Telehealth Recommendations for Dysphagia Management during COVID-19

INTRODUCTION

Up until now, the use of telehealth for the management of dysphagia in the US and globally was a reality for only a few researchers and clinicians. Despite well-intentioned research efforts, legal, reimbursement, and licensure restrictions significantly limited its use, especially in medical settings and for the adult populations. Today, we face a situation where medical care is rapidly adapting to try and address this unprecedented pandemic and save as many lives as possible. Dysphagia care needs to adapt accordingly, and unfortunately this has to be done while legal, reimbursement, and practical guidelines and policies continue to evolve and change. Undoubtedly public health, as well as patient and clinician health and safety, should be prioritized. The use of telehealth, when based on current evidence-based practice and conducted ethically and with established guidelines, can allow our profession to continue offering some of our services using this valuable service delivery modality. For peer-reviewed telehealth research articles discussing the evidence level of this modality for dysphagia services specifically, please see list of citations.

This webpage serves as a resource guide with practical recommendations for clinicians who want to consider adapting their practices and adopt telehealth solutions for dysphagia management both ethically and safely. Given the evolving nature of the situation, this website is a living resource and will be updated regularly. We absolutely welcome feedback and suggestions for additional resources. The recommendations offered herein are based on published policy documents available at the time of publication, high quality peer-review research, and our lab director’s 14 years of clinical and research experience in the tele-management of dysphagia. This resource guide has three parts: A) Introduction and Initial Considerations, B) What to know BEFORE you get started (privacy, security, reimbursement, legal safeguards), and C) How to do this – Technology and Practical Guidelines and Caveats. Click on each link below to review the respective recommendations, resources, and tips. This information was designed to be read in order, so please read through sections sequentially, starting with Part A.

Before you start, check out this TELEHEALTH CHECKLIST FOR DYSPHAGIA, which you can also use as a guide as you review the material!