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P. Hancock

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    OS21 - Advancing Telehealth: The Next Wave of Opportunities (ID 33)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS21.02 - Mixed Method Exploration of Telehealth for Autism Intervention Services (ID 299)

      P. Hancock, Western Regional School of Nursing; Corner Brook/CA

      • Abstract
      • Slides

      Purpose/Objectives: Western Health serves a catchment area of approximately 70,000 residents across a large geographic area of Newfoundland and Labrador (NL). Children who are diagnosed with autism spectrum disorder (ASD) within the jurisdiction of Western Health are eligible to receive early intervention services in the form of Applied Behavioral Analysis (ABA) therapy. Traditionally, orientation and ongoing follow-up for these services have been provided in face-to-face format, requiring travel by family members and healthcare providers (HCP). This modality has many limitations for families as well as for involved HCPs, primarily due to the rural nature of the area as well as needs of families who care for vulnerable children. Telehealth has been implemented to ensure adequate access for families as well as maximal efficiency for all involved at three distinct phases of the Western Health ABA delivery process, including the three-day ABA training, mentorship and support for healthcare providers, and to facilitate ongoing evaluation/communication with the family and home therapist in the child’s home. The research team leading this mixed methods study have followed a patient-engagement framework perspective. Quantitative data provided insight into registration information and family/healthcare provider participant satisfaction with using telehealth. Qualitative data from focus groups and interviews provided more extensive exploration of the processes and experiences of families and HCPs involved in the program. The program and evaluation framework are based on the Patient Provider Expectations Model. The final evaluation of the various phases of the project have informed changes required to transform the program to one that is truly “home based.” Based on study results, the researchers conclude that telehealth is a viable method of delivery for the three phases of the ABA program delivery, with the results having implications for improving efficiency of additional programs. The aim of this study is to build upon the existing use of telehealth for the ABA program’s three-day training and then expand into a telehomecare component for the mentoring phase. The objectives of the study include: 1. Implementation of telehomecare in the delivery of ABA parent/caregiver training 2. Explore the experiences of healthcare professionals and clients in the implementation of telehomecare 3. Summative and formative evaluation of health professional and client satisfaction with use of telehomecare for delivery of ABA orientation and ongoing mentoring 4. Review of cost and clinical effectiveness of telehomecare implementation to determine clinical efficacy of this mode of program delivery 5. Provide recommendations for further implementation of telehomecare initiatives

      Methodology/Approach: Mixed method methodology

      Finding/Results: Surverys received from over 60 participants of the three day ABA training. Results include: 87% satisfaction rate among participants; significant cost savings of participants (up to $2000 per participant); emotional benefits (avoidance of travel and separation from children for training). Individual interviews and focus groups provide insight into the challenges and solutions to identified issues.

      Conclusion/Implications/Recommendations: The first phase of this project included a one year pilot of telehealth use for the three day ABA sessions. Based on the results and feedback received from this review, the program has been adapted by the facilitators to be “telehealth-friendly”. Based on the successful results and subsequent change to the program, Telehealth is now used to assist in the delivery of all sessions of the three-day ABA training. Recommendations have been made based on the surveys and other feedback from participants and facilitators, including the recommendation that all staff who will be involved in facilitating the sessions via Telehealth participate in comprehensive telehealth orientation.

      140 Character Summary: Celebrating successes in telehealth -- bridging the gap for families of children with ASD and healthcare providers involved in ABA program delivery!

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