Pediatric TeleRehabilitation Consultation

1
Pediatric Tele-Rehabilitation Consultation
Follow-up to Rural Clients

• David Thompson Health Region
• Clearview School Division
• Prairie Land Regional Division
• Presenter Kerry McKinnon RSW

2
Overview of Proposed Clinical Objectives

• Supplement existing rehabilitation services (OT,
  PT, SLP) to pediatric clients living in the
  eastern part of the health region (Hwy 12)
• Integrate tele-rehabilitation services at two of
  the five rehab sites (RD Drumheller)
• Increase therapists contact time with clients
• Integrate the videoconferencing capabilities of
  the education health sectors to improve
  services to children

3
Overview of Target Groups

• Students aged 2 1/2 to 18 years of age
• Identified by the schools with developmental
  delays, physical disabilities, or chronic health
  conditions that affect their ability to learn
• Living in communities within the boundaries of
  Clearview or Prairie Land school jurisdictions
  (4 hrs to 6 hrs drive time (return) from Red
  Deer or Drumheller)

4
Participating Communities
5
Update

• 13 children were seen by Occupational or Physical
  Therapists for a total of 19 therapy visits and
  13 case conferences.
• Additional uses of Videoconference Equipment
  were
• 11 Meetings with other health care providers
• 10 Inservices
• 2 Hospital discharge conferences

6
DVD

• Prior to a VC visit, therapists fax out
  information, materials needed, and instructions
  to the Education Assistant, so they are prepared
  once the visit starts.
• Well see a short video to demonstrate a visit in
  action.

7
Challenges met successfully

• Using VC equipment and rooms, designed to meet
  the educational needs of students, in a clinical
  application
• The room size was not a problem for our
  Occupational Therapist. Our ability to zoom in
  with the camera from our remote location allows
  us to see the child and his or her work very
  clearly.
• The Physical Therapist found small room sizes
  problematic.

8
Challenges met successfully

• Acceptance of Videoconferencing by therapists
• Therapists report great satisfaction in the use
  of this equipment as an enhancement to in person
  visits. It was found to be a useful therapeutic
  tool.
• Therapists can adequately perform follow-up
  visits to monitor and advance therapeutic
  programs and support the function of children in
  the classroom.

9
Challenges met successfully

• Will more contact with therapists improve the
  confidence of clients, parents, teachers, and
  educational assistants?
• Early results indicate great satisfaction with
  the additional services
• Videoconferencing provides school staff with
  additional support and opportunities to integrate
  therapeutic activities into classroom settings.

10
Update on Challenges

• Concern that VC may replace existing, if minimal,
  face-to-face contact with therapists.
• Therapists strongly recommend a minimum of three
  in person visits during the school year.
• Both OTs and PTs have identified there are some
  activities that need to be done in person such as
  assessments and the demonstration of some
  activities.

11
Remaining Challenges

• Scheduling and rescheduling of visits has been
  cumbersome and time intensive.
• Small technical glitches have affected picture
  clarity at times and staff tend to forge on
  rather than call for technical help.
• Obtain doll to help PT demonstrate things like
  hand placement

12
Preliminary Findings

• Using VC equipment in other sectors did support
  the delivery of health care through therapy
  visits, case conferences, meetings and
  inservices.
• The use of VC equipment in the context of
  pediatric rehabilitation is seen as enormously
  successful. We enjoy the clear images and the
  user friendly equipment.
• The use of VC does allow DTHR to maintain
  services to under-served communities when human
  resources are affected (e.g., illness or
  maternity leaves) and in inclement weather

13
Conclusion

• This has been a successful pilot project
• We are currently surveying and compiling the
  results.
• We are giving consideration to extending the
  project to additional school divisions where
  distance is a challenge.

14
Grand Finale