A Lasting Shift: Embracing Telepractice Access as a Permanent Legacy

The COVID-19 pandemic brought about profound challenges, and —  it also forced us to innovate and adapt in remarkable ways.

One of the most significant advancements to emerge was the front and center stage of tele-visits — particularly in speech-language pathology (SLP).

Telepractice has transcended its origins as a temporary solution, becoming a lifeline for countless patients by offering safe, accessible, and effective care.

As the expiration date for Medicare coverage of telepractice services approaches on March 31, 2025, we must act to secure its future. While the recent extension is appreciated, it is not enough.

Patients, families, and providers deserve assurance that this transformative tool will remain available for those who qualify, and desire it.

Telepractice is not merely a reaction to a crisis—it is an essential part of equitable healthcare that must endure.

For those who meet clinical standards and choose telepractice, its impact is undeniable.

What we have learned, as a field from the pandemic’s opening to access for virtual care:

1. Patients in remote areas no longer face grueling travel for care.
2. Immunocompromised individuals can receive therapy safely at home.
3. Parents balancing jobs, caregiving, and countless responsibilities can schedule therapy without sacrificing other commitments.
4. Patients managing medical complexities can maintain consistency in their care without the logistical burdens of in-person visits they need to juggle and coordinate.
5. Home-schooled children have easier access now to virtual flexible scheduling with outpatient clinics when prior the only access may have been a local school district.
6. Second opinions from a different SLP is now easier since finding a provider virtually allows for exploring other therapy options.
7. Some patients respond better to virtual care than in person, in some limited cases (for example, modeling a velar /k/ or /g/ may be easier with use a “mouth” cam as opposed to in person, as the angle of the camera can catch the tongue rising up/and whiteboard technolgy allows for innovative ways to highlight and teach concepts in engaging ways.
8. When interruptions hit a practice, such as a broken leg of the provider, or a patient has been exposed to COVID, if the patient is clinically eligible for telepractice — services need not stop.
9. For family emergencies of the patient or provider for whose who meet clinical criteria for services involves last-minute travel to a different part of the state — services need not stop.

The pandemic taught us valuable lessons about the importance of access and innovation in healthcare. Telepractice is one of the bright outcomes of those difficult times, proving that care can be effective and compassionate, even at a distance. By making telepractice a permanent option for those who qualify and desire it, we honor this progress and build a future where no one is left behind.

Telepractice creates opportunities that were previously unimaginable. It allows neurodivergent patients to thrive in familiar, controlled environments. It offers flexibility for busy families and professionals. It reduces financial strain by eliminating travel costs. For many, it is not just about convenience—it is about survival, dignity, and independence.

Ensuring telepractice maintains the same quality as in-person care is paramount. Clinicians carefully evaluate each patient to determine if virtual therapy can meet their needs and achieve equivalent outcomes. Technology readiness, adequate caregiver support, and a conducive environment are critical components for success. With these elements in place, telepractice becomes a powerful tool for achieving meaningful therapeutic goals.

This is not about applying telepractice universally—it is about offering it as an option for those who qualify clinically and who would benefit from it. It is about honoring the diversity of patient needs and meeting them where they are. By addressing barriers such as geography, mobility, and financial strain, telepractice opens doors to care that were previously closed.

The power of telepractice is reflected in the stories of the lives it has changed. There’s the child in a rural town who overcame a speech delay because virtual therapy brought care into their home. There’s the elderly patient who regained the ability to communicate with loved ones without stepping outside. There’s the caregiver who found a way to prioritize their child’s progress while managing a full-time job. These stories remind us that telepractice is not just about therapy—it’s about hope, connection, and possibility.

As a nation, we must rally behind telepractice. Congress has the opportunity to solidify its permanence by passing bipartisan-supported legislation such as the Expanded Telehealth Access Act. Patients, providers, and advocates must raise their voices, sharing the profound impact of telepractice to demonstrate its necessity. Collaboration across healthcare fields can amplify this effort, emphasizing telepractice’s value as a tool for all disciplines.

Investing in infrastructure, such as broadband access, will ensure telepractice reaches even the most underserved areas. By doing so, we create a healthcare system that prioritizes equity, adaptability, and resilience.

The value of “technology checks” prior to proceeding cannot be overstated. SLPs benefit from prior to starting services virtually so to validate that:

— the signal of the service in the area is sufficient.

— the engagement factors are manageable so to effectively modify tasks regarding telepractice, as a choice to the patient/family.

— during “technology checks,” the following can be discussed, and allow for the visit to be all about the clinical services to be delivered:

• • Finding a quiet/secure location, without distractions,
  • The logistics of how to start a visit, what to do if there are technology challenges,
  • Learning the anatomy of the features of the encounter (how to chat, how to share the screen, how to mute the sound, the video, etc.),
  • Stating: “If we cannot have a quality visit due to signal issues, or focus issues by the patient, or for any other issue, we would halt the visit and make plans to resume when an in-person visit is possible, thanks.” (that certain clinical standards have to be met for a virtual visit to be proceeded with. If it doesn’t work out),
  • Requirements for care, such as 100% supervision by an adult at all time for pediatric virtual visits, etc. How to proceed if the adult needs to take a call or use the restroom, so to continue to ensure 100% supervision on the video for receiving care,
  • Focus and engagement skills that are basic to participation, and choices available if this is not possible, at this time,
  • How caregivers can assist in the visit,
  • Checking the sound qualify,
  • Checking the video qualify,
  • Workaround if there are variations in the quality,
  • What materials the patient needs for visits (paper/pencil, mirror, etc.),
  • If the patient/family desire subtitling,
  • Discussing how virtual visits look as compared to a traditional visit/set expecations of everyone’s roles,
  • Discuss virtual methods for sharing data that is private and works for the family, given their comfort level with technology,
  • Discuss areas to treat, and if these areas (and solutions for therapuetic solutions avaialble) can be provided virtually,
  • Discuss how hybrid services, such as once a month in-person visits — might allow for mostly virtual therapy,
  • Troubleshooting: what to do when the unexpected comes in the signal, or in the patient presentation when conducting a virtual visit,
  • What accommodations are needed so that the standard of care can be met, if possible,
  • Address troubleshooting topics in advance, such as unexpected issues with signal interruptions or patient presentation during a virtual visit to ensure the session proceeds effectively,
  • Participate in discussions about accommodations —such as planning in advance and iImplement necessary adjustments to meet the standard of care, ensuring the patient’s needs are addressed, and,
  • Discussing opportunities for alternative options, such as If the standard of care cannot be met through telepractice after a technology check. This will allow the SLP and the family explore alternatives such as finding the nearest provider, sharing modified care plans, or transitioning to in-person services.

Let us embrace what we learned during the pandemic.

Let us preserve the glimmers of good—higher access to care—that emerged,  use them to strengthen our healthcare system for all.

Together, we can ensure that the legacy of telepractice endures, providing hope and healing to individuals, families, and communities for years to come.