7/30/2019 Welcome NICU Consortium Education Program/Webinar July 31, 2019 NICU Consortium Education Program Agenda, July 31, 2019 Welcome and Introductions NICU Consortium Partner Updates NICU Consortium Committee Reports Using Telehealth for Children in Early Intervention Becky Cohill, OTD, OTR/L Judy Delaware, OTR, Families Perspective of Telehealth Moderator: Beth Cole, Provider Relations Manager, Early Intervention North Metro Missy Oiler, Service Coordinator The Resource Exchange Lisa Bisbee Nancy Haddad Mesa County Developmental Services Jeanie Larsen, Service Coordinator Adjourn NICU Consortium Partnership Members Updates and Announcements 1
7/30/2019 Using Telehealth for Children in Early Intervention Dr. Becki Cohill Assistant Professor at the University of St. Augustine Occupational Therapy Program San Marcos, CA. Judy Delaware, OTR/L, CLC Pediatric Occupational Therapist and Feeding Specialist, Certified Lactation Counsellor Boulder, Colorado An introduction to telehealth Making Meaningful connections Learning Objectives: • Understand the service delivery model of telehealth. • Illustrate the benefits of telehealth as a service delivery model in family centered early intervention. • Diagram a proposed model to integrate tele health into current early intervention process. • Differentiate when tele health may be an appropriate model for service delivery. 2
7/30/2019 Learning Objectives • Evaluate current technology available based on HIPAA and family needs. • Integrate telehealth information into a case example for infants transitioning from NICU • Measure outcomes of tele health program and caregiver satisfaction. Mentimeter What is Tele health? Telehealth is a collection of means or methods for enhancing health care, public health and health education delivery and support using telecommunications technologies. Telehealth encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services (Hu, n.d.) (cchpca.org, n.d.) 3
7/30/2019 The Elephant in the Room Mentimeter • “I became a healthcare provider to work with people” • “How great… I can sit at Starbucks and facetime!” • “Sounds good, but is it HIPPA compliant?” • “But technology…UGH!” • “Telehealth is a specialty service” 4
7/30/2019 Regulations • Licensing/portability • Ethics • Compliance • Reimbursement • Legal Technology considerations We are living in a time of rapid and unpredictable change. Advances in knowledge and technology have made our lives more interconnected and complex” (Hinojosa, 2007, p. 629). (Birth2Work, n.d.) Technology Considerations • Considerations • Confidentiality (security, privacy) • Integrity (information protected from unauthorized users) • Availability (information, services) • Cost/benefit ratio • Socio – economic considerations • Using existing infrastructure • Technology connection requirements • Sound and image quality • Accessibility of equipment • Provider/ and user comfort ad expertise with technology 5
7/30/2019 Telehealth and Early Intervention Telehealth in early intervention • Ability to provide services in natural environment • Tele health model utilizes coaching method of service delivery • Using telehealth allows for routines based intervention Benefits of tele health • A review of evidence indicates that outcomes for a tele health service delivery model are the same or higher than of traditional methods. It is also of significance that multiple studies, across multiple age groups indicate a high level of caregiver satisfaction with the tele health service delivery model (Cason, 2014;Cottrell et al, 2018) 6
7/30/2019 Provider Benefits • Decreases travel constraints • Reduces health-related cancellations • Facilitates access to interpreters • Increases use of family-centered coaching strategies • Supports family involvement goals • Provides access to qualified providers • Provides opportunities to work as a team Benefits for Families • Increased child responsiveness to parent • Increased skills of family members • Improved child language development and listening skills • Increased confidence in promoting childs skills Coaching • The mission of early intervention and the purpose of effective help giving practices is to build the capacity of parent, support and enhance parent confidence and competence and assist parents and other care givers in sustained achievement of desired outcomes 7
7/30/2019 Reflection • Type of questions – Awareness – How did that work for you? Why? – Analysis- What did you do that got that outcome? – Alternative- What different things could you have done? – Action- What do you plan to do next time? Why? • Question Content – Knowledge and understanding (what you know) – Practice ( What did you do) – Outcome ( What was the result) – Evaluation ( what about the process) Tele health in action • Video Case example • Baby was born at 23w2d. Age at discharge 4 months, corrected age at discharge 44weeks 2 days. DX: LBW < 1200 grams, good bottle feeder, 02 1/32, ROP, IVH, GERD, difficulty with sleep routine. Family has infant digital scale, Dr. Brown bottle preemie nipple system. Family concerned about travel outside of the home due to mom primary caregiver to maternal grandmother who lives with this family. How can EI thru Telehealth be helpful and where to start? 8
7/30/2019 Mentimeter Case Example • 6 month old child with Spina Bifida and bilateral club feet. Receiving service coordination and occupational therapy services. Child has 3 caregivers during her week, what are some ways the telehealth program can improve communication between parents and caregivers? Mentimeter 9
7/30/2019 Case examples • Case study two: • Baby born at 31.5 weeks, Turner syndrome, low muscle tone, weak suck, possible vision concerns. • Baby is 4 months old and struggling with weight gain, and delayed gross motor skills. • Family has two older children, live in rural situation, and are two and a half hours from the nearest Pediatric Therapy Center. • How can we help this family thru Telehealth? Mentimeter Outcome Measures Interview and observation-based assessments is the best match for telehealth service delivery model. • RBI/SAFER • Parent Satisfaction Survey • COSF • Interview based 10
7/30/2019 QUESTIONS? (technotparent, n.d. ) Mentimeter References • Benzies, K., Magill-Evans, J., Hayden, K., & Ballantyne, M. (2013). Key components of early intervention programs for preterm infants and their parents: a systematic review and meta- analysis. Pregnancy and Childbirth , 13, 1-15 • Cason, J. (2014). Telehealth: A rapidly developing service delivery model for occupational therapy. International Journal of Telerehabilitation, 6 (1), 29-36. doi:10.5195/ijt.2014.6148 • Center for Connected Health Policy. (n.d.). Retrieved from https://www.cchpca.org/ • Clawson, B., Selden, M., Lacks, M., Deaton, A. V., Hall, B., & Back, R. (2008). Complex pediatric feeding disorders: Using teleconferencing technology to improve access to a treatment program. Pediatric Nursing , 34 , 213-216. • Cottrell, M. A., Hill, A. J., O’Leary, S. P., Raymer, M. E., & Russell, T. G. (2018). Clinicians’ perspectives of a novel home-based multidisciplinary telehealth service for patients with chronic spinal pain. International Journal of Telerehabilitation, 10(2), 81-88. https://doi-org.prx- usa.lirn.net/10.5195/ijt.2018.6249 • Hinojosa, J. (2007). Becoming innovators in an era of hyperchange. American Journal of Occupational Therapy , 61 , 629-637. • Kelso, G., & Olsen, S. (2009). The feasibility of virtual home visits to provide early intervention. Infants & Young Children , 22 , 332-340. • Little, L. M., Wallisch, A., Pope, E., & Dunn, W. (2018). Acceptability and cost comparison of a telehealth intervention for families of children with autism. Infants & Young Children, 31 , 275- 286. Retrieved from http://prxusa.lirn.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edsgin &AN=edsgcl.560648317&site=eds-live • Rush, Dathan D., Shelden, M’Lisa L. (2011). The Early Interventions Coaching Handbook, Paul Brooks Publishing, Baltimore Md. • Special thank you to CB for the use of his video 11
7/30/2019 Break – Save the Dates September 20, 2019 NICU Consortium Partnership Annual Meeting November 1, 2019 Celebrating World Prematurity Month “Creating a Community of Support for Babies and Their Families After Discharge from the NICU” Families Perspectives of Telehealth in Early Intervention Moderator: Beth Cole Provider Relations Manager Early Intervention North Metro Missy Oiler, Service Coordinator The Resource Exchange Lisa Bisbee, Service Coordinator Nancy Haddad, Service Coordinator Mesa County Developmental Services Jeanie Larsen, Service Coordinator North Metro Missy Oiler Service Coordinator 12
7/30/2019 Mesa County Developmental Services Jeanie Larsen Service Coordinator • Families served by TV1 • Families receiving private OT • Families receiving private SLPA • Families served through Alliance primarily for speech The Resource Exchange Lisa Bisbee Service Coordinator Nancy Haddad Service Coordinator Early Intervention 13
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