Application of telepractice for head and neck cancer management: a review of speech language pathology service models.
OBJECTIVE
Head and neck cancer (HNC) is a complex and heterogeneous disease, requiring specialist intervention from a multidisciplinary team including speech language pathology (SLP). Unfortunately, multiple patient and service-related challenges exist which currently limit equitable access to SLP support for all individuals. This review highlights the existing evidence for different telepractice models designed to help patients and services optimize management of swallowing and communication disorders arising from HNC.


RESULTS
Emerging evidence exists for using computerized screening to enhance the identification of treatment-related toxicities and assist referrals to services, including SLP. Asynchronous telepractice applications are being used to assist delivery of intensive home-based dysphagia therapy, whereas videoconferencing can offer a feasible and effective method to support ongoing management for patients with limited access to local specialist SLP services. Patient and clinician satisfaction with all models has been high.


CONCLUSIONS
SLP services can be redesigned to incorporate a range of telepractice models to optimize clinical care at different stages of the HNC survivorship pathway. Early evidence supports telepractice can improve patient access to services, enhance outcomes, and optimize health service efficiency; however, further systematic research is needed into these models, particularly relating to large-scale implementation and costs/economic analyses.
aCentre for Functioning and Health Research, Queensland Health bCentre for Research in Telerehabilitation, School of Health and Rehabilitation Sciences cCentre for Research Excellence in Telehealth, University of Queensland dSpeech Pathology and Audiology Department, Royal Brisbane and Women's Hospital eSpeech Pathology Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Elizabeth C
EC
Ward
Laurelie R
LR
Wall
Clare L
CL
Burns
Bena
B
Cartmill
Anne J
AJ
Hill
D003147:Communication Disorders / Q000209:etiology / Q000628:therapy*; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000628:therapy; D006297:Health Services Accessibility; D006801:Humans; D010342:Patient Acceptance of Health Care; D013066:Speech-Language Pathology; D017216:Telemedicine / Q000379:methods* / Q000458:organization & administration