Thanks to Marissa for sharing this innovative use of technology for therapy with us today! Marissa A. Barrera, MS, MPhil, MSCS, TSHH, CCC-SLP is the owner of New York Neurogenic Speech-Language Pathology, P.C., a licensed Speech-Language Pathologist (SLP) and Professor of Acquired Motor Speech & Swallowing Disorders. With private practices located in Midtown and on the Upper West Side of Manhattan, Marissa and her team of SLPs feel privileged to provide therapeutic services to hundreds of patients each year. A graduate of Columbia University, she has earned an MS, MPhil, and a Multiple Sclerosis Certified Specialist certification (MSCS) while working towards her PhD in Neurolinguistics (language science). In short, Marissa is proud to be a part of the WebPT community and hopes to help you foster optimal speech and language development in your patients! www.nyneuroslp.com

In honor of this month in which Speech-Language Pathologists (SLPs) all over the country join together to spread the word of awareness, I thought it would be appropriate to share with you a way for you to grow your practice, help more individuals in need, all the while reducing your practice’s operation costs.

Living in a world where companies are no longer confined to conducting business within a local radius, globalization affords businesses the opportunity to work without boundaries. Although historically Speech-Language Pathologists have always treated their patients within an arm’s reach, in this modern, global market we now too have the opportunity to help patients well outside of our immediate geographic area.

To own a speech-language pathology private practice in the past meant you had to feverishly market yourself to local doctors, psychologists, social workers, PTs, OTs, schools and neighborhood families. In the event that there were multiple practices within close proximity, you had to work twice as hard just in order to maintain a presence in the local market. If the practice model I’ve just described sounds like YOUR current business, then perhaps it is time for you to branch out and consider providing web-based speech and language therapy. If you are tired of participating in the referral rat race, wanting to expand your revenue sources, and are genuinely interested in helping as many individuals as possible, I encourage you to take a moment to peruse the basic facts and some unique benefits to administering web-based therapy.

1.  Frequently used terms: Web-based therapy is referred to in various ways. You may come across some of the following terms: telehealth, Skype therapy, telepractice and telerehabilitation.

2.  Software: Computer software such as Skype, LogMeIn, and GoToMeeting offer an affordable medium for you to remotely connect with your patients. All three of the software listed allow you to share your computer screen so both you and your patient can view worksheets, exercises, handouts and visuals just as if they were sitting along side you. 

3.  Scheduling: Being able to provide therapeutic services while your patients are home, at their office, or out-of-town allows for scheduling flexibility, which may lead to an increased number of appointments and fewer cancellations. Patients who may typically not be available to schedule appointments until after work or while away on business can now receive treatment while on their lunch break or while traveling for work or pleasure.

4.  Cost Savings: For therapists who rent treatment rooms on an hourly or daily basis, web-based therapy can offer a tremendous cost savings. If you are able to provide speech and language therapy from your home, it eliminates the need and cost for renting a separate space. Lets not forget to mention that with the rising prices of gas and mass transit fares, eliminating traveling for both the patient and the clinician is mutually beneficial.

5.  Treatment Efficiency: If you are concerned that administering treatment in a distance-based modality will interfere with your patient’s therapeutic outcomes, then consider reading an “Overview of Telehealth Activities in Speech–Language Pathology” written by Pauline A. Mashima and Charles R. Doarn appearing in Telemedicine and e-Health. Yes, it is important you must carefully consider each patient’s candidacy prior to administer web-based therapy (see Patient Candidacy for additional details) however, research studies examining the application of ‘telehealth’ to all areas of speech-language pathology (dysarthria, apraxia, aphasia, articulation, fluency, swallowing and cognitive rehabilitation) currently exist (see the Appendix of Mashima & Doarn).

6.  Reaching the Unreachable: Given our country’s ever-growing population of disabled Americans and senior citizens, utilizing telehealth allows SLPs to provide quality, therapeutic services across the country.

7. Patient Candidacy: Some important patient characteristics to consider when treating patients via the web is 1) focus, 2) motivation to improve, 3) reliability, 4) willingness, and 5) dedication to the treatment. Patients will only see improvements if they are committed to participating in their treatment sessions and consistently complete their home exercise program. 

8.  Niche or Expertise:If you have a clinical expertise or a particular set of specialized skills, by expanding your practice to include web-based services you can now broaden the marketing of your expertise regardless of proximity.

9.  Legalities: Here are some important rules to remember when considering adding web-based therapy to your private practice.

  • You can only provide telepractice if you’re licensed in the state where the patient lives. For more information on this topic please consult ASHA’s website concerning telepractice.
  • HIPAA requires all electronic health care transactions to be secure in order to protect patient privacy. Given the importance of maintaining HIPAA compliance, it is exciting to learn that video calls made via FaceTime on Apple devices such as iPhones and iPads are in fact HIPPA compliant! For clinicians who do not use Apple devices, in order to be fully HIPAA compliant SLPs must have wireless connection that utilizes WPA2 Enterprise security with 128-bit AES.  This security protocol was created in order to safeguard the information that goes both in and out of your computer.  For more information about the use of FaceTime and HIPAA, Barbara Fernandes, aka the GeekSLP describes the details surrounding the use of FaceTime in her article “FaceTime calls on iPad are HIPAA compliant” at her website www.geekslp.com.

10.  Equipment: Before beginning web-based speech therapy, it is important to remember that all video call/conferencing software relies on the quality of computers, networks and the strength of the internet connections. Over the past 5 years, the internet has become more robust and reliable, but even with the best infrastructure in place, sometimes technology can interfere with service delivery. It is important to know how to troubleshoot, as well as when it is best to stop and reschedule a session. Overtime, your skills for problem solving and troubleshooting the technology associated with web-based therapy will improve.  

In lieu of Better Speech and Hearing Month, if you have ever considered including web-based speech therapy to your service delivery model, I hope this informational article provides you with the tools necessary to start expanding your business!

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