Mobility Feature
A look at the cost-effectiveness , efficiency and quality of using telehealth as the primary assessment tool within the Highland Blue Badge service .
Mobility Feature
The clinical benefits of telehealth
A look at the cost-effectiveness , efficiency and quality of using telehealth as the primary assessment tool within the Highland Blue Badge service .
D
uring the 2022 Elizabeth Casson Memorial Lecture , Dr Sidney Chu discussed the importance of delivering occupational therapy services efficiently , to effect clinical outcomes cost-effectively ( Chu 2022 ). As costs and demand for health and social care services increase , there is a need to critically examine not only clinical outcomes , but also the organisational infrastructure of service efficiency and cost-effectiveness ( Chu 2022 ).
In response to the call for the occupational therapy community to consider how our services are delivered , the authors felt a recent honours degree project was relevant for the discussion . This article outlines the service evaluation collaboration between Queen Margaret University and the Highland Blue Badge service and shows how students can gain practical skills while contributing to practice-relevant evaluation projects .
Our role
The Blue Badge service is a national scheme , providing accessible parking spaces for those with a physical disability or who may pose a risk to themselves or others in traffic ( Department of Transport 2021 ).
Occupational therapists working within Blue Badge services are identified as independent mobility assessors ( IMAs ). The role of the IMA is to determine an applicant ’ s eligibility for a Blue Badge ensuring an objective , efficient assessment . Within the Scottish Highlands , there is one part-time IMA post .
The Scottish Highlands are a rural area of Scotland with a population of approximately 310,000 ( Ruf et al 2019 ). The Blue Badge service provides an important link for accessible transport in an area characterised by its diverse and at times challenging geography .
Continued service delivery during the COVID-19 pandemic was considered integral to facilitating occupational engagement and access to essential goods and services , such as shops and healthcare .
Service evaluation
Before the pandemic , service users in NHS Highlands were assessed face-to-face , requiring the IMA to complete assessment clinics across the Scottish Highlands , dependent on the needs of the service and geographical location of service users .
However , to comply with public health advice , telehealth methods – including video using the ‘ Near Me ’ platform – and telephone assessment were introduced , with virtual assessments carried out from the base clinic in Inverness .
Literature suggests clinics in rural areas can benefit from telehealth as it can reduce waiting times , facilitating a more efficient healthcare assessment , while specifically reducing the travel requirements to and from the main district hospital in the Highlands ( Garfen et al 2020 ; Ruf et al 2019 ).
However , telehealth is not without limitations , particularly when assessments need to be conducted face to face , to ensure their accuracy and validity ( Garfen et al 2020 ).
As little literature was available regarding the current use of telehealth in other Blue Badge services , the service evaluation was intended to act as a reference point for the sustainability of telehealth assessment within this service and across other Blue Badge services .
In order to guide a telehealth service evaluation , the Non-adoption , Abandonment , Scale-up , Spread and Sustainability telehealth framework ( NASSS ) can be used by assessing barriers and enablers to the sustainability of telehealth technology within seven domains ( Greenhalgh et al 2017 ).
48 OTnews October 2023