Tele-audiology is a concept that has been defined and explained excessively in literature. However, there is a paucity of documentation on the practical implementation of tele-audiology in one’s clinic, more especially in the developing world context.
I’m sure we’ve all come across the different definitions of this concept but all of these boil down to one idea, the use of telecommunications technologies to provide remote and distance clinical hearing healthcare.
With the concern of universal health coverage, tele-audiology is one of the chief ways to deliver hearing health care services to those who need it the most.
The need and benefits of tele-audiology
The need for tele-audiology is clear and as healthcare providers, we certainly aren't where we should be to meeting this demand. In a previous post we did on How Telemedicine is Changing the Face of Audiology Forever, we highlighted the benefits of this model and how it improves access to care, improves the quality of care in rural areas and how it’s a cost-effective way to meet patient demand.
How does tele-audiology work, practically?
There are three different ways in which tele audiology is applied or implemented in clinics. Some clinics will have continuous internet connectivity, some intermittent and others no internet connectivity at all. The different principles of implementing tele-audiology considers the clinic's context. Below are the three principles of tele-audiology which can be applied to each setting:
Synchronous: The audiovisual aspect happens in real-time by having a computer at the patient’s site and at the clinician’s site connected to the internet. The clinician remotely controls the computer at the patient’s site to monitor the status of the patient’s hearing. The clinician will then analyze and interpret the patient data in real-time, and provide recommendations.
Asynchronous: The trained healthcare worker assesses the patient’s hearing, then forward the patient’s data to an audiologist once the healthcare worker has access to the internet. The audiologist then interprets the patient data and sends back recommendations (i.e. ‘ototoxicity detected, please reduce drug dosage or frequency’) to the patient site.
Hybrid: This is the use of both synchronous and asynchronous methods.
This ensures improved access to audiological services in urban, rural and remote areas even without a hearing healthcare professional being present at the site.
How to practically implement it?
Get the right military strategy
As the saying goes, ‘When you fail to plan you plan to fail’, and the same holds true for tele-audiology solutions. A comprehensive program and technical plan that outlines the workflow from start to finish at both the main hub and remote clinic site is needed. The main hub here refers to the clinician's site where they will be based. The remote clinic site then refers to the clinic set up or any patient test site at a distance from the clinician.
A step by step workflow from when the patient enters to when the patient leaves would need to be clearly outlined and understood by all parties involved.
Check your arsenal
Armies will never engage in battle without the necessary equipment, and if we are to fight the scourge of hearing loss, we need to be prepared. You need to purchase the right and appropriate equipment with the correct specifications that are tele-audiology enabled. Here is some of the key tools you will need to start a tele-audiology practice:
- Computer with high-resolution webcam
- A video otoscope (Interfaces with a computer)
- Internet connection (continuous or intermittent, depending on the principle you will follow)
- An audiometer with tele-audiology capabilities
- Video conferencing tools (i.e. Skype)
- Immittance equipment
- Hearing aid programmer (i.e. HI Pro box)
- Computer software for remote control (TeamViewer)
- Like all armies, you too need a plan - check out this article on planning a teleaudiology practice
Recruit braveheart soldiers
The success of your business hangs on the staff you employ and with tele-audiology, the staff at the remote clinic and those at the main hub (clinician’s site) need to be tailored for the job.
- The best way to ensure success at both locations is to employ a competent overseer or a coordinator. Someone who will oversee all day to day activities and someone with strong leadership capabilities.
- IT staff: Technically savvy and knowledgeable individuals who will know about applications and tools used.
- Tester/technician: for preparing the patient for the clinician, giving patient test instructions and conducting basic tasks such as collecting patient history.
- Audiologist: for conducting testing, analyzing data, and making patient recommendations at the main hub.
Teamwork between the locations is crucial for a smooth-running tele-audiology practice.
What services can you provide?
Tons. Below is a list of the quality services you can provide through tele-audiology.
- Video otoscopy
- Hearing screening
- Diagnostic pure tone audiometry, speech audiometry, tympanometry, real-ear hearing aid evaluation
- Fitting and programming of hearing aids
- Aural rehabilitation
- Hearing aid troubleshooting and repair
Research has shown a reduced patient wait time, and high levels of patient satisfaction with tele-audiology compared to face to face meeting. Furthermore, you can reach your patients everywhere!