1. Transdisciplinary Care
Observation
CREATING A TELEHEALTH FIELDWORK EXPEREINCE
Amy B. VanCamp, OTD, OTR/L ✦ Tracey Ellis OTR/L, MPH ✦ Kathryn Holloran, MA, BCBA
Background
Level I Fieldwork Objectives
Telehealth is revolutionizing the way healthcare providers deliver services, but are we as educators providing opportunities for our fieldwork students to be comfortable in telehealth? Creating unique fieldwork experiences that prepare students for entry level practice while reflecting current practice trends is a top priority for OT programs across the country.  UNH OT teamed up with Tracey Ellis, UNH OT alumni and founder of International Diagnostic Solutions (IDS), to create an opportunity to see pediatric OT in a teletherapy clinic providing live, online therapy solutions to children, families, and schools across the globe.  
Professional Behaviors
Interpretations
A Snapshot in Telehealth Setting
Rationale
Telehealth FW provides the same breadth of experience as a traditional Level 1, resulting in the student’s ability to::
Articulate links between OT theory and practice
Interpret the results of client evaluation/intervention
Identify FOR used in practice
Describe clinical reasoning process
Identify & describe therapeutic value of various interpersonal styles with clients
Additional value:
Enhanced understanding of global reach of OT when geographic barriers are removed
Encourages creative ways of problem solving and creating new resources in an emerging practice area
Inspiration for new research foundations for the field of OT in telehealth
Congruent with AOTA’s Vision 2025 by promoting “effective solutions” to those clients and families living in remote or underserve areas
Aligns with ACOTE technology standard (B.1.18)
3 levels of observation:
Client
Therapist / Professionals
Self (through video capture)
Telehealth delivery:
Synchronous & Asynchronous sessions
Remote Patient Monitoring (RPM)
Mobile Health
Interdisciplinary meetings:
SLP
Teachers
Behavior analyst
Psychologist
Online platforms: Zoom, Vsee, Skype
Assessment procedures using online tools:
Direct online assessment
Video review
Q Global assessment tools)
Documentation / goal planning
Observation of professional behaviors among/between OT and other professionals during both synchronous & asynchronous sessions
Demonstrated professional behaviors during telehealth sessions:
Timeliness
Appropriate appearance
Communication (verbal, non-verbal, written, etc.)
Environmental Set-up
Flexibility
Positive attitude
Commitment to learn and educational excellence
Team player
Discussed assessment data/tool choices OT
Demonstrated telehealth technology troubleshooting in real time
Replay opportunities
Orientation
HIPAA overview
Mock telehealth sessions, scheduling, sending an introductory to “client,” hosting a short mock session, reviewing video, self reflection and feedback from IDS team 
Introduction to electronic medical record (EMR) and use of practice platform
Lecture/Presentation of Telehealth Modalities with Quiz
Transdisciplinary Care
Benefits
Experienced a new and growing delivery model for the field of occupational therapy
Replay option allows for additional opportunities to review client/therapist relationship, analysis of client performance and clinical observations and additional opportunities for interpretation in preparation for treatment planning & professional behaviors
Observed multiple supervisors which allowed for examination of diversity in therapeutic use of self
Increased comfort level with EMR
Developed greater understanding for transdisciplinary care & interdisciplinary communication
Exposed to different telehealth databases & various modes of delivery
Experienced scheduling, billing, and HIPAA integration
Utilized various apps & online resources in delivery
Limitations
References
Accreditation Council for Occupational Therapy Education. (2018) Accreditation Council for Occupational Therapy Education Standards and Interpretive Guide. Retrieved from
American Journal of Occupational Therapy. (2013). Telehealth. 67, S69-S90. doi: /ajot S69
American Occupational Therapy Association. (2017). Vision American Journal of Occupational Therapy, 71, 
Scheduling challenges due to extended duration (1 semester vs. 2 weeks)
Time zone challenges with student class schedule
Less opportunity for therapist to view student behaviors as observers given the need to limit the number of faces/screens active during therapy delivery (therapist & client vs. therapist, client, student)
Requires increased flexibility to develop relationships with clients and therapists