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