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Tele-health in Audiology

The time when tele-health was a futuristic concept years in the future has come to an end. Many audiologists have already started using tele-health in their practices, some without even realizing it! We don't want tele-health to be a complicated concept that's feared, but rather see it as another tool that audiologists can use to improve the efficiency of their appointments and help them build on their therapeutic relationship with their patients.  This month, Ida is sharing not only their own work with tele-health, but examples of audiologists already putting it into practice, and suggestions for how to get started.

Tele-health in Action

An Audiology Session Via Skype

Heidi Limareff, a participant in our Tele-health process, recorded two Skype sessions with her mother, Marilyn, for our meetings. Marilyn has a minor, high-frequency hearing loss, and is a new hearing aid user. In their first session, Heidi showed Marilyn how to put on her hearing aids, change the batteries, and clean them. In the second session, shown here, Heidi asks Marilyn follow-up questions about her hearing aid use and experience, and talks her through cleaning a tube. The sessions show some of the real-time challenges of tele-audiology -- unclear web cams, environmental distractions, and an inability to troubleshoot as easily across the miles as one could in person. Heidi also identified barriers to finding clients such as internet connection that was fast enough or not having internet at home at all, and not having web cams. Even as a first attempt by both Heidi and Marilyn, the session runs quite smoothly, and shows that there isn't such a big learning curve for tele-health after all. 

Ideas Worth Hearing

Online Videos

Online Videos

Launch a series of online videos about hearing loss to provide millions with a unique peek into what it means to live with hearing loss on a daily basis.
Online Game

Online Game

Create an online game that is fun and will encourage people to learn more about hearing health and hearing loss.

From the editor

Tele-health in Audiology

Does it sound futuristic? Well tele-health is already here. Physicians, nurses and other healthcare providers use tele-health for diagnosis, teleconsultations and monitoring to support their patients’ health and well-being. 

While fitting hearing aids remotely or holding a Group AR session over Skype may not be for everyone yet, but hearing healthcare professionals worldwide are already implementing tele-health practices. At Ida Institute, we’ve shown the benefits of tele-health through our E-Learning, Ida Basics, and University Course, and we’re eager to expand. 

Many clinicians among the standing-room-only crowd attending Ida’s featured section, The Future of Hearing Care, at this year’s AudiologyNOW! Conference, expressed their readiness to use tele-audiology. In post-conference feedback, we received questions such as: “I would like to know how we will initially connect with patients who need tele-health services. How do we identify them?” “I need evidence to demonstrate to administrators that the investment of my time and the technological structure in a new model of patient care is effective and thus worthwhile,” and “As a student, I need more training and experience with tele-health. I don’t know much about it or how I will be able to use it.”

See the presentations from our Tele-health focus group meeting for the projects IMP3D, Audiocation, and the Innovation Implementation Process.

The Tele-Health Project

Ida Institute first began exploring the role of tele-health in the future of hearing healthcare more than a year and a half ago as part of our Vision 2020 process. “The goal of the Tele-health work stream is to help audiologists embrace tele-health as a new means of delivering services, rather than seeing it as a threat to their livelihood,” said Managing Director Lise Lotte Bundesen. “Just as important, we want to help keep patient centered care at the core of tele-audiology practices.” 

The true way of being patient centered is you deliver your service in line with what your patient wants. So if your patient doesn’t want to come to the office, guess what? You have to do it tele. Sorry.
— Nerina Scarinci, Ida Visiting Scholar and Tele-health group participant

In February, the Institute convened a focus group meeting on Tele-health in Skodsborg, Denmark. Clinicians in private and public practice and audiology education collaborated with Ida staff to devise projects with the potential to facilitate integration of tele-health and provide benefits to both patients and professionals. In developing the projects, participants considered the ways that tele-health is used today in audiology, how it might be used in the future, and how it could be streamlined for use in every day practice. The group explored a variety of applications of tele-health in audiology from education and rehabilitation to remote hearing aid fittings. These are the projects they developed.

How can you use tele-health right now?

·         Take appointments through an online booking system or via email ·         Answer basic questions via email ·         Conduct individual AR sessions over Skype ·         Film videos on your phone or tablet demonstrating how to clean a hearing aid or change a battery.
          Upload the videos on YouTube to share with your patients.

IMP3-D Framework

The first project aimed to show how existing Ida resources could be delivered in a tele-health mode to empower audiologists and patients to make the most of their face-to-face interactions. The group used a framework to illustrate how different aspects of audiological services could be adapted to tele-health applications, including intake processes, education, outcome measurement, intervention, and peer support. The IMP3-D model highlighted the importance of Informing, Individualizing, and Involving (3-I) in order to Motivate, Manage, and Maintain (3-M), when working with Patients, the Public, and Partners (3-P). By streamlining administrative tasks such as intake processes and making educational materials available through tele-health, IMP3-D can be used to prime the patients so they know what to expect in their appointments. Patients can complete these tasks outside of the appointment, giving the audiologist more time during the session to focus on establishing a therapeutic relationship with patients and their partners.

Audiocation Platform

The second project proposed a framework which was inspired by a review of existing tele-health models. The framework is designed to provide audiologists with structure, helping them to consider the perspective of patients and professionals as they develop tele-health solutions. The framework also illustrates the importance of considering cost, quality, and access across different clinical, educational and administrative activities. The Audiocation platform gives simple guidance to audiologists and can be used as a checklist to ensure that the audience, focus, and activity have been considered for each tele-health solution. 

Tele-audiology can be a real advantage in the implementation of relationship centered care. Patients can complete questionnaires online and view documents and videos about how to manage their hearing aids. This will allow the audiologist to focus on communication with patients and communication partners. It will also give patients the tools they need to self-manage their hearing impairment.
– Jill Preminger, Tele-health group participant

Innovation Implementation Process

While all of the projects touched on the idea of using existing tools in tele-health, the Innovation Implementation Process is the one project put forward which demonstrates to audiologists in a step-by-step detail how they can transform existing products into viable future products. The Innovation Implementation Process is a way of guiding audiologists through a change process, allowing them to explore the experience and journey of the end user, hypothesize about which step to take first, and complete a risk/impact analysis for each new tool or technology.

Taking Tele-health Into the Future

Ida is taking the input from the February focus group meeting and carrying it forward to create a framework for audiologists to practice tele-health in a patient-centered way. “Our goal is to make tele-audiology accessible and cost effective, and show how audiologists can make changes, no matter how big or small,” said Bundesen. “Audiologists around the world are already using many tele-health solutions. We believe tele-health will allow for more focus on the counseling aspect of their appointments.”

There are bound to be hiccups and challenges as hearing care professionals adjust to new technologies in the shift to tele-audiology. Ida looks forward to help ease the transition.