I’ll be honest – the idea of a video appointment with my audiologist made me nervous. This familiar apprehension always relates to anticipating communication difficulties in an important meeting. Communication impacts comprehension – and patient comprehension is crucial to successful healthcare.
Like everyone else, when the coronavirus started snaking through society, my active life transferred to home and online life almost overnight. Soon I was comfortably “Zooming” with family, friends, and colleagues around the world. I used technical devices to stream sound into my CI sound processor and hearing aid, bringing the people on-screen as close as if we were sitting around the kitchen table. The captioning provided by Zoom or Google Meet was not perfect but helpful.
Although we all joked about our corona-hair and shortages of oatmeal, we were worried about getting sick and anxious about being cut off from essential services like hearing healthcare. The closure of audiology clinics was an amplified version of the typical hearing loss experience of our hearing aids breaking down on weekends or vacations, and we would have to wait until Monday morning for the audiology clinic to open. But now, on Monday mornings, the clinics weren’t going to open. What if I needed help, or my hearing aid imploded, or the mold cracked (as it has, never)? I went to the website of my audiologist and found that they were open for business. Oh, hallelujah!
Except, they weren’t actually open.
Coping with communication barriers
In those early, panicked days of lockdown, my clinic was providing curbside drop-off and pick-up service for hearing aids that needed work.
Great! I thought.
Other issues would be handled by telephone.
Excuse me, the phone?
For many clients with hearing loss, the telephone is a major communication barrier, the reason they’re going to the audiologist in the first place! I do well on the phone, but it’s not my preferred mode of healthcare. A couple of weeks later, I read that my audiologist was offering telehealth video meetings – hooray, I’m great at video! A load of stress immediately evaporated.
Adapting to telehealth
When asked to write this article, I immediately booked a video appointment with my own audiologist, Dr. Erin Wright in Victoria, to discuss the audiology telecare she was providing in her two clinics.
Like health practitioners everywhere, Erin wasn’t expecting a pandemic that eliminated in-person appointments. It took a lot of work to prepare for the telehealth services she started offering her clients, and there was a learning curve for both provider and clients. Erin found that telehealth appointments worked best when the clients are already tech-savvy and comfortable with video meetings. Many of her clients don’t use the wide variety of streaming technology that I use for my bimodal devices.
A good technical connection is crucial to the appointment’s success. I could hear Erin well enough, but the video connection seemed a bit blurry. This was not optimal for a person dependent on visual cues to complement residual hearing. However, since no one else had complained about it, I shrugged it off.
Two days later, Erin contacted me. She had mentioned my concern to a colleague and learned that a focus button on her system would improve the client’s view of her. This is important, because a good technical connection is crucial to the appointment’s success. Good picture, lighting and sound quality can help recreate the sense of intimacy from which both the client and audiologist derive satisfaction during face-to-face meetings.
I believe that, with practice, clients may learn to relax during online sessions. I liked the efficiency of the process; you log in at a predetermined time, connect, and are quickly discussing the issue, solutions, and any follow-up required. In the “old days,” an audiology appointment took time. You needed to book the appointment, travel to the clinic, meet with the audiologist, and return home.
I was surprised to find how many services hearing care professionals can provide during a telehealth session: most hearing aid manufacturers have apps which allow audiologists to do “live” remote tuning of devices. After the first fitting of a new hearing aid, follow-up sessions can be done via telehealth – and it is these first few meetings which can establish one’s success with hearing aids.
Looking to the not-so-distant future
Software that allows adequate remote hearing testing is still not widely offered, but I say, bring it on. Having my hearing tested when I’m in my own home would be less stressful; I’d feel less pressure to pass this test (yes, after decades of testing, I still secretly hope for an improved audiogram). While my remote audiologist cannot look in my ears or examine the actual hearing aid, I’m sure there will be an app for that in the not-so-distant future.
In a December 2018 Ida Institute article on the role of telehealth in the future of hearing healthcare, Lise Lotte Bundesen wrote that telehealth beautifully aligns with the ideals of person-centered care: “…like person-centered care, telehealth helps to put the person with hearing loss first. Telehealth is a way to connect people and provide hearing care at times and in places convenient for them.”
With a stable internet connection, headsets, computers with adequate speakers and microphone – as well as a willing client and a trained professional – the audiology telehealth system is poised to succeed. I’m looking forward to a “real” audiology telehealth session and the perfect place to start would be with my cochlear implant/tinnitus audiologist who is in a different city. Getting there means taking a ferry and an hour’s drive to the hospital. That’s a full day for a two-hour appointment. How wonderful to think that one day, my CI mapping, device checking, and the long discussions about tinnitus could be done between my CI audiologist in her city office and me in my island home.