Telepractice in family support: what does it take?


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Elly Robinson of the Parenting Research Center looks up what the child and family services sector can learn from moving to remote service during the pandemic, and outlines five areas that provide a roadmap for change.

After the outbreak of the COVID-19 pandemic last year, a large number of social services switched to long-distance delivery. This included the use of online and telephone-based technologies such as video conferencing platforms and telephone-based services to provide support that has traditionally been provided in person. In the child and family services sector, we have called this type of delivery “telepractice”, pointing out the similarities with telemedicine, but also the differences.

The uncertainty surrounding COVID, reflected in recent lockdowns, slow vaccination rates, and ongoing hotel quarantine issues, will continue to affect family care and support for some time. However, it is also increasingly recognized that a mixed model of care, including telepractice and personal services, can increase the availability of support to parents and children, including previously excluded or non-engaged groups. Mixed care models already widespread in the health sector would lead to service offerings that better fit the way families live and work in Australia today.

However, as technology-based approaches to service delivery in the child and family services sector have been underutilized compared to the health sector, there is a need to pool some energy at both the political and contract level and within the service delivery organizations in order to build up the sector Modes to use.

This is important because early experience with telepractice tells us that in some people, telepractice increases their engagement with services, which in turn helps participants achieve better outcomes (e.g. our service level data shows that telepractice has opened up more opportunities to connect with men and fathers, particularly in the service areas of family dispute resolution, anger management groups and parenting programs.

A Article by Emma Thomas and colleagues from the Journal of Telemedicine and Telecare outlined five priority areas for the long-term sustainability of telemedicine:

  1. Develop a qualified workforce
  2. Empowering consumers
  3. Reform funding
  4. Improving digital ecosystems
  5. Integration of telepractice into routine care

If we look at this from the perspective of “telepractice”, we see several focal points that would contribute to promoting the use of a blended model in child and family services.

Area 1: Skilled Workforce Development

This area focuses on building the additional skills and support required to deliver care via telepractice. The more successfully telepractice is used, the more likely the practitioner will be comfortable. However, due to the comparatively slow spread of telepractice compared to telemedicine, the focus of skills development in social services may be different. There is a need for increasing digital literacy, ongoing technical support and training for staff, and support with implementation that can help improve consistent and sustainable practice.

Area 2: Empowering customers

There is still work to be done to better understand customer needs in relation to telepractice and to find ways in which customer-centric models can be adopted in this area. This includes gathering information about clients’ experiences and understanding their expectations or preferences regarding access to care. Some customers may also need help building digital skills and having access to appropriate equipment and data plans that would facilitate remote access, especially in rural and remote areas. Certain customer groups, such as people with disabilities or culturally diverse families, may need tailored approaches that help increase engagement and participation in child and family services.

Area 3: Reform funding

Given the promising early signs of the impact of telepractice deployment, we believe that further investigation into the political and financial implications is warranted. This research should also take into account that telepractice is not necessarily a cheaper option for service delivery and should not replace personal services. However, more work needs to be done to understand whether increased involvement in key prevention and early intervention services translates into savings in later needs for tertiary services.

Area 4: Enhancing digital ecosystems

More thought needs to be given to how the national digital infrastructure could be improved to enable a more digitally inclusive community. This could include setting targets for telepractice use similar to those set in the UK prior to COVID-19. In the health sector in Australia, the government has funded a telemedicine technology company (Healthdirect Australia) to offer doctors a video consultation. Similar partnerships between the social services sector and IT companies could be explored, as could ways to improve digital access and access to devices for members of communities currently experiencing digital exclusion.

Area 5: Integration of Telepraxis into routine care

There is a need to develop practices that reflect an integrated and consistent approach to mixed care models. These practices could be supported by clear implementation plans. On the basis of implementation science, agencies could be provided with guidance and support in building human resources in telepraxis and in targeting implementation drivers to support consistent and faithful use in day-to-day practice. Support could include the development of a range of capacity building resources, training and skills assessment tools to maximize the reach and sustainability of telepractice support.

Conclusion

There is the potential to significantly increase people’s reach and engagement in key social services through the provision of telepractices. To do this in a way that maximizes positive outcomes for participants, a systems-level approach that engages the policy and service community is required. The five areas outlined above provide a roadmap for change. Early leadership in this area already sees great collaborative action from people across the sector, but efforts need to continue beyond the pandemic so that telepractice becomes a regular part of care for individuals and families in need of assistance.

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About Ellen Lewandowski

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