Provide your patient with an evidence-based, cost effective, live video,
that is a GOLD STANDARD in swallowing diagnostics.
YOUR PATIENTS DESERVE THE BEST.
First and foremost, you can NOT diagnose, assess, and treat what you can not see. We owe it to our patients to provide the most research based, comprehensive, cost effective assessment of swallowing. At Mobile Dysphagia Diagnostics, we provide mobile FEES (flexible Fiberoptic Endoscopic Evaluation of Swallowing) services. FEES has been found to be a GOLD STANDARD in assessment and management of oropharyngeal dysphagia. Recent research has shown that FEES and MBSS have a 97-100% inter-rater reliability, but did you know that FEES has been shown to be higher in specificity and severity in identifying penetration, aspiration, residue, and spillage? You do now!
Don’t be the swallowing police
As Speech Pathologists, we are in the incredibly powerful position to greatly improve or drastically decrease someone’s quality of life. Have you ever felt awful about putting someone on a restricted diet because you thought you were making the best decision for them by decreasing their chances of aspiration? Or hearing that a patient or family hates you because you took away their coffee? Or having the administrator question whether you made the best recommendations because the family is now complaining about you? These are tough positions to be in. We get it. We’ve all been there. A mobile FEES procedure can answer all of these questions, and in fact has been shown to increase patient satisfaction ratings and quality of life in assisting with the decision making process related to oral intake. Wouldn’t you like to be the hero of your facility? You have the power to provide the patient and their family with comprehensive, valuable swallowing functioning information, and it is ultimately up to them and their doctor to make the best decisions for themselves. No patient has ever complained about making an informed decision for their own life, only when one has been forced upon them with no rationale to support it. Don’t arrest your patients. Be the hero.
A picture is worth a thousand words
Yes, Speech Pathologists have been trained to perform clinical bedside swallowing exams (CSEs), but a CSE is considered by all top experts and researchers in the field to be a screen for all intents and purposes. The job of the Speech Patholoist is to treat the underlying pathophysiology of the swallowing mechanism with evidence based treatments and strategies. Pretty difficult if we can’t see what we’re treating! Even if a patient had an MBSS in the hospital or acute care, chances are they will paint a much different picture in a SNF once medically stable weeks later.
How many times have you sent patients out with no communication between SLPs only to get recommendations that the patient can not or will not comply with? We work closely with the facility SLP to trial strategies that we know the patient is capable of implementing. If they are absolutely refusing thickened liquids, no way, no how, we cant possibly think that we should recommend honey thick liquids and move on the next patient! We have to trial all consistencies and then trial specific strategies.
This is also where the high definition image of the swallow comes in. If it is determined that thickened liquids or a modified diet are the best choices, we are now able to show the patient the exact moment that the bolus is falling in to the airway. This has helped several patients to see and understand our recommendations, and now adds VALUE and VALIDITY to our profession. I don’t know about you, but I’m not sure that I would trust an arbitrary report that just came in on an antiquated fax machine to now tell me that I can’t eat or drink my favorite foods, but when shown in real time, the causes and events of aspiration, it is very difficult to argue the camera. This has eliminated many arguments between patients, Speech Pathologists, and Nurses, because it is difficult to deny the truth. Remember; even the best, most experienced clinicians in our field, will make an error in their recommendations at the bedside, 70% of the time.
Seeing is believing
A mobile FEES procedure provides objective, measurable data to prove medical necessity of speech therapy services and document progress, or lack thereof, and to justify accurate calculation of RUG levels. How many times have you doubted yourself as a clinician, wasn’t quite sure how to document the suspected problem, or just unsure which exercises to do? With a mobile FEES done in the patient’s natural environment, you are now able to confidently take the documented impairments and look up the most research based treatments for this underlying pathophysiology. No more arbitrary lingual exercises for everyone, real EVIDENCE-BASED patient-specific treatments. Having a mobile FEES done at the bedside allows for the flexibility of time. There are no radiation restrictions or barium limits that have to be followed. If you are suspecting fatigue with a patient, the study can be performed for the entire meal. Have you ever recommended a diet only to have the CNAs tell you that after 15 minutes he’s too tired to stay upright in his ‘perfect eating positioning’ and is coughing and choking on everything? The MBSS is great at giving us an objective snapshot of the swallow, but is not ideal for a patient that fatigues easily. A mobile FEES procedure provides a realistic assessment, and captures the “true picture” of what is happening at meals by the patient self feeding in his/her natural eating position over time.
That which is oldest is not always best
The MBSS was once considered the only gold standard in the instrumental assessment of dysphagia. It has its limitations, especially in the geriatric population, as it is an x-ray that has to be done in the radiology suite of a hospital. FEES has shown that it is an extremely safe, well tolerated, and dynamic procedure that is rightfully becoming more widely accepted and utilized across all populations. The utility and flexibility of FEES is helping to reduce the rate of complications from dysphagia while aiding to restore patients to their normalized oral intake. With FEES we are also able to view excess secretions and signs and symptoms of laryngopharyngeal reflux (LPR), two conditions that are not viewed on an MBSS, but are very prevalent in the geriatric population.
We’re here for you
Wait, you don’t have time in your overly productive day to call central scheduling and be on hold for 30 minutes to schedule an MBSS? We don’t either. Schedule a FEES by phone, text, email, or click the contact button at the top. Billing? That’s a no-brainer as well. Since the FEES CPT code is considered a Speech Therapy code, we follow Medicare’s Consolidated Billing Guidelines.
Our promise is that we will be to you within 1-2 business days from your request. If the family would like to be present, we are always flexible and willing to accommodate. We can come at a time convenient for you. You have productivity standards, we don’t! Also, you are able to bill the 92526 dysphagia treatment code WHILE assisting with the FEES procedure. You are NOT allowed to bill for the time that the scope is in the patient’s nose (usually 15 minutes), but all other time is productive, billable hours. We want you to be present, and we greatly value your input, as you know your patient best!
We always travel with snacks. (Who doesn’t?) But we are more than willing to use your kitchen’s food/thickened liquids (withOUT barium paste), as some facilities can differ greatly in their diet consistencies. We can also include ‘special requests’ or actual medication, whatever the patient wants to eat! Is your patient happy consuming the puree diet because he doesn’t want to wear those stupid dentures anymore anyways, but is always stealing the pancakes off his neighbor’s tray at breakfast? Have no fear, pancakes can be trialed!
How many times have you sent your patient out for an MBSS only to have them come back rejoicing that they passed and you’re left scrambling to find out what in the heck diet consistency “passed” means? This is especially fun on a Friday afternoon when no one from medical records at the hospital is answering the phone. We provide a detailed report (including color photos) to you BEFORE we leave. (We don’t want you to have to track us down on a Friday afternoon either, especially when Happy Hour is calling.) All reports and video recordings are backed up on secured, confidential storage for comparison of studies in future. We also can leave DVDs of the study upon request. Some medical directors often like to review the study as well. (And then you look real smart explaining to them what they are looking at.)
We’re nothing without you
We highly value our relationship with our referring Speech Pathologists. We even shower you with gifts to show our appreciation! But that’s not the point, we are willing and honored to serve as ongoing consultants for you free of charge. We may have seen something on the FEES a few weeks ago, and now the patient is requesting to try something different. We are able to view the study and provide recommendations based on the presenting anatomy and pathophysiology without charging the facility to come back out again. We know it can be very isolating out on our own dysphagia islands, and we are willing to be additional source of information and support for you and your patients. Unfortunately, we do not know everything, but we do know everyone and can find an answer to any predicament you may find yourself in.