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Hearing care paths to success during the COVID-19 crisis

By Clint McLean

Over the past months, hearing care professionals (HCPs) across the globe have strived to find new ways of providing hearing care services and staying connected with clients during the COVID-19 crisis. 

We asked five audiologists what they have done to support their clients during the pandemic. 

Emily Balmer, The Hearing Suite, UK

Initially I thought telecare would be the way forward. I set myself up with Coviu software that integrates with my practice management system, but the uptake was very low. People wanted to send in their hearing aids for adjustments or have me do doorstop drop-offs rather than use remote fitting software. 

After a soft re-open with two client slots a day, I am now booking appointments throughout the day with 30 minutes in-between for cleaning and to ensure no patients pass each other on their way in or out. Everyone receives a pre-consultation form to complete before they arrive. They come in alone and I bring them straight into the clinic room. We have a physically-distanced conversation and then they put on personal protective equipment (PPE) from packs we have prepared — and I do the same. 

I then do otoscopy, wax removal, and any required testing. We remove the PPE and have a final physically-distanced conversation.

I have this week booked up and I think that is partly because of a video I shared about the changes we are making at the clinic. It seems to have given some people the confidence to come in. In the private sector, what we need more than anything right now is consumer confidence. 

Jodi Conter, Gardner Audiology, US

We closed the offices for about five weeks and initiated curbside service one day a week at each primary office during that time. We allowed drop off at the front door, where we collected the hearing aids, serviced them, and returned them to the drop-off table for the patient to collect. Repairs and service are still curbside. 

After those initial five weeks, we began using remote care through manufacturer apps. We’ve also rolled out telehealth appointments that include video conferencing. It’s seamless. All we have to do is schedule the appointment and 30 minutes before it starts, the Sycle software sends a link to the patient, which they just have to click on to connect. We are going to provide a loaner iPod for those who don’t have compatible devices.  

For patients we meet with at the clinic, we use in-office remote care as much as possible to reduce contact with the patient. The patient goes in one room and we connect via video conferencing from the next room and program their hearing aids or do tests.  

I’ve been making masks with vinyl windows to allow for lip reading, but they sure are hotter to wear.  

One positive thing: suddenly everyone is onboard for telehealth!

Darcy Benson, California Hearing Center, US

California was one of the first states in the US to implement a shelter-in-place policy, allowing only businesses that provide "essential services" to remain open. Fortunately, audiology services are considered to be essential. However, at California Hearing Center, we limited our services to what is truly essential and not just routine. We mostly saw patients curbside, mailing supplies and batteries, and doing home pick up and delivery. We also started doing remote care. Our patients have been extremely appreciative that we were available to help them. I also added enhanced infection control procedures, per US Centers for Disease Control guidelines. We are very happy to be able to open up our doors to patients again.

During the crisis, I kept in contact with our patients via a series of email blasts, personal phone calls to as many as possible, and mailed a paper newsletter to reach those without email addresses. I also put a notice on our website, our Google Places page, our Yelp page, and on to let people know we were open for essential services and had created a safe and healthy office environment.

Between those activities, I’ve been busy applying for federal loans and grants, updating our infection control policies/procedures handbook, and participating in on-line seminars, webinars, meetings. . . and a few Zoom happy hours with friends, just to stay sane.

Natalie Buttress, NB Hearing, South Africa

NB Hearing has done as much as possible to protect our patients during COVID-19. We have downscaled physically to only one audiologist and one administrator at each of our three locations. That means our accounting team and two audiologists are working remotely. 

On site, patients are screened by phone prior to appointments. They’re provided with information about Covid-19’s risks and educated regarding the protocol they can expect when they arrive. They are screened (case history and comorbidity), and a non-contact temperature is taken on arrival. Forms are provided by email, or if this is not possible, patients are asked to bring their own pens. 

Our own team complete daily questionnaires to monitor symptoms and record their temperatures. We have also extended appointments by 15 minutes to allow time between patients, and for sanitizing and sterilizing of stations and equipment.  This means no patients wait in our waiting room.  

Audiologists and administrators are wearing PPE scrubs (washed daily), disposable gloves, and 4-layered masks with patients who have mild hearing loss, and face screens while seeing patients with moderate, severe or profound hearing loss (masks on for close contact). We have also placed Perspex dividers on each desk to add protection. 

For patients who require hearing aid repairs or want to purchase consumables such as batteries or wax guards, we have both courier and curbside collection (on a tray with a disposable napkin). Patients who may be at higher risk are being seen at home so that they are only in contact with one person who is extremely careful. 

Paula Johnson, Hear and Say, Australia

Hear and Say is a not-for-profit early intervention and all of life implantable hearing technology program, based in Queensland Australia, with five centers and a tele-practice program.

Our staff were placed on a work-from-home schedule and center-based services were minimized and replaced by tele-practice when appropriate. Most center-based appointments were audiology-related, given the limitations of tele-practice in the space of pediatric CI assessment and programming. There was also an urgency to complete all pre-cochlear implant testing as elective surgeries were getting ready to be suspended.  

For in-center appointments, families were contacted 24-hours prior to their appointment and case histories or questionnaires were completed by phone when possible. Strict cleaning guidelines for all equipment, surfaces, toys, etc. were put in place. Remote mapping was also put in place. To make sure clients were not missed and communication remained strong, tele-practice functional assessments were completed via Zoom with an audiologist to access function.  

A child’s “switch-on” has always been a celebration of hearing shared with family and friends. That was no longer an option, so we had to change how that moment was celebrated and shared. We set-up Zoom links and utilized social media to share these incredible moments.   

We have a long history of delivering Listening and Spoken Language therapy via tele-practice. This level of experience meant that we were able to transition approximately 250 families, as well as group programs, in less than two weeks to this model of care.

Now, we look to the next challenge as we put together a roadmap to return to center-based services.