“To start with, you don’t have to go and sit in a waiting room for an hour. And you can do it from wherever — if I’m in Vancouver we can do this, if I’m in Florida we can do this. There are so many advantages.”
This is Marlene, a client of Trevor Menchenton’s Audiocorp clinic in New Brunswick, Canada, raving about the benefits of online appointments. As an older woman who struggles with technology, she’s part of a cohort that some hearing care professionals might consider unsuitable for remote care. And yes, she and Menchenton did face some technical challenges in her first online appointment. But the benefits to Marlene – and therefore to her audiologist – have far outweighed the problems.
Their story reflects a wider one. The decision to start offering online hearing care appointments does bring technological and practical questions, for both client and clinician, and new skills to be learned. But evidence shows that there are significant advantages in terms of convenience, flexibility, access to care, and involvement of family (Tebeje and Klein, 2021; Eikelboom et al., 2021).
Levels of client and clinician satisfaction are also just as high after online compared to in-person hearing care appointments (Jenkins et al., 2021; Daye et al., 2021; Parmar et al., 2021, Bennett et al., 2020) and outcomes just as good (Allen at al., 2020; Buckmann et al., 2020). And patients are increasingly willing – even eager – to try them (Aazh et al., 2020, Eze, et al., 2020).
Furthermore, when done well, online appointments can actually improve the client-clinician relationship and enable the delivery of care and counseling that is even more person-centered than in-person consultations.
Remote care is not just a detour to take when a global pandemic interrupts physical access to clients. It’s a way to meet them when, where, and how is convenient for them, and provide high-quality, person-centered care.
Here, we look more closely at the key benefits.
1. Convenience, flexibility, access
Marlene saves herself a five-hour round trip each time she meets Menchenton online instead of in person. Her journey times may be unusually long, but even for clients who live much closer to the clinic, online appointments eliminate travel times, costs, and stress.
They also mean greater flexibility. For example, a working client can schedule a hearing care appointment during their lunchbreak, logging in from their office via a laptop or smartphone, rather than taking an hour or more out of their day.
A 2016 review of tele-audiology literature concluded that it “appears to be an increasingly useful method for providing hearing healthcare access to consumers anytime and anywhere” (Krumm, 2016), while another study describes remote services as offering “unique opportunities for improved clinical care, widespread access to services, and more cost-effective and sustainable hearing health care… No alternative strategy can currently offer the same potential reach for impacting the global burden of hearing loss in the near and foreseeable future” (Swanepoel et al., 2010).
2. Involvement of family
Involving your client’s family members in appointments (when appropriate) is a key part of person-centered care. This becomes much easier when the appointment is online, enabling multiple family members to join from different locations and saving them traveling time and costs.
Olga is mother to Isla, a girl with hearing loss in the UK. Following an online appointment with Isla’s audiologist, Melissa Harrison, she described the process as quick and easy, remarking on “the convenience of logging in” rather than dealing with “car journeys and traffic and parking.” Harrison has seen the benefits for families too, describing how parents and other family members often log into an online appointment using FaceTime.
This anecdotal evidence is backed up by research, including a 2020 study evaluating video visits in neurology during Covid-19. It found that these appointments were more convenient for families and caregivers as well as patients themselves (Saliba-Gustafsson et al., 2020).
3. Access to the home environment
Karen, another of Trevor Menchenton’s clients, has benefitted hugely from his ability to connect her hearing aids to her television and home phone – and optimize those connections – during online appointments, a task that’s impossible for him to do from the clinic.
And there are benefits for the clinician too, who gets a window into their client’s home environment that yields new insights and a deeper understanding of their daily life and challenges, enabling the clinician to better tailor their support.
Dr Kimberly Shea of The University of Arizona gives several concrete examples in a 2021 article. In one appointment, the clinician spotted kinesiology tape in the patient’s house. When asked, the patient said that he was using the tape on his swelling ankles, a relevant piece of information that might not have been revealed during an in-person appointment. In other visits, glimpses of throw rugs and medication prompted valuable conversations about the risk of falls and the importance of storing medicines properly.
4. Being person-centered
Technology is often seen as the enemy of person-centered care (PCC). But the relationship is much more complex and, in the case of remote appointments, technology can enhance the person-centered approach.
A key element of PCC is understanding and responding to the individual needs and preferences of your clients. For many, having appointments online is sometimes or always preferable, due to logistical factors, health issues, or caregiving responsibilities, for example. Those needs and preferences will also change over time, which hearing care providers can respond to by keeping both options open.
Online appointments are also ideal for encouraging clients to be more active in their own care and in managing their condition – key goals of the person-centered approach. For example, instead of showing a client how to fit a mold or change a wax guard, the client will be doing this themselves, closely guided by the clinician. Learning by doing builds confidence and empowers people with hearing loss to try out other self-management techniques. And for clients such as Marlene, simply using the technology required for an online appointment develops skills that have value far beyond hearing care consultations and that can improve quality of life.