Telehealth Intervention: A Proposal for a Telemedicine Manual to Ascertain the Civil Disability Status in Italy.

(1) This paper aims to propose a telematic method for assessing the state of disability by a social worker member of the Medico-Legal Commissions of INPS. (2) We have proceeded to delve into and compare the current methods with new strategies to enhance the experience linked to the assessment of the status of disability in terms of timing and accessibility, eliminating the need for a direct visit. (3) The proposed protocol can be applied in cases where patients cannot be physically moved, following a medical visit at home, and when the mere evaluation of documents is sufficient. In both cases, a remote session with the Commission is necessary to fill in the required information about the socio-environmental section. This protocol can be applied to different platforms such as Skype™ since it is free and widely used throughout the country. (4) It should be noted that telemedicine solutions cannot completely replace face-to-face interaction; however, in some limited cases, they can optimize the process and timing, avoiding the need to move or interact only by telephone.

Intercorporeity, Un-Distancing, and Aura in Skype Analysis.

The Covid pandemic has forced analysts around the world, some more than others, to work using Zoom and Skype. The technical innovation is here to stay and raises questions on a theoretical level. Is online analysis 'real' analysis or not? What is lost from the analytical experience? What, if anything, is gained? The global health emergency, on the one hand, has made these questions inescapable; on the other, it has provided a kind of huge experimental field to deal with them. Here, the author argues that when viewed from the perspective of the concepts of intercorporeity (Merleau-Ponty), un-distancing (Heidegger), and aura (Benjamin), some of the issues of 'presence' in teleanalysis become clearer.

Videoconference Fatigue: A Conceptual Analysis.

Videoconferencing (VC) is a type of online meeting that allows two or more participants from different locations to engage in live multi-directional audio-visual communication and collaboration (e.g., via screen sharing). The COVID-19 pandemic has induced a boom in both private and professional videoconferencing in the early 2020s that elicited controversial public and academic debates about its pros and cons. One main concern has been the phenomenon of videoconference fatigue. The aim of this conceptual review article is to contribute to the conceptual clarification of VC fatigue. We use the popular and succinct label "Zoom fatigue" interchangeably with the more generic label "videoconference fatigue" and define it as the experience of fatigue during and/or after a videoconference, regardless of the specific VC system used. We followed a structured eight-phase process of conceptual analysis that led to a conceptual model of VC fatigue with four key causal dimensions: (1) personal factors, (2) organizational factors, (3) technological factors, and (4) environmental factors. We present this 4D model describing the respective dimensions with their sub-dimensions based on theories, available evidence, and media coverage. The 4D-model is meant to help researchers advance empirical research on videoconference fatigue.

The effect of tele-speech therapy on treatment of stuttering.

PURPOSE: The aim of this study was to evaluate the effect of tele-speech therapy on the recovery of patients with a stutter. METHODS: This research was an interventional study conducted on the patients visiting two rehabilitation centres. In this study, patients with a stutter participated in the tele-speech therapy sessions via Skype. Stuttering Severity Instrument-Fourth Edition was used to determine the severity of stutter before and after the intervention. RESULTS: The results showed a significant difference in the mean scores of stuttering severity before and after tele-speech therapy (p = 0.001). Our findings showed a mean reduction of 13.8% in stuttering scores. More than half of the patients (56.6%) reported a "high" and "very high" satisfaction with this treatment method. CONCLUSIONS: Tele-speech therapy is an effective way for the treatment of stuttering patients irrespective of their age, gender, and educational background. This method can improve patient's speech and reduce stuttering. Implications for RehabilitationTele-rehabilitation is an effective way to treat stuttering.Tele-speech therapy can be implemented for any group of stuttering patients.Participants were satisfied with the tele-rehabilitation intervention.Tele-speech therapy accelerates the treatment process.Tele-speech therapy eliminates patient travels to speech therapies.

Frequency of contact with friends and relatives via internet and psychosocial factors in middle-aged and older adults during the COVID-19 pandemic. Findings from the German Ageing Survey.

OBJECTIVES: Previous studies have examined the association between frequency of contact with friends and relatives via internet and psychosocial factors (in terms of loneliness, life satisfaction and depressive symptoms). However, far less is known about such a link during the COVID-19 pandemic, particularly based on nationally representative samples. Therefore, the aim of this study was to examine this association among middle-aged/older adults. METHODS/DESIGN: Data were taken from the short survey of the German Ageing Survey (June/July 2020, 3134 individuals in the analytical sample). The De Jong Gierveld scale was used to quantify loneliness, the Satisfaction with Life Scale was used to quantify life satisfaction and the 10-item version of the Center for Epidemiological Studies-Depression was used to quantify depressive symptoms. RESULTS: Regressions showed that-compared to daily users-less frequent users of the internet for contact with friends and relatives reported increased loneliness, lower life satisfaction and more depressive symptoms. With regard to covariates, better psychosocial factors were associated with medium education (compared to low education), living with partner in the same household (compared to singles), better self-rated health, and favourable COVID-19 factors (in terms of decreased feeling that the Corona crisis is a threat for oneself, not having an infection with the coronavirus and an increased feeling that you can influence an infection with the coronavirus yourself). CONCLUSIONS: Data suggest that individuals with a high frequency of contact with friends and relatives via internet reported better psychosocial factors. Future research in other cultural settings are required.

Feasibility of school students Skyping care home residents to reduce loneliness.

BACKGROUND: Intergenerational friendship has proved useful for older people in increasing socialisation. We explored the feasibility of school students Skyping older people in care homes with the long-term aim of reducing loneliness. METHODS: Six school students from one secondary school and twenty older people, including seven with mild to moderate dementia, from three care homes, engaged in Skype video-calls over six weeks. A conversational aid aimed to help school students maintain conversations was employed. Students and care staff completed feedback forms after each session on video-call usage, usefulness of the conversational aid, and barriers and benefits of video-calls. Six care staff provided further feedback on residents' experiences through unstructured interviews. Interviews and field notes were thematically analysed. RESULTS: Residents enjoyed Skype-calls with school students. Over six weeks, video-calls became longer, and more residents participated. Analysis revealed four themes. First, the intervention led to increased mobility for three older people and improved self-care in regard to personal appearance for five residents. Second, school students and older people formed friendships which inspired the need to meet in person. Third, the use of video-calls enabled participants to view each other's environments in real time. Last, directly experiencing the intervention was important for the continued participation of the care staff in the study. Skype-calls between schools and care homes are feasible and may help reduce loneliness. CONCLUSIONS: Institutional collaboration between educational settings and care homes through cost effective video-calls can be useful to increase socialisation for older people, and promote later on-going use with other external organisations to help reduce loneliness and social isolation.

If There's Something Strange in Your Neighbourhood, Who You Gonna Call? Perceived Mental Health Service User Suitability for Video Consultations.

COVID-19 has placed additional challenges on mental health services. Video consultations (VCs) have provided a short-term solution to lockdown restrictions but could also increase long-term capacity to meet the anticipated rising demand. A total of 7752 VCs were conducted over six weeks. Thematic analysis of 474 online survey responses identified twenty patient attributes that influenced staffs' decisions to offer VCs. Their opinions were diverse, at times contradictory, and not always evidence based. There was reasonable consensus (and published evidence to support) of the probable suitability of VC for patients who: are IT savvy and suitably equipped; are teenagers; live in remote/rural locations; have caring responsibilities; have anxiety disorders or express a preference. No consensus was reached regarding eight attributes and there was a corresponding paucity of evidence, indicating the need for further research. Conversely, old age; paranoia, sensory impairment/communication difficulties; high risk and trauma/PTSD (posttraumatic stress disorder) were generally seen as contraindicated by staff, despite published evidence of success elsewhere. It may be possible to overcome staff's reticence to offer these groups VCs. As staff are effectively the gatekeepers to VC interventions, it is important to understand and support them to overcome reservations that are contrary to the empirical evidence base. This will ensure that their initial anxieties do not become unnecessary barriers to services for those most in need. As with all mental healthcare, such decisions should be made collaboratively, and on an individual basis.

Aesthetically Designing Video-Call Technology With Care Home Residents: A Focus Group Study.

BACKGROUND: Video-calls have proven to be useful for older care home residents in improving socialization and reducing loneliness. Nonetheless, to facilitate the acceptability and usability of a new technological intervention, especially among people with dementia, there is a need for user-led design improvements. The current study conducted focus groups with an embedded activity with older people to allow for a person-centered design of a video-call intervention. METHODS: Twenty-eight residents across four care homes in the South West of England participated in focus groups to aesthetically personalize and 'dress-up' the equipment used in a video-call intervention. Each care home was provided with a 'Skype on Wheels' (SoW) device, a wheelable 'chassis' comprising an iPad or tablet for access to Skype, and a telephone handset. During the focus group, residents were encouraged to participate in an activity using colorful materials to 'dress-up' SoW. Comments before, during and after the 'dress up' activity were audio recorded. Framework analysis was used to analyze the focus group data. RESULTS: Older people, including seven with dementia were able to interact with and implement design changes to SoW through aesthetic personalization. Themes arising from the data included estrangement, anthropomorphism, reminiscence, personalization, need for socialization versus fear of socialization and attitudes toward technology. After this brief exposure to SoW, residents expressed the likelihood of using video-calls for socialization in the future. CONCLUSION: Care home residents enjoy engaging with new technologies when given the opportunity to interact with it, to personalize it and to understand its purpose. Low cost aesthetic personalization of technologies can improve their acceptability, usability, and implementation within complex care environments.

[Point of view: A lesson from lockdown, histopathology through videoconferencing]. / Point de vue : une leçon tirée du confinement, l'histopathologie en visioconférence.

The use of videoconferencing had increased significantly during lockdown. During this period, videoconferencing has been used in the pathological department of pathology (Timone university hospital, Marseille, France) for academic, diagnosis and referral. We provide our point of view regarding the use of this tool. As discussing slides through videoconferencing is a new and specific activity, we have also summarised specific recommendations for practical remote histopathology meetings.

Intergroup 'Skype' Quiz Sessions in Care Homes to Reduce Loneliness and Social Isolation in Older People.

Video calls using software such as Skype, Zoom and FaceTime can improve socialisation among older people and family, however it is unknown if video calls are able to improve socialisation among older people and their peers. Twenty-two residents across three British care homes engaged with each other using 'Skype quiz' sessions with the support of staff once a month over an eight-month trial. Video calls were accessed via a 'Skype on Wheels' intervention that comprised a wheeled device that could hold an iPad, or through Skype TV. Residents met other residents from the three care homes to build new friendships and participate in a thirty-minute quiz session facilitated by eight staff. Staff were collaborators who recruited older people, implemented the intervention and provided feedback that was analysed using thematic analysis. Residents enjoyed being able to see other residents' faces and surroundings. Analysis of the field notes revealed five themes of: residents with dementia remember faces not technology, inter and intra connectedness, re-gaining sense of self and purpose, situational loneliness overcome and organisational issues create barriers to long-term implementation. Inter-care home connection through video calls to reduce feelings of loneliness in residents seems acceptable and a feasible, low cost model, especially during times of public crisis such as COVID-19.

The feasibility of online video calling to engage patients with cystic fibrosis in exercise training.

INTRODUCTION: Physical activity, including structured exercise, is an essential component in the management of cystic fibrosis. The use of telehealth such as video-calling may be a useful method for the delivery of exercise and physical activity interventions, though the feasibility of this remains unknown. METHODS: Nine patients with cystic fibrosis (three female, six male, 30.9 ± 8.7 years) volunteered to participate. Participants completed an eight-week exercise training intervention conducted via Skype, using personalised exercises, with all sessions supervised by an exercise therapist. Feasibility was assessed by demand, implementation, practicality and acceptability. Changes in anthropometric, pulmonary, physical activity and quality of life variables were also assessed. RESULTS: Two male participants withdrew from the study, citing lack of available time. The remaining participants found use of Skype useful, with a mean satisfaction rating of 9/10, and three participants requesting to continue the sessions beyond the duration of the study. Mean compliance with sessions was 68%, with mean duration of sessions being 20 min. A total of 25% of calls suffered from technical issues such as video or audio lags. Anthropometric, pulmonary, physical activity and quality of life variables remained unchanged over the course of the study period. DISCUSSION: The use of Skype to deliver an exercise intervention to patients withcystic fibrosis was found to be technologically feasible, and acceptable among participants. Findings have implications for clinical practice and could allow care teams to engage patients remotely in exercise. Further research is required to assess the efficacy of this modality on increasing physical activity and associated health outcomes.

Comparing Skype (video calling) and in-person qualitative interview modes in a study of people with irritable bowel syndrome - an exploratory comparative analysis.

BACKGROUND: Within qualitative research in-person interviews have the reputation for being the highest standard of interviewer-participant encounter. However, there are other approaches to interviewing such as telephone and e-mail, which may be appropriate for a variety of reasons such as cost, time and privacy. Although there has been much discussion of the relative values of different interview methods, little research has been conducted to assess what differentiates them using quantifiable measures. None of this research has addressed the video call, which is the interview mode most like the in-person interview. This study uses quantifiable measures generated by the interview to explore the relative value of in-person and video call interview modes. METHODS: Interview data gathered by a qualitative research study exploring the views of people with IBS about hypnotherapy for their condition were used. In-person and video call interviews using the same topic guide were compared on measures of length (time and word count), proportion of time the interviewer was dominant, the number of topics generated (codes) and the number of individual statements on which those topics were based. RESULTS: Both interview methods produced a similar number of words and a similar number of topics (codes) were discussed, however the number of statements upon which the variety of topics was based was notably larger for the in-person interviews. CONCLUSION: These findings suggest that in in-person study interviews were marginally superior to video calls in that interviewees said more, although this was on a similar range of topics. However, the difference is sufficiently modest that time and budget constraints may justify the use of some video call interviews within a qualitative research study.

Psychoanalytic psychotherapy and its supervision via videoconference: experience, questions and dilemmas.

The patient lives in Berlin, the therapist in Lisbon and the supervisor in Budapest. Not long ago, continuous psychotherapy and supervision would have been impossible in such a setting. Nowadays, modern communication technologies via the Internet create new possibilities for patients, therapists, and supervisors. However, when we engage in psychoanalytic practice via modern means of telecommunication, we need to examine if the fundamental tenets of the psychoanalytic process are preserved. We need to think about initial assessment, about how we arrange the setting, how we work with transference and countertransference, what kinds of new forms of resistance we are facing and, indeed, how we can recognize new phenomena and handle inevitable problems. In this clinical paper, we tackle these questions in the context of three-times-a-week psychoanalytic psychotherapy.

Measuring QoE of a Teleconsultation App in Mental Health Using a Pentagram Model.

The QoE measurement has become a novel theme today. To achieve a quality service and minimize the negative impact that traffic on network can cause, it's very important to manage the devices that intervene in this service. Hence, the QoE evaluation allows obtaining benefits both customers and service providers. The main objective of this paper is to measure QoE of a teleconsultation application in Mental Health named Psiconnect, using an approach based on pentagram model. For the QoE evaluation of Psiconnect application we used the pentagram model based on the measurement of 5 factors (integrality, retainability, availability, usability, and instantaneousness). This model allows to design quantifiable metrics for quality evaluations. Using the model cited the value of QoE for Psiconnect is 1.793 (between 1.6 and 1.8). Comparing with Mean Opinion Scores (MOS) test, some users are dissatisfied with the use of the application although the result is near 1.8, so the most of users are satisfied with the use of teleconsultation service based in Skype in the Psiconnect app. There are different models to measure QoE having into account subjective parameters. This is important an estimation of QoE in a quantitative form. Other models can be used to improve the quality of apps.

Teleanalysis: Slippery Slope or Rich Opportunity?

In certain cases, and under certain conditions, extremely useful analytic work can be done on the phone or through videoconferencing. Contrary to what some critics of teleanalysis maintain, with patients who are motivated and can make use of analysis, physical distance between analyst and patient and/or occasional technological difficulties do not limit or preclude successful analysis. Clinical material from three teleanalyses demonstrates various conditions that help make teleanalysis useful. Instead of being a disadvantage, the juxtaposition of the experience of the "tele" and the in-person settings (in occasional in-person sessions) provides increased and unique opportunities for analysis.

Exploring the acceptability of delivering Cognitive Processing Therapy (CPT) to UK veterans with PTSD over Skype: a qualitative study.

Background: Research shows that veterans with mental health difficulties are reluctant to engage with treatment due to a number of practical and psychological barriers. Tele-therapy has been proposed as an alternative method of delivering therapy to ensure hard-to-reach groups receive the care they need. Objective: This study aimed to explore the acceptability of using tele-therapy for treating PTSD in a sample of UK veterans. Methods: Sixteen participants who had engaged with tele-therapy for PTSD were contacted following the cessation of their treatment, including those who had not completed the full course of therapy. Semi-structured qualitative interviews were conducted and the transcripts were analysed using thematic analysis. Results: Five key themes emerged: Effect of your own environment, Importance of good therapeutic alliance, Technicalities and practicalities, Personal accountability and Measuring change. Effect of your own environment was described with sub-themes of control over your own environment, lack of support between sessions and snap back to reality. The Importance of good therapeutic alliance encompassed putting a face to the name, impersonal feeling and no different from being in the room. Technicalities and practicalities depicted good preparation is key, the flexibility of Skype, technical aspects and session length and timing. Personal accountability detailed finding the time and space, managing attendance and engagement and moving forward. Measuring change illustrated negative past experiences with therapy, improving self-recognition and managing symptoms. Discussion: Tele-therapy appeared to be acceptable within this sample of veterans with many reporting overall positive experiences and improvements to their health. Future research is needed to foster a more supportive environment during and after therapy.

Antecedentes: La investigación muestra que los veteranos con dificultades de salud mental son reticentes a comprometerse con un tratamiento debido a un número de barreras psicológicas y prácticas. La tele-terapia ha sido propuesta como un método alternativo de realizar terapia, para asegurar que grupos difíciles de alcanzar reciban el cuidado que necesitan.Objetivo: Este estudio apuntó a explorar la aceptabilidad de usar tele-terapia para tratar TEPT en una muestra de veteranos del Reino Unido.Métodos: Se contactó a 16 participantes que participaron en tele-terapia para TEPT, tras el cese de su tratamiento, incluyendo aquéllos que no completaron totalmente la terapia. Se realizaron entrevistas cualitativas semiestructuradas y las transcripciones se analizaron utilizando análisis temático.Resultados: Surgieron cinco temas clave: Efecto de su propio ambiente, Importancia de una buena alianza terapéutica, Aspectos prácticos y tecnicismos, Responsabilidad personal, y Cambio medible. El efecto de su propio ambiente fue descrito con sub-temas de control sobre su propio ambiente, falta de apoyo entre sesiones y vuelta a la realidad. La importancia de una buena alianza terapéutica abarcó poner una cara al nombre, sentimientos impersonales, y no es diferente de estar en una habitación. Los Aspectos prácticos y tecnicismos indicaron que una buena preparación es clave, la flexibilidad de Skype, aspectos técnicos, duración y momento de la sesión. La responsabilidad personal destacó encontrar el tiempo y espacio, manejo de asistencia y compromiso y seguir adelante. Cambio medible ilustró experiencias pasadas negativas con terapias, mejorar el autoconocimiento y manejo de síntomas.Discusión: La tele-terapia parece ser aceptable en esta muestra de veteranos con varios reportes de experiencias positivas y mejoras en su salud. Se necesita investigaciones futuras para fomentar un ambiente más alentador durante y después de la terapia.

"It's not one size fits all"; the use of videoconferencing for delivering therapy in a Specialist Paediatric Chronic Fatigue Service.

BACKGROUND: There are few specialist paediatric Chronic Fatigue Syndrome (CFS/ME) services in the UK. Therefore, the distance some families have to travel to reach these services can be a barrier to accessing evidence-based treatment. Videoconferencing technology such as Skype provides a means of delivering sessions remotely. This study aimed to explore the views of children and young people, their parents, and healthcare professionals of treatment delivered by videoconferencing in a specialist paediatric CFS/ME team. METHOD: To explore the experiences of the participants, a qualitative design was selected. Twelve young people (age 9-18), and 6 parents were interviewed about their experience of treatment sessions delivered via videoconferencing within a specialist CFS/ME service. A focus group explored the views of healthcare professionals (N = 9) from the service. Thematic analysis was used. RESULTS: Three themes were identified from the data: "Challenges and concerns", "Benefits" and "Treatment provision". Challenges and concerns that participants identified were; difficulties experienced with technology; a sense of a part of communication being lost with virtual connections; privacy issues with communicating online and feeling anxious on a screen. Participants felt that benefits of videoconferencing were; improving access to the chronic fatigue service; convenience and flexibility of treatment provision; a sense of being more open online and being in the comfort of their own home. In terms of treatment provision participants talked about videoconferencing as a part of a hierarchy of communication; the function of videoconferencing within the context of the chronic fatigue service; additional preparation needed to utilise videoconferencing and an assumption that videoconferencing is "part of young people's lives". CONCLUSIONS: Although the experience of sessions provided by videoconferencing was different to sessions attended in person, participants tended to be positive about videoconferencing as an alternative means of accessing treatment, despite some barriers. Videoconferencing could be an additional option within an individualised care plan, but should not be an alternative to face to face support.

Video-calls to reduce loneliness and social isolation within care environments for older people: an implementation study using collaborative action research.

BACKGROUND: Older people in care may be lonely with insufficient contact if families are unable to visit. Face-to-face contact through video-calls may help reduce loneliness, but little is known about the processes of engaging people in care environments in using video-calls. We aimed to identify the barriers to and facilitators of implementing video-calls for older people in care environments. METHODS: A collaborative action research (CAR) approach was taken to implement a video-call intervention in care environments. We undertook five steps of recruitment, planning, implementation, reflection and re-evaluation, in seven care homes and one hospital in the UK. The video-call intervention 'Skype on Wheels' (SoW) comprised a wheeled device that could hold an iPad and handset, and used Skype to provide a free video-call service. Care staff were collaborators who implemented the intervention within the care-setting by agreeing the intervention, recruiting older people and their family, and setting up video-calls. Field notes and reflective diaries on observations and conversations with staff, older people and family were maintained over 15 months, and analysed using thematic analysis. RESULTS: Four care homes implemented the intervention. Eight older people with their respective social contacts made use of video-calls. Older people were able to use SoW with assistance from staff, and enjoyed the use of video-calls to stay better connected with family. However five barriers towards implementation included staff turnover, risk averseness, the SoW design, lack of family commitment and staff attitudes regarding technology. CONCLUSIONS: The SoW intervention, or something similar, could aid older people to stay better connected with their families in care environments, but if implemented as part of a rigorous evaluation, then co-production of the intervention at each recruitment site may be needed to overcome barriers and maximise engagement.

An equivalence study of interview platform: Does videoconference technology impact medical school acceptance rates of different groups?

Web-based interviewing may be an effective element of a medical school's larger approach to promotion of holistic review, as recommended by the Association of American Medical Colleges, by facilitating the feasibility of including rural and community physicians in the interview process. Only 10% of medical schools offer videoconference interviews to applicants and little is known about the impact of this interview modality on the admissions process. This study investigated the impact of overall acceptance rates using videoconference interviews and face-to-face interviews in the medical school selection process using an equivalence trial design. The University of New Mexico School of Medicine integrated a videoconferencing interview option for community and rural physician interviewers in a pseudo-random fashion during the 2014-2016 admissions cycles. Logistic regression was conducted to examine whether videoconference interviews impacted acceptance rates or the characteristics of accepted students. Demographic, admissions and diversity factors were analyzed that included applicant age, MCAT score, cumulative GPA, gender, underrepresented in medicine, socioeconomic status and geographic residency. Data from 752 interviews were analyzed. Adjusted rates of acceptance for face-to-face (37.0%; 95% CI 28.2, 46.7%) and videoconference (36.1%; 95% CI 17.8, 59.5%) interviews were within an a priori ± 5% margin of equivalence. Both interview conditions yielded highly diverse groups of admitted students. Having a higher medical college admission test score, grade point average, and self-identifying as disadvantaged increased odds of admission in both interview modalities. Integration of the videoconference interview did not impact the overall acceptance of a highly diverse and qualified group of applicants, and allowed rural and community physicians to participate in the medical school interview process as well as allowed campus faculty and medical student committee members to interview remotely.

Using Skype to support remote clinical supervision for health professionals delivering a sustained maternal early childhood programme: a phenomenographical study.

BACKGROUND: Skype technology was implemented by the Australian Maternal Early Childhood Sustained Home-visiting (MECSH) Support Service as a tool for the remote provision of clinical supervision for clinicians working in the MECSH program in Seoul, South Korea. OBJECTIVES: To gain a better understanding of the processes underpinning sustainable delivery of remote clinical supervision using digital technologies. DESIGN: A phenomenographical study. METHODS: Recorded notes and reflections on each supervision session, noting exemplars and characteristics of the experience were read and re-read to derive the characterizations of the experience. RESULTS: The experience has provided learnings in three domains: (1) the processes in using Skype; (2) supervisory processes; and (3) language translation, including managing clarity of, and time for translation. CONCLUSION: Skype has potential for use in remote provision of clinical supervision, including where translation is required. Further research evaluating the benefit of telesupervision from supervisor and supervisee perspectives is necessary to determine if it is a sustainable process.