Lightning Oral Presentation Australian and New Zealand Stroke Organisation Conference 2026

Feasibility and acceptability of using Telepractice to remotely conduct Videofluoroscopic Swallowing Studies (TeleVFSS) to support regional stroke dysphagia management in Western Australia (Stage 3) (139707)

Louise M Cleary 1 2 , Rebecca Kingston 1 2 , Sophie Maines 2 3 , Trish Chivilo 3 , Nicole Jeffree 4 , Katherine Royer 4 , Rosamund Barnes 3 , Asher Verheggen 2 , Robyn Trzaskowski 2 , Natalie Cross 1 2
  1. Speech Pathology - Allied Health, Osbourne Park Hospital, Perth, WA, Australia
  2. Speech Pathology - Allied Health, Sir Charles Gairdner Hospital , Perth, WA, Australia
  3. Allied Health, Geraldton Health Campus, Western Australian Country Health Services (WACHS) Midwest, Geraldton , WA, Australia
  4. WA Country Health Service Central Office, WA Country Health Service (WACHS) Midwest, Perth, WA, Australia

Background: Credentialled Speech Pathologists (C-SPs) use Videofluoroscopy Swallow Studies (VFSS) to diagnose dysphagia, preventing aspiration pneumonias1,2. Regional Western Australian (WA) hospitals have VFSS equipment, however frequently no C-SPs. TeleVFSS Stage 1 and 2 demonstrated technology design facilitated adequate image quality for concurrent livestreaming from a regional site (with C-SP onsite support) to a metropolitan hospital, establishing practicality and safety.

Aim: Determine the feasibility and acceptability of conducting VFSS regionally by concurrent livestreaming to a metropolitan hospital with external C-SP support only.

Method: Participants (n=7) were recruited from Geraldton Health Campus. The C-SP was located at Osborne Park Hospital, 405kms away. All participants had a post stroke dysphagia diagnosis. TeleVFSS clinics followed Stage 2 technology setup.

Results: All primary outcomes were met: 1)100% (7/7 participants) achieved ≥4 on the image quality rating scale (benchmark >80% score ≥4 on a rating scale); 2) 93% of all swallows were attributed a Penetration-Aspiration Score3 (benchmark of >80% of swallows receive a score); and 3) positive service acceptance by staff and patients utilising the Theoretical Framework of Acceptability questionnaire4. Secondary outcomes included average clinical run time was 27.86 minutes (KPI 30 minutes average) and radiation exposure time average was 2:29 min (KPI 3 min average).

Conclusion: TeleVFSS involving concurrent livestream to an external computer 405kms away, supported by a C-SP externally, is deemed feasible and safe for patient care as well as acceptable to patients and staff. TeleVFSS, is an innovative, scalable solution which could result in better access, equity, and patient outcomes across WA.

  1. Lin LC, et al. Prevalence of impaired swallowing in institutionalized older people in Taiwan. J Am Geriatr Soc. 2002;50(6):1118-1123. https://doi.org/10.1046/j.1532-5415.2002.50270 2.
  2. Cichero JA, et al. Definition, prevalence and burden of oropharyngeal dysphagia: a serious problem among older adults worldwide and the impact on prognosis and hospital resources. Nestle Nutr Inst Workshop Ser. 2012;72:1-11. https://doi.org/10.1159/000339974 3.
  3. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996;11:93-98. https://doi.org/10.1007/BF00417897
  4. Skehon M, Cartwright M and Francis JJ. Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions. Bmc health services research 2022, 22 : 279 https://doi.org/10.1186/s12913-022-07577-3