Technology guidance

Technology in speech and language therapy

Technology has expanded the boundaries of speech and language therapy.

Technology may be used for:

• Communication between professionals
  • Telephone and  video call/conferencing
  • Email
  • Electronic records
  • Twitter
• Communication between service providers and users 
  • Text message
  • Email
  • Video calls
• Promoting therapy services
  • Websites
  • Twitter
  • Facebook
• Networking
  • Online forums
  • Blogs
  • Social media
• Enhancing knowledge and development
  • E-learning
  • Accredited websites
  • Online journals and research databases

Technology may be used in:

• Provision of therapy services

For example:

• Apps
• Software packages
• Telehealth
• Support and augmentation of communication

For example:

• Disability access features on tablets
• Videos and pictures to support understanding and expression – these may be generic (eg YouTube, google images) or specialised (eg aphasia friendly iBooks and apps).
• Apps that support reading, writing and talking
• Voice banking
• Easy access information websites

The huge application of technology can make it difficult to regulate. Boundaries between personal and professional use of technology can become blurred, as can the boundaries between service user and service provider’s use of technology.

Find out more about your responsibilities, see the technology – learning page

Explore frequently asked questions, or test your response in technology based scenarios.

Responsibilities

Speech and language therapists are responsible for familiarising themselves with local policies and guidelines relating to technology. They are also responsible for highlighting any security risks and breaches that they identify during the course of their work.

Independent practitioners: should develop their own policies relating technology, in line with guidance from the Information Commissioner’s Office (ICO).

Technology continues to advance rapidly. Speech and language therapists should be aware that current information is subject to change, and carry out their own research on advances in technology and new guidance/standards, in order to make informed decisions about technology.

There are national guidelines to cover the use of technology.

Visit Health Care Professions Council (HCPC) for supporting guidance on adhering to regulation standards. Key sections include:

• Promote and safeguard the interests of service users and carers
• Communicate appropriately and effectively
• Respect confidentiality
• Manage risk

It also highlights the importance for all speech and language therapists to:

• Understand the legislation
• Act as resource investigators
• Build supportive infrastructure
• Work in partnership

Benefits and challenges

Technology has the potential to:

• Improve time efficiency
• Improve quality of services
• Expand types of services offered
• Improve access
• Reduce cost

New technology can be difficult to implement. It requires:

• Understanding of how to source funding
• Understanding of information governance issues
• Understanding of consent / confidentiality issues
• Understanding of hardware and software security
• Knowledge of the technology itself

Working with stakeholders and creating robust policies and procedures is essential.

Some technology is unregulated and has little research base. Speech and language therapists need to explore the evidence before implementing new technologies. RCSLT Research centre

However, new guidance and support for using technology is coming online all the time, this means improved regulations; assurance of quality and standards. For example NHS digital has recently launched a BETA Digital Apps Library, listing NHS approved apps. The technology learning resource page contains further resources that support researching quality-assured technologies.

Service-users may be keen to use technology as part of their care. The National Office of Statistics report that in 2017 90% of UK households had internet access and 73% of adults access the internet “on the go” using mobile devices. There are many benefits and risks to supporting service-users to access technology.

The Centre for Workforce Intelligence (2014) predicts one possible future where health care services fail to act and grasp the opportunity of technology. Patients go elsewhere, sourcing unregulated resource of varying quality.

BBC news report 2017 reports on the growth of secret recordings by service-users of their professional assessments.

Implementing new technology

Initial Investigations:

• What is the technology required for?
• Is the chosen technology fit for purpose, will it achieve what you need?
• What is the evidence-base?
• How do others use it?
• Do you have the infrastructure to support it?
• Does it need access to the internet?
• How does it fit with service strategy?

Initial Considerations:

• How much does it cost?
• Is the cost recurrent – increasing numbers of online software providers, do so by monthly subscription services.
• Is there a support service available?
• How will hardware be maintained, repaired, replaced?
• Who will be responsible for it?
• What are the security issues – both physical and digital?

Funding:

Funding needs to consider the issues mentioned above. If is not available from within the speech and language budget you may wish to consider:

• Local Hospital League of friends
• School League of friends
• Hospital consultant’s research budget
• SLT Budget? Check for underspend due to maternity/staff vacancy
• Hospital charity
• Ex-patient fundraisers
• Hospital Trust – Capital Funding Bid
• NHS Regional Innovation Fund
• NHS technology fund (£1bn was made available to upgrade NHS networks nationwide)
• Local golf club
• Rotary Club/Lions
• Social Media/Crowd funding/Radio Appeal
• Charitycommission.gov.uk – search for charities here
• Stroke Association
• MNDA
• Tavistock Trust for aphasia – individual software funding
• The Stammer Trust
• SLT Trust Fund – RCSLT Welfare fund offers grants for specialist medical equipment

The Computers in therapy toolkit CIT CEN contains download forms and letters for applying for funding.

Implementing:

New hardware and software should be recorded on a database.

Liaise with relevant stakeholders to create robust policies and procedures for use of the new technology. Policies and procedures should cover the following issues in relation to technology:

• Provision, monitoring, use, maintenance and disposal of assets
• Information governance – how will content generated be recorded and stored under the data protection and freedom of information acts?
• Consent and confidentiality – how will service users consent to use of the technology and how will any personal information stored on it be kept confidential
• Security
• Infection control

Liverpool Community Health NHS Trust has produced a document on device allocation SALT device allocation (2017).

Evaluation

How will the new technology be evaluated?

• User feedback
• Formal outcome measures
• Audit

National Legislation and Guidance

National legislation:

Data Protection Act (1998)

Defamation Act (2013)

Computer Misuse Act (1990)

Freedom of Information Act (2000)

Guide to the General Data Protection Act (2018)

Find specific guidance on Communication Technologies, Telehealth and Apps

NHS-specific policies include:

Government Digital Services (2017). Code of Practice for Technology.

NHS Digital (2015) Information and technology for better health care

NHS England Social media and comment moderation policy

Social Media All Wales Policy

NHS Education for Scotland policy.

NHS Trusts will have their own information governance policies regarding the use of communications technology such as telephone and e-mail correspondence. Many NHS trusts are also developing their own social media policies.

National frameworks and guidance

BMA Social Media Guidance. Using social media: practical and ethical guidance for doctors and medical students.

Digital Health and Care Scotland. Information Governance Assurance.

General Medical Council. Doctors’ use of social media.

Health Education England – The Topol Review. Preparing the healthcare workforce to deliver the digital future.

Health Education England. Development of a digital competency framework for UK Allied Health Professionals.

Healthcare Improvement Scotland. How we use social media.

NHS Choices and NHS England outline their comments policy on their websites.

NHS Employers. HR and social media in the NHS.

NHS Information governance toolkit: information security assurance detailed guidance on secure transfers.

NHS England. A Digital Framework for Allied Health Professionals

Definitions

Telehealth is the provision of healthcare services remotely using technology such as video conferencing. Telehealth is often used interchangeably with telemedicine, telepractice and, in the case of speech and language therapy, synonymously with telespeech and teleslp.

Bandwidth

Amount of data that can be sent from one computer to another through a particular connection in a certain amount of time, e.g. via a computer to the Internet and vice versa.

The more bandwidth available, the faster you are able to access information. Bandwidth is usually measured in kilobits per second (Kbps) or megabits per second (Mbps).

Document reader

Digital imaging hardware that allows paper copies of documents to be projected on to the shared screen allowing the therapist and client to view the same objects. Therapists can often make instructional objects appear larger in order to demonstrate in detail to clients and caregivers.

Hardware

The physical parts of a computer system, e.g. monitor, mouse, keyboard, etc.

Host device

Computer or other device connected to a computer network as the prime device in a telehealth setting, e.g. a video conference. The host may offer information resources, services, and applications to other users on the network.

HTTP endpoints

An endpoint is the service that processes server calls and returns data to the user.

To display Internet-based information on your computer screen, your computer makes a call to a remote server. The server returns information that is interpreted by your browser to form the website or an application displayed in your browser.

Learning platform

Technology used to provide a single online location at which course resources can be made available to learners. These resources can include course materials, communications tools such as email and conferencing, and a storage area for learners’ work.

Platform

Group of technologies that are used as a base upon which other applications, processes or technologies are developed. In personal computing, a platform is the basic hardware (computer) and software (operating system) on which software applications can be run.

Platform-independent

Software that runs on any type of computer.

Software

Generic term that describes all kinds of computer programs, applications and operating systems. Software is not tangible; it is a set of instructions written in a programming language executed by the computer.

Webinar

Live meeting that takes place over the internet. It can be used to deliver training, host/attend meetings, have discussions and meet with many people all at once.

References

See Technology – Learning page