Application of telepractice for head and neck cancer management: a review of speech language pathology service models.

Purpose of review: Head and neck cancer (HNC) is a complex and heterogeneous disease, requiring specialist intervention from a multidisciplinary team including speech language pathology (SLP). Unfortunately, multiple patient and service-related challenges exist which currently limit equitable access to SLP support for all individuals. This review highlights the existing evidence for different telepractice models designed to help patients and services optimize management of swallowing and communication disorders arising from HNC. Recent findings: Emerging evidence exists for using computerized screening to enhance the identification of treatment-related toxicities and assist referrals to services, including SLP. Asynchronous telepractice applications are being used to assist delivery of intensive home-based dysphagia therapy, whereas videoconferencing can offer a feasible and effective method to support ongoing management for patients with limited access to local specialist SLP services. Patient and clinician satisfaction with all models has been high. Summary: SLP services can be redesigned to incorporate a range of telepractice models to optimize clinical care at different stages of the HNC survivorship pathway. Early evidence supports telepractice can improve patient access to services, enhance outcomes, and optimize health service efficiency; however, further systematic research is needed into these models, particularly relating to large-scale implementation and costs/economic analyses. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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