Applications of Telemedicine in Speech‐Language Pathology: Evaluation of Patient Satisfaction

Abstract

Objectives The study aimed to evaluate patient satisfaction with speech‐language therapy televisits and to identify factors influencing the level of satisfaction. Methods Participants were recruited from an academic tertiary voice and swallowing center who had completed ≥1 telehealth session of speech‐language therapy with a speech‐language pathologist between March, 2020 and April, 2021. Patient satisfaction was assessed using the Short Assessment of Patient Satisfaction (SAPS), a validated 7‐item survey. Demographic characteristics of participants were collected from a review of patient charts. Results 65/239 patients completed the SAPS survey, representing a response rate of 27%. The average age of study participants was 54.92 ± 16.45 years, with 49.2% identifying as female, 33.9% as male, and 16.9% as trans‐female. The mean SAPS score was 22.60 ± 3.89, with 84.62% of patients satisfied or very satisfied with their visit. Patients were most satisfied with provider respect (3.91 ± 0.34) and care received (3.74 ± 0.64), and least satisfied with visit length (2.32 ± 1.38) and explanation of treatment results (2.62 ± 1.72). Patient satisfaction was positively correlated with younger age and an increased number of televisits. Satisfaction did not differ significantly by gender identity, type of therapy received, insurance type, travel distance, or prior in‐person therapy. Conclusion Clinicians are able to achieve high patient satisfaction with speech‐language therapy when delivered by telehealth. Patient satisfaction remained high across diverse patient populations and range of clinical needs. Clinicians should remain cognizant of the unique limitations of older patients when conducting telehealth visits. Lay Summary Clinicians are able to achieve high patient satisfaction with speech‐language therapy when delivered via telehealth. Satisfaction remained high regardless of gender identity, type of therapy received, type of insurance, travel distance, or completion of prior in‐person therapy. Level of Evidence 4 Laryngoscope, 133:895–900, 2023

Medicare Restriction of Telehealth Speech Services Negatively Impacts Patient Care

“…VSU therapy are well‐established medically necessary service modalities to treat patients suffering from these symptoms 1,4,5,8‐11,16,18‐21,27‐32 . Delivery of these services through a virtual format, via teletherapy, have shown equivalent or better outcomes compared to in‐person therapy 16,18‐21,27‐32 .…”

“…VSU therapy are well-established medically necessary service modalities to treat patients suffering from these symptoms. 1,4,5,[8][9][10][11]16,[18][19][20][21][27][28][29][30][31][32] Delivery of these services through a virtual format, via teletherapy, have shown equivalent or better outcomes compared to in-person therapy. 16,[18][19][20][21][27][28][29][30][31][32] In this study, changes in reimbursement for teletherapy speech-language pathology services (ie, the elimination of teletherapy services for Medicare patients) had a clearly negative impact on patients' access to this effective and impactful care.…”

“…1,4,5,[8][9][10][11]16,[18][19][20][21][27][28][29][30][31][32] Delivery of these services through a virtual format, via teletherapy, have shown equivalent or better outcomes compared to in-person therapy. 16,[18][19][20][21][27][28][29][30][31][32] In this study, changes in reimbursement for teletherapy speech-language pathology services (ie, the elimination of teletherapy services for Medicare patients) had a clearly negative impact on patients' access to this effective and impactful care. Even after reversal of this decision reinstated access, two-thirds of patients eligible to reschedule did not do so, thus never completing the treatment initially prescribed to address their presenting symptoms.…”

“…This was a marked change from their earlier policy where “prior to this waiver Medicare could only pay for telehealth on a limited basis.” 26 With this financial support, speech‐language pathology in particular shifted strongly toward virtual methods of delivery. A body of literature continues to grow, which clearly demonstrates that teletherapy delivery of VSU therapy is equally therapeutically effective, if not better, and teletherapy provides a variety of other benefits (eg, access, patient access burden, quality of life and adherence, patient satisfaction) 16,18‐21,27‐33 …”

“…A body of literature continues to grow, which clearly demonstrates that teletherapy delivery of VSU therapy is equally therapeutically effective, if not better, and teletherapy provides a variety of other benefits (eg, access, patient access burden, quality of life and adherence, patient satisfaction). 16,[18][19][20][21][27][28][29][30][31][32][33] In mid-March 2023, CMS announced the discontinuation of reimbursement for teletherapy services in hospitalbased outpatient departments (HOPDs), effective May 11, 2023. This rule change was identified as significantly impacting SLPs in particular; physicians were not affected.…”