NAP Telepractice Toolkit:
A Resource for Interprofessional Collaborative Practice
Introduction
Teri Kennedy, PhD, MSW, ACSW, FGSA, FNAP
Chair, NAP Telehealth Research Subcommittee (Editor)
Telehealth, the use of electronic information and telecommunication technologies to support person-centered and client-facing virtual clinical care, or non-client-specific advice, for people and animals has been linked to improved access to care, quality of care, and health outcomes, and reduced cost of care. Traditionally viewed as a tool to improve access to care for individuals and families living in rural and frontier communities, COVID-19 and temporary pandemic-era policies facilitated the reach of telehealth to new people/animals, families, caregivers, and communities through expanded provider eligibility and inspired novel applications, care delivery models, and team-based approaches to care.
A 2020 position statement by the National Academies of Practice (NAP) supports expansion of telehealth provisions among the acceptable and clinically appropriate services offered by all healthcare providers to support the wellbeing of patients/clients, families, and caregivers. The National Association for the Support of Long Term Care (NASL) and National Association of Rehabilitation Providers and Agencies (NARA), in partnership with other professional associations, supports telehealth as a way to assure universal access to health care. Advocacy efforts are currently underway to promote continuation of pandemic-era coverage and practice models, expansion to new providers, and adoption of universal broadband access.
While advocacy efforts continue, the burgeoning use of telehealth services has intensified the need for the dissemination of best practices, development of competencies, and diffusion of knowledge regarding current telehealth reimbursement, regulation, and related policies. There is also an opportunity to explore team-based models of telehealth and related policies to advance the science of interdisciplinary collaboration and interprofessional collaborative practice. In response to this need, the Telehealth Research Subcommittee of the NAP Public Policy Committee has developed the NAP Telepractice Toolkit.
Just as telehealth practice has undergone change, the language pertaining to telehealth has evolved. In 2022, NAP adopted the more generic term telepractice, which includes telehealth, teletherapy, teledentistry, telemedicine, telenursing, and telecare. The authors have adopted terminology in the NAP Lexicon 2.0, as approved by the NAP Council on October 25, 2022, and have noted where terminology may differ by profession or where language may vary specific to reimbursement, regulation, and related policies. As stated in the lexicon:
For the purposes of NAP academies seeking transparency, inclusivity, and full representation, including communication with accrediting bodies for academic and healthcare clinical programs, the following terms are defined:
- Those for whom we are providing care may be referred to as "consumer," “patient," “client,” "service user," and/or “resident."
- Those for whom we are providing education may be referred to as “student” and/or “learner."
- Those providing care for a patient and/or client may be referred to as “carer,” “caregiver,” “family,” “friend,” and/or “service provider."
- Actions involved in caring for a patient and/or client may be referred to as “care” or “service."
- The following terms may be used for a variety of reasons by different disciplines or professions or in different contexts.
- Healthcare is an element of social determinants of health as defined by Healthy People 2030. Social determinants of health (SDOH) are the conditions in the environments where people are born, live, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
- Definitions with a term followed by another term in parentheses are intended to show more inclusive (common, less inclusive) use.2 (p. 3)
- consumer (is) (used in many settings including mental health)
- healthcare provider(s); healthcare worker(s); healthcare workforce; health professional(s); health workers
- individuals; people; person(s)
- practitioner(s); social care provider(s)
Please note that in veterinary telehealth, the client is the pet parent or animal owner, while the patient is the animal being treated by the veterinarian. The relationship is referred to as the Veterinarian-Client-Patient Relationship (VCPR).3
Each chapter in this toolkit addresses a specific aspect of telepractice with a focus on sharing resources. Other than Chapter 1: Telepractice Types and Terminology, readers may access the chapters in any order based upon their needs. Chapter topics and content are understandably interrelated, therefore there will be areas of overlap and some duplication to preserve the author’s intent. While the information presented does not address every aspect of telepractice (for example, we addressed the uses of various technologies, not the technology itself), it points readers to information useful to practice.
Given the fast-paced development of telepractice and the policy landscape, this toolkit captures a snapshot in time. Readers are urged to remain cognizant of continuing developments in telepractice and use available professional and state resources to stay knowledgeable about telehealth laws and regulations specific to their discipline and the states in which they practice.
It is hoped that pandemic-era innovations in interprofessional collaborative practice will continue. In the meantime, “It is the position of NAP that expanding telehealth services supports the wellbeing of patients/clients, families, and caregivers and should be available for services provided by all healthcare providers.”1
References
1. National Academies of Practice. NAP Position Statement on the Provision of Telehealth Services. Lexington, KY: June 29, 2020. tinyurl.com/2p9tdacj
2. National Academies of Practice. NAP Interprofessional Practice and Education Lexicon 2.0. Lexington, KY: October 25, 2022. https://www.napractice.org/assets/docs/NAP%20Lexicon%202.0.pdf
3. American Veterinary Medical Association. Veterinary Telehealth: The Basics. 2023. https://www.avma.org/resources-tools/animal-health-and-welfare/telehealth-telemedicine-veterinary-practice/veterinary-telehealth-basics
Approved by Council, 3/20/2023
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