives.
Discussion:
TeleVFSS to an on-site and external computer provided adequate image quality and consistently attributed a PAS score. TeleVFSS may be a feasible solution to provide rural clients equitable access to a specialised VFSS service, potentially reducing health care costs and improving health outcomes.