Service Delivery Methods
Following are service delivery methods used by audiologists and SLPs, including the use of interprofessional education and interprofessional collaborative practice (IPE/IPP).
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See also: Medical Necessity
Individual Treatment
Individual treatment consists of services that a clinician provides directly (i.e., one-on-one) to an individual patient.
Group Treatment
Group treatment consists of services that a clinician simultaneously provides to more than one individual, all of whom may be working on either similar or separate goals. In group treatment, the clinician focuses on helping the beneficiary achieve improved outcomes through receiving services in a group setting. The clinician must consistently attend all group treatment sessions, but one-on-one contact with each individual is not necessary. The treating clinician should determine group size based on how well the treatment modality can meet each patient's clinical needs. Arbitrary limitations are inappropriate.
Co-Treatment
Co-treatment refers to services provided by practitioners from different professional disciplines to effectively address distinct treatment goals in a single treatment session. Patient benefit is the primary consideration when deciding whether co-treatment is appropriate. The clinician should limit co-treatment to two disciplines within a session, explicitly document the session as co-treatment, and specify the distinct goals of each discipline.
Skilled Maintenance
In situations where improvement is not possible, skilled care is medically necessary as maintenance in order to prevent or slow a decline in function. Skilled care includes the development and periodic reassessment of a maintenance program—a care routine designed to keep the person at their current level of function. Once the clinician establishes the maintenance program, the clinician does not need to be regularly involved in treatment, except to ensure patient safety and periodically update the plan of care and adjust the maintenance program for maximum effectiveness.
Telepractice
Telepractice (also called telehealth, tele-speech, and tele-audiology) is the application of telecommunications technology to the delivery of audiology and speech-language pathology professional services at a distance by linking clinician to patient (or clinician to clinician) for assessment, intervention, and/or consultation. Telepractice represents a method of service delivery rather than a treatment approach. Telepractice services must be equivalent in quality to those delivered in person. See additional clinical guidance from ASHA for telepractice specific to audiology and speech-language pathology.
See also: Telepractice resources during COVID-19.
Consultation
Consultation with other professionals and with the patient between direct treatment sessions will maximize treatment outcomes and will provide opportunities to monitor progress and respond to changes in the patient's environment.
IPE/IPP
Coordinated interprofessional education and interprofessional collaborative practice (IPE/IPP) and patient-/client-centered care enhance clinical outcomes. A wide variety of professionals collaborate with audiologists and SLPs based on each client's individual needs. Regular collaboration is an essential element of effective care coordination.
