Asynchronous Telehealth for Dysphagia Management: Evidence, Possibilities, and Practical Examples.
Cagla Kantarcigil, Rebecca Frances Smith, Bonnie Martin-Harris and 2 others
Asynchronous telehealth for dysphagia is a viable addition to in-person care.
The strongest evidence cited is one study of 19 children with cerebral palsy showing substantial to excellent agreement between remote and in-person swallowing assessment. It cannot replace hands-on examination.
Key findings
1In a study of 19 children with spastic cerebral palsy (aged 6.9 to 17.5 years), three trained clinicians found substantial to excellent agreement between in-person and asynchronous telehealth assessments using the Dysphagia Disorder Survey, covering oral motor skills, swallowing safety, and overall dysphagia severity.
2A pilot study with 15 oropharyngeal cancer patients found that SwallowIT, an app guiding home-based swallowing exercises with instructional videos and text, was rated easy to use, convenient, and motivating, with flexibility that helped patients adhere to therapy goals.
3The review identifies that asynchronous telehealth cannot provide real-time hands-on assessment, that not all patients have reliable internet or the devices needed to capture and transmit quality images or videos, and that insurance coverage and reimbursement rates for these services vary widely and may not adequately compensate providers.
Still to come
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a narrative review without a systematic search strategy, inclusion criteria, or quality appraisal of the studies it cites. The evidence base is very small: one reliability study of 19 children, one pilot of 15 patients, and two single case reports. The review itself states that high-level clinical efficacy data are currently lacking in this domain. Asynchronous telehealth cannot provide real-time hands-on assessment, so a comprehensive cranial nerve examination or subtle physical findings may be missed. Not all patients have reliable internet, appropriate devices, or the digital literacy to use these platforms, which limits who can actually benefit. Reimbursement policies for asynchronous telehealth vary widely and may not adequately compensate providers, creating a practical barrier to adoption. The two case examples (ALS teleconsultation, head and neck cancer ambulatory monitoring) describe single patients and cannot be generalised to a population.
Declared interests
Georgia A. Malandraki has patents pending related to telehealth wearable technologies, which the authors note are not discussed in this article. The other authors declare no conflicts of interest. No funding source is named.
The easy way to misread this
Do not read this review as evidence that asynchronous telehealth is proven for dysphagia management. The cited evidence is one reliability study of 19 children, one pilot of 15 patients, and two single cases. The review itself states that high-level clinical efficacy data are currently lacking in this domain, and the two case examples describe what happened to one person each, not what will happen to your patients.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →