Accessibility Occupational Therapist
Virtual meeting tools
Finding an application that is broadly used and PHIPA compliant is a challenge.
Microsoft Teams available through one employer is PHIPA compliant, but is not preferred by many clients.
Criteria for virtual visits
Computer access
If computer is not available, then a tablet or other device may be okay - depends if they can screen share and allow remote access
May have to ask to borrow a computer
Internet access
Screen sharing
Screen control
If client has limited or no access to these things, then it will need to be dealt with on a case-by-case basis.
Major functions during an assessment
See client’s screen
Remote control client’s device
Changing camera position
Asking remote helper to assist in being the clinician’s “hands”
Clients Transition to Virtual
At one place of employment, students are required to have a computer
Transition to virtual assessments has been rather seamless.
Students were happy to have convenience of virtual service
Virtual service also meant that client’s personal computer was used in the assessment
This made the service more personal and relevant as clinician can directly remote control client’s computer.
Otherwise if assessments were done in person clients would be using the clinic’s computers
Connectivity is generally not an issue (clients mostly in Toronto area)
Audio quality is more an issue, especially when on speaker phone.
Built-in cameras in monitors are a challenge as they’re hard to move
Clinician Transition to Virtual
In a place of employment, one Zoom account is shared with multiple clinicians, so booking can be complicated
Takes longer to do things than in-person
Multiple forms that need to be sent back and forth
Voice call and equipment check (can take 1 to 1.5 hours)
Check remote control ability
Install software etc.
Set up permissions for screen share and remote control
In the past whole sessions were just installing stuff, so now all of that is done ahead of the appointment.
Remote assessments almost always requires a support person with the client to help with moving the camera, adjusting things, or fixing tech issues.
Clinician had to figure a lot of things on their own and come up with their own procedures.
Clinician had to come up with their own screening “checklist” which is a list of questions to ask. This list changes over time based on experiences with clients.
Example:
_ what are known needs and can it be provided
_ do you have computer?
_ do you have internet?
_ are you comfortable using something for X hours
_ are you comfortable with using zoom?
_ are you okay with remote access?
Clinician always initiates the call so it sets the expectation that they are the ones to re-establish any dropped connections
Assessments
There’s a script that was developed to help run through to set reasonable expectations
This was developed based on experience
Vendors provide training on equipment, but have not been doing so because of COVID.
All training is now virtual
Expression of Needs and Preferences
A lof of this is done during the assessment
Take client’s feedback and figure out why - maybe it’s more training, or different equipment needed.
Privacy and security concerns
In some cases using tools that are not Phipa compliant - in these cases the risks are explained to client and informed consent is given.
In most cases clients aren’t really concerned about privacy and security, but clinicians are regulated and obligated in this area.
Some clients lack private space
Family members around
One client was even in their car
At the start of the call, confirm their identity, ask who’s in the room, and ask who else may come in.
“Ongoing consent” if contexts change