Understanding the implementation of telepractice in speech and language services using a mixed-methods approach

Area of Science:

• Speech-language pathology
• Healthcare delivery
• Telehealth implementation

Background:

• Telepractice offers solutions for healthcare access challenges.
• Speech-language pathology (SLP) telepractice has existed for a decade, but implementation factors remain understudied.
• A knowledge gap exists regarding sustained telepractice in SLP.

Purpose of the Study:

• To identify factors influencing the routine and long-term implementation of telepractice in SLP services.
• To explore barriers and facilitators for sustainable telepractice delivery.

Main Methods:

• A mixed-methods approach combining a scoping review and semi-structured interviews.
• Inclusion criteria focused on studies describing telepractice in SLP with an operational definition of implementation.
• Data from 11 studies mapped to nine telepractice projects were analyzed.

Main Results:

• Telepractice in SLP covered diagnostics, therapeutics, and follow-up care, primarily using synchronous video conferencing.
• Common models included 'professional-facilitator-patient' and 'professional-patient'.
• Barriers included funding, reimbursement, internet issues, patient hesitancy, and lack of policies; facilitators were funding, dedicated teams, and systematic planning.

Conclusions:

• Telepractice in SLP often lacks explicit guidance from implementation science frameworks.
• Implementation frameworks are crucial for systematic planning and feasibility assessment.
• Program implementers should consider these frameworks for scaling telepractice services.