keskiviikko 31. heinäkuuta 2013

Suomalaisesta etäpuheterapiasta - englanniksi

Ennen kuin perustin suomenkielisen blogini ( noin vuosi sitten bloggasin hetken etäpuheterapiasta englanniksi. Sittemmin ymmärsin, että vaikka kansainväliset kontaktit ovat tärkeitä, on vielä tärkeämpää tarjota tietoa etäpuheterapiasta suomeksi, suomalaisille puheterapeuteille. Eivätkä kansainväliset kontaktini hävinneet suomeksi blogatessani, vaan saan sekä tarjottua tietoa suomalaisille kollegoilleni että pidettyä englanniksi yhteyttä kansainvälisiin kontakteihini.

Ohessa eräs, internetin syövereistä löytynyt kirjoitukseni englanninkielisen blogini ajalta. Pyrin kirjoituksessani kuvaamaan maailmalla asuville, etäpuheterapiaa jo toteuttaville ammattilaisille etäpuheterapian tilaa Suomessa nykyään ja sen tulevaisuutta myöhemmin.

Having questions, ideas or arguments? Just comment this blog post, I’d be glad to discuss this topic!

Telepractice in Finland – Current status and future?

I have been asked many times what are the challenges telepractice is facing in Finland. In my humble opinion, there are multiple factors that are influencing telepractice and its status in Finland. So here’s a little wrap-up about my own opinions about this issue.

Telepractice (speech therapy via videoconferencing over the internet) in Finland is at the moment very unknown method. There’s no research about this subject in finnish. We also don’t have any materials, information or manuals about the subject what so ever. The method has been mentioned in a few articles, but within only one sentence. I have emailed every finnish university that teaches logopedics and none of them had any knowledge about this subject. There are few pilot try outs on telepractice in Finland, but there are very limitedly reported. Also, the pilots have been short and haven’t continued after the time limit.

So technically, we’re starting from scratch.

What needs to be done so that telepractice would be widely known, widely utilized and actively researched and documented in Finland? It seems to me that we have all the chances making telepractice work well and widely in Finland. Here’s why: Finland is the only country in the world that has statute that parallels internet connection with telephone and postal services. Meaning, that it is the law, that citizen must have access to a 1 Mbps broadband internet connection from hes/hers permanent residence. Our telecommunications infrastructure is well built, and actively developing. Finnish citizens are used to using computers and internet and almost all of us have a cellphone (or even two!). Many university hospitals already also have proper video conferencing systems in use, that could be utilized with telepractice as well.

So we have the basics ready – how about our motivation then? Our long geographical distances, four changing seasons and aging population are straining our healthcare system and challenging our few speech-language pathologists. Many municipalities haven’t had SLPs in years, and are facing many more years in the future. SLPs are struggling to provide even the most urgent and important assessments and rehabilitation for their clients. Every year even fewer new SLPs are graduating because of the education reducements. It seems like we should be embracing telepractice already! Why aren’t we?

The biggest issue at the moment – in my opinion – is that we don’t even know that this kind of method even exists yet. By raising the awareness we’re pushing telepractice forward little by little. So how SLPs react when they hear about telepractice? It mostly depends who much time do you have to discuss about the subject with them. Just mentioning about it might leave them with false impressions. I myself use two finnish terms about telepractice, mostly depending on how formal the situation is: remote speech therapy (etäpuheterapia) and speech therapy via videoconferencing (videovälitteinen puheterapia), the second term being a bit more formal than the first one. If I just mention those terms, most people think that remote speech therapy means independent speech therapy tasks that you can perform over the internet, without any SLP intervention. So they think it’s like a one-way game. With the second term people often think that SLP has a pre-recorded video about the client that he/she is assessing. So no two-way connection in there either. When I tell them, it’s like using Skype – in fact, some SLPs are using Skype to provide speech therapy in telepractice settings – most of the SLPs understand what I’m talking about.

Eventhough there are few SLPs in Finland who understand and are “into” telepractice already, most of the SLPs react to this subject either neutrally or negatively. Neutrally reacting SLPs understand the methods potential, yet they feel like it’s not for them. “Good for you, that sounds interesting!”. SLPs reacting negatively often question how speech therapy could possibly be offered while not being physically in the same room with the client. Depending on how much time do I have and how negatively these people are actually reacting, I’m trying to enlighten them about the basics of telepractice and effectiveness studies that have been made about the subject. When offering proper information about telepractice I’m allowing other SLPs to form their own opinion about this subject – based on the research and studies made about it. Either it’s positive, neutral or negative. Understandably, most of the SLPs feel like this method is not for them. At this point, SLPs have to be pretty open-minded and technologically oriented, that they would feel like using telepractice in their work. But that’s okay – most important thing is that they know right facts about this method. Hopefully somewhere in the future we have such ready settings for this method, that SLPs don’t have to be tech-gurus or pioneers on this subject to utilize it.

Okay, so I know about telepractice and I like it. How do I use it? With what kind of clients? What do I need to make it work? As told, we don’t have any research about this subject in finnish. We’re also missing manuals and operating models. This is actually the issue that I myself am currently researching: translating english telepractice studies and materials into finnish, trying to create continuous and clear “users manual” for telepractice. I’m hoping this issue might actually be my Master’s thesis’ subject. Finnish SLPs surely can understand english, but patchy instructions all over the internet need to be translated, put together and adapted into finnish language and culture. Trying to create a simple, yet extensive checklist and manual what you need to know about telepractice and how you can start using it.

I feel like that after creating this kind of a so-called formal manual it’s possible to provide consistent, secure and researchable speech therapy via telepractice. These manuals also need to be eventually tested in practice and develop these manuals with the information received in the testings. After the pilots these manuals are hopefully useable in clinical work, allowing SLPs to provide speech therapy via telepractice in real life. When having the proper manuals for telepractice, hopefully Kela (The Social Insurance Institution of Finland) would also start to cover telepractice in time. Kela coverage would allow private SLPs to provide telepractice for their clients. Though, this method also needs to be introduced to municipal healthcare.

So here are my thoughts on telepractice in Finland – it’s current status and it’s future. Having questions, ideas or arguments? Just comment this blog post, I’d be glad to discuss this topic!

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