Telepractice is the application of telecommunications technology to the delivery of speech language pathology and audiology professional services at a distance by linking clinician to client or clinician to clinician for assessment, intervention, and/or consultation.
Supervision, mentoring, pre-service, and continuing education are other activities that may be conducted through the use of technology. However, these activities are not included in ASHA’s definition of telepractice and are best referred to as telesupervision/distance supervision and distance education. See ASHA’s Practice Portal page on Clinical Education and Supervision for a detailed discussion of telesupervision.
ASHA adopted the term telepractice rather than the frequently used terms telemedicine or telehealth to avoid the misperception that these services are used only in health care settings. Other terms such as teleaudiology, telespeech, and speech teletherapy are also used by practitioners in addition to telepractice. Services delivered by audiologists and speech-language pathologists (SLPs) are included in the broader generic term telerehabilitation (American Telemedicine Association, 2010).
Use of telepractice must be equivalent to the quality of services provided in person and consistent with adherence to the Code of Ethics (ASHA, 2016a), Scope of Practice in Audiology (ASHA, 2018), Scope of Practice in Speech-Language Pathology (ASHA, 2016b), state and federal laws (e.g., licensure, Health Insurance Portability and Accountability Act [HIPAA; U.S. Department of Health and Human Services, n.d.-c]), and ASHA policy.
Telepractice venues include schools, medical centers, rehabilitation hospitals, community health centers, outpatient clinics, universities, clients’ homes, residential health care facilities, child care centers, and corporate settings. There are no inherent limits to where telepractice can be implemented, as long as the services comply with national, state, institutional, and professional regulations and policies. See ASHA State-by-State for state telepractice requirements.
Common terms describing types of telepractice are as follows:
Synchronous (client interactive)—services are conducted with interactive audio and video connection in real time to create an in-person experience similar to that achieved in a traditional encounter. Synchronous services may connect a client or group of clients with a clinician, or they may include consultation between a clinician and a specialist.
Asynchronous (store-and-forward)—images or data are captured and transmitted (i.e., stored and forwarded) for viewing or interpretation by a professional. Examples include transmission of voice clips, audiologic testing results, or outcomes of independent client practice.
Hybrid—applications of telepractice that include combinations of synchronous, asynchronous, and/or in-person services.
Clinicians and programs should verify state licensure and payer definitions to ensure that a particular type of service delivery is consistent with regulation and payment policies.