7/30/2019 NICU Consortium Education Program Agenda, July 31, 2019 Welcome Welcome and Introductions NICU Consortium Partner Updates NICU Consortium Committee Reports Using Telehealth for Children in Early Intervention NICU Consortium Education Becky Cohill, OTD, OTR/L Judy Delaware, OTR, Program/Webinar Families Perspective of Telehealth Moderator: Beth Cole, Provider Relations Manager, Early Intervention North Metro July 31, 2019 Missy Oiler, Service Coordinator The Resource Exchange Lisa Bisbee Nancy Haddad Mesa County Developmental Services Jeanie Larsen, Service Coordinator Adjourn NICU Consortium Partnership Members Using Telehealth for Children in Early Updates and Announcements 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 Learning Objectives: • Understand the service delivery model of An introduction to telehealth telehealth. Making Meaningful connections • 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. 1
7/30/2019 Learning Objectives Mentimeter • 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. The Elephant in the Room 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.) 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” 2
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 Telehealth and Early Intervention • 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 Telehealth in early intervention Benefits of tele health • Ability to provide services in natural • A review of evidence indicates that outcomes environment for a tele health service delivery model are the same or higher than of traditional methods. It • Tele health model utilizes coaching method of is also of significance that multiple studies, service delivery across multiple age groups indicate a high • Using telehealth allows for routines based level of caregiver satisfaction with the tele intervention health service delivery model (Cason, 2014;Cottrell et al, 2018) 3
7/30/2019 Provider Benefits Benefits for Families • Decreases travel constraints • Increased child responsiveness to parent • Reduces health-related cancellations • Increased skills of family members • Facilitates access to interpreters • Improved child language development and • Increases use of family-centered coaching listening skills strategies • Increased confidence in promoting childs skills • Supports family involvement goals • Provides access to qualified providers • Provides opportunities to work as a team Coaching Reflection • Type of questions • The mission of early intervention and the – Awareness – How did that work for you? Why? purpose of effective help giving practices is to – Analysis- What did you do that got that outcome? build the capacity of parent, support and – Alternative- What different things could you have enhance parent confidence and competence done? – Action- What do you plan to do next time? Why? and assist parents and other care givers in • Question Content sustained achievement of desired outcomes – 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 Case example • Video • 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? 4
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 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 5
7/30/2019 QUESTIONS? Mentimeter (technotparent, n.d. ) 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/ Break – Save the Dates • 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. September 20, 2019 • 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- NICU Consortium Partnership Annual Meeting 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. November 1, 2019 • 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 Celebrating World Prematurity Month http://prxusa.lirn.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edsgin &AN=edsgcl.560648317&site=eds-live • “Creating a Community of Support for Babies and Rush, Dathan D., Shelden, M’Lisa L. (2011). The Early Interventions Coaching Handbook, Paul Brooks Publishing, Baltimore Md. Their Families After Discharge from the NICU” • Special thank you to CB for the use of his video Families Perspectives of North Metro 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 Missy Oiler Nancy Haddad, Service Coordinator Service Coordinator Mesa County Developmental Services Jeanie Larsen, Service Coordinator 6
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