These include ( Greenhalgh et al 2017 ):
• suitability of telehealth for assessment of the health condition
• benefits and challenges of the technology
• value proposition
• benefits and challenges for those adopting the technology
• impact of the technology at organisational
• wider systems level
• overall evaluation of adaption over time .
Due to time constraints , domains one to five were a focus for this project .
Considering the above domains of the NASSS framework and in line with the Casson Memorial Lecture 2022 , the aim of the project was therefore to evaluate the cost-effectiveness , efficiency and quality of telehealth assessment within the Highland Blue Badge service , through the following objectives :
• Identify any cost and time savings ( costeffectiveness ) associated with telehealth for travel expenses and staff travel time .
• Understand how processing times ( efficiency ) of assessment were impacted through telehealth .
• Determine whether quality has been maintained through understanding if service users were satisfied with the outcome of their telehealth assessment , identifying if this is a sustainable assessment method moving forward .
In order to meet these aims , a six-month period was selected from both assessment groups to allow for comparison between face-to-face and telehealth assessment . Pre-existing data collected by the service was summarised to show the number of assessments completed in each period , outcomes in terms of whether a Blue Badge was approved , processing times , locations of assessment clinics , which would have been necessary if a face-to-face service had been maintained during COVID-19 , and finally whether the assessment outcomes were appealed .
What the project means for practice
Placing a student with the Blue Badge Service to analyse data not only helped to answer questions arising from the NASSS framework , but also supports Dr Chu ’ s findings , along with highlighting the benefits of student collaborations to facilitate service evaluation .
The absence of travel to assessment clinics during the six-month COVID-19 period , produced a saving of 1,534 miles , while also facilitating an increase in clinical practice time of 34.1 hours . This in turn also reduced the overall Blue Badge average assessment processing time from 48.6 to 26.2 days ( a reduction of 22.4 days ) or approximately three weeks ( see figure 1 ).
© dragana991 via Getty Images
Average number of days to process Blue Badge assessments pre and during COVID-19
60
50
Processing time ( days )
40
30
20
10
Pre-COVID-19 COVID-19
Inverness Fort William Thurso Kingussie KOL GOS Golspie
41.7 |
46 |
47 |
56 |
0 |
0 |
27.8 |
25.6 |
32.7 |
33 |
17.3 |
24.1 |
Location of clinics
52.3 23.2
0
Figure 1 : Average processing times
October 2023 OTnews 49