Improving efficiency through innovation in the ‘real-world’: feasibility of a co-designed telehealth solution for individuals with aphasia

BACKGROUND: Research indicates that speech and language therapy for individuals with aphasia delivered via telehealth is acceptable and facilitates good outcomes. Although adoption of telehealth has increased following COVID-19, it has not been implemented broadly. Telehealth could assist services to meet the recommended intensity of therapy for individuals with aphasia. OBJECTIVE: The study aimed to investigate the barriers and facilitators to adopting telehealth for individuals with aphasia at two local NHS trusts; and to co-design a telehealth solution responding to these challenges. The feasibility of this solution was also investigated. A secondary objective is to highlight the value of real-world data (RWD) collection in evaluating clinical practice. METHODS: An experience-based co-design study was conducted, which developed and piloted a bespoke telehealth solution across service pathways at two NHS sites. Feasibility was evaluated qualitatively through interviews and quantitatively from RWD collected through the telehealth software. RESULTS: The telehealth solution incorporated outsourcing of the service to a specialist company, provision of hardware and software and regular support for individuals with aphasia and their carers. Take up was associated with a positive impact and the RWD revealed a substantial increase in the hours of therapy the individuals with aphasia received. CONCLUSION: Personalised telehealth solutions which respond to local and personal needs are feasible and an acceptable way to increase the intensity of speech and language therapy for some individuals with aphasia, bringing services more in line with evidence-based recommendations and optimising patient outcomes. Embedded RWD collection systems are valuable for evaluation.