Don’t you wonder that it would have been better if you got to get in touch with a doctor or a health professional in one go, anytime and anywhere. Because health breakdowns can occur anytime, even when you have no health professional around to help you out! In such a case, telehealth systems can save you!
What is Telehealth and Teleaudiology?
Telehealth refers to the distribution of health-related services and their associated information via the electronic media and telecommunication technologies. It involves long distance patient-doctor/health professional contact and communication, care, advice, education, intervention, reminders, monitoring and even remote admissions. All of these are done over some electronic and telecommunication technologies - the best example being videoconferencing. Life has become so much easier, isn’t it?
Telehealth has expanded its scope to the field of audiology as well. There are audiologists who really care about you and your hearing health! Because you never know when you might face hearing problems - it may be sudden! In that case, you might not always get the scope to contact a good and professional Audiologist near your location. Wouldn’t it be wonderful if you have a quick and instant access to a hearing loss treatment in a condition like that?
Teleaudiology refers to the process by which telehealth is utilised to provide audiological services. It can be as simple as a conversation of a patient with an Audiologist over the phone, discussing matters regarding his or her hearing problems in real time. Teleaudiology uses electronic and telecommunications technologies to support distance hearing healthcare services and advice by professionals, and manage matters regarding public education and public health care and administration.
It all began in the era when there was an emergence of telecommunications systems along with other electronic media, when video-conferencing, web-conferencing and distance education was on the rise - so much so that it has already become a MUST HAVE in every home! Hence, these media stated to be used in audiology education and in rendering audiological services.
We now live in a world where an Audiologist sitting at some distant location can log onto his computer and/or other devices and provide audiological services via speech to patients so many miles away.
Although ‘teleaudiology’ has become a quite accepted term for rendering audiological services to the remote patients, there are other terms as well which are used interchangeably - such as ‘telemedicine’, ‘virtual care’, ‘connected health’, and of course the one mentioned above, that is ‘telehealth’. Whatever the term, all of them more or less mean the same thing. The keypoint is that there is no ‘face-to-face’ encounter in the traditional sense of the term as the provider and the patient are remotely connected. Teleaudiology and telehealth is basically used to reach out to those people who have very little or no access to health professionals (in this case Audiologists). There are so many remote and interior areas where there is no sufficient healthcare set-up and instruments available.
Why it has Become Important to Serve Distant Patients?
There is a widespread need for offering services ‘at a distance’. Telehealth and teleaudiology is not a very new concept, yet these days, it has become a really important aspect due to such a radical technological evolution, people prefer fast services and quick and easy access to almost everything. It becomes all the more necessary in the fields of healthcare, as people look for professional services and most importantly to consult a healthcare professional on-the-go. There are so many reasons for this - the primary one being the urgency and the immediate need of a professional care and support. Other reasons include travelling cost and time, unavailability of clinical professionals nearby, and so on.
However, it should be noted that, teleaudiology is not limited to the rural areas only, its services are extended to urban areas as well. The main motto of teleaudiology is to place the patient at the centre-point of care and support, and to take care that he or she is receiving on-time and effective treatment of hearing loss or other hearing problems without compromising on the quality of the service, via the electronic and the telecommunication technological systems. Care is taken that not a single person is left out, especially for those dwelling in the interiors and the remote areas, due to the unavailability of proper audiological services. The practice of teleaudiology ensures that a strong connection is built between the Audiologist and the patient, and that the barrier of physical distance is not felt. Patient case studies show that teleaudiology has proved to be quite productive and have shown the same or even better outcomes than traditional face-to-face clinic visits.
Apart from the distance, studies have shown that there are other factors too like the travelling time, the busy work schedule, the driving distance and the driving time, parking, and other such coordination challenges that patients face in maintaining the traditional scheduled appointments. There so many urban dwellers who prefer teleaudiology more than anything else, as they feel it is much more easier to access. Also, it is much more beneficial not only for the patients, but also for their caregivers who accompany them and travel with them.
Practices of Teleaudiology
According to the Department of Veterans Affairs (VA), a leader in the delivery of telehealth services, there are three major areas of the practice of teleaudiology, which are -
Clinical video telehealth (CVT) - It involves real-time video-conferencing to diagnose, assess, treat, care and support persons suffering from hearing problems.
Home telehealth (HT) - It involves the monitoring and the management of patients (mostly at home) with the help of video and mobile devices.
Store and forward telehealth (SFT) - It uses various advanced technologies to acquire and store information such as data, images, videos, sounds, etc., which are often forwarded to various clinics or professionals or can even be retrieved by Audiologists for further and detailed evaluation and analysis of the person’s hearing health, and to begin a hearing loss treatment procedure accordingly.
But is it Feasible?
Yes I can hear you asking, ‘Why and how is it going to solve my hearing problems in my real life day-to-day activities?’ Talking about the benefits of teleaudiology, such as the various opportunities in the many areas of education, intervention, screening, diagnosis and treatment, answers for ‘why’.
The answers of ‘how’ is equally very simple! Remember the ‘Store and forward’ teleaudiology system we spoke of in the above section? Yes, these valuable data transferred over various telecommunications networks have boosted up the scope and the outcomes of teleaudiology to an unimaginable extent! The videos, sounds, images recorded and sent to Audiologists and hearing clinics, are done in real-time - thus paving the way towards starting with hearing loss treatment methods - solving the real problems of the patient. This is how the whole procedure of telehealth and teleaudiology is helping the person coping his or her problems in daily life. This is how the virtual world of telehealth is being converted and translated in real life.
Benefits of Teleaudiology
You will be surprised to know about the benefits of teleaudiology - the list is huge! But research studies and Audiologists have confirmed about the four fundamental and most important benefits, which are -
Improved access - Although the primary focus is to improve the accessibility of the patients, yet it has been extended to Audiologists, other hearing healthcare professionals and hearing clinics who can now expand their reach outside their clinics and offices. It has therefore made it possible for people with very little or no access to proper hearing care and support to easily reach out to them. It has thus benefitted millions of people suffering from hearing loss, with most of them not even having the proper awareness of the extreme need of a good hearing loss treatment, and the proper guidance.
Improved quality - You might ask whether the quality of teleaudiology is as good as traditional audiological services rendered at the clinic. The good news is that it is, and studies have proved that! Actually telehealth services in the field of audiology is even better at times due to the improved access, and immediate consultation facilities that the patient is getting. This cuts down traveling cost and time, and thus having better outcomes and patient satisfaction.
Cost efficient - By cutting down the traveling cost, teleaudiology has made its way easily to reach out to those who step back from a good hearing loss treatment access due to budget shortfall. There are so many people even today who neglect their hearing problems because they feel that they couldn’t bear the costs of hearing care. With teleaudiology this problem has been solved as the telecommunications technology has not only reduced the clinical and traveling costs and time, but has also increased the efficiency due to a better management of patients, thus resulting in a fewer patient dissatisfaction.
Meets patient demands - Although teleaudiology has not fully replaced the traditional face-to-face hearing care, people are however, wanting to reach out to these telecommunications technologies, especially in times of urgent need and when you have a packed and busy schedule when you find it difficult to travel to the clinic. Also, it is a very effective health care solution for senior citizens or for those who have mobility issues.
What Statistics Say?
You will be quite surprised to know what recent research studies performed at the Veterans Administration (VA). Approximately 60% of the veterans who have enrolled at the VA are urban dwellers, about 37% are rural dwellers, and very few people less than 2% reside in the highly rural areas. As mentioned above, there are many factors such as the travel distance, the travel time and other geographic barriers which limit a person’s access to the specialised hearing loss treatment clinics.
What are the Services Offered in Teleaudiology?
If you think that teleaudiology and other remote hearing services is a complex process, which is preventing you from stepping forward towards it, then it’s time that you should THINK AGAIN! There are a vast range of services offered by teleaudiology which you might never even thought of, ranging from counseling to hearing screening to full-fledged clinical diagnosis and hearing tests. Some common services offered by a teleaudiological clinic include -
Diagnostic tests and hearing evaluation, including tympanometry, ABR, BERA, ASSR, OAE tests, etc.
Hearing aid trial and fitting services
Remote troubleshooting, or the programming or reprogramming and the orientation of hearing aids and cochlear implants
Auditory verbal therapy
Aural rehabilitation sessions for tinnitus evaluation and management
Making use of video and mobile technologies to make hearing aid programming and other adjustments at home environments and even outside
Automated pure tone audiometry test
Remote assessment and diagnosis of hearing problems as well as balance disorders
Home-based after care
Auditory rehabilitation services, and so much more.
Applications of Teleaudiology Seen Worldwide
Pediatric evaluations with pure tone audiometry, tympanometry, and otoacoustic emissions (Case Western Reserve University, Cleveland, OH).
Mentoring and post-doctoral training with telehealth supervision (Marion Downs Hearing Center, CO).
Development of protocols for infant diagnostics (HRSA Grant awarded to Minot State University, ND).
Paediatric diagnostics for ruling out hearing loss (Thunder Bay, Ont).
Tele-intervention and parent coaching and counseling (Utah State University, UT).
Cochlear implant mapping (St. Petersburg and Sarasota, FL).
Connecting third world countries to audiology services in developed nations (University of Pretoria, SA).
Hearing aid trial and fittings (Mayo Clinic, MN).
Audiometric evaluations (Minot State University, ND).
Live videoconferences with patients as well as their caregivers (Mark Krumm, AAA Taskforce on telehealth and tele-audiology).
Telemedicine initiative in Vanderbilt University’s Department of Hearing and Speech Sciences is working to make follow-up hearing tests for newborns and to make them more accessible in rural areas of Tennessee.
University of California Davis is launching a pediatric audiology telemedicine program in northern California which uses telemedicine to provide comprehensive audiology diagnostic evaluations over long distances. This program evaluates those infants who do not pass their newborn hearing screening.
Royal Institute for Deaf and Blind Children (RIDBC) (NSW AU) has a research project that aims to allow city-based audiologists to test children’s hearing remotely, relying only on unqualified helpers at the remote site.
Tinnitus management and treatment (Tinnitus Treatment Solutions).
Cochlear implantation (Queensland’s Hear and Say in conjunction with Sydney Cochlear Implant Centre NSW AU).
(2015, October 16). Retrieved from https://www.audiology.org/practice_management/resources/current-practices-tele-audiology
How to Build a Successful Teleaudiological Program?
Behind every successful program of efficient practices lies a series of plans and lessons, which gradually evolve all the way down from inception to the day when it became the accepted one. Similarly, a successful teleaudiological program has seen vast developments till they successfully came to be known as the ‘best practices’. The key to a successful program primarily lies in implementing a well-planned structure. Check out the following guide to successfully set-up a program in teleaudiology.
1. Make your mind ready for starting a teleaudiology program - You must know and accept that it is not going to be very smooth process. You will have to face the many challenges that will come your way, especially while getting started - it might be anything between economic shortages, time-consuming, and so many other hurdles coming your way. Be prepared to face all that! Consider and examine both the advantages as well as these challenges before starting out. An ideal teleaudiological program must meet the following -
- Match with the goals and the motto of the organisation or clinic
- Identify the need for starting a teleaudiology program, by considering the consequences
- Identify the talent pool and recruit from it the best professionals, i.e., Audiologists and other hearing health care specialists
- Analyse whether your plans and strategies are going to serve and fulfil your long-term goals
- Analyse the objectives and identify the unfulfilled or unmet requirements and to devise strategies and approaches to meet them efficiently
- Always make sure that the approaches you are taking will really be beneficial for your clinic/organisation in the long-run. Make an effort to improve the outcomes, client satisfaction, hearing loss treatment methods, the geographic location and financial status
- Bring in and implement new and innovative approaches and instruments
- Last but not the least, you must have a clear understanding of your clinic’s mission and the type of services you will render
2. Perform a thorough market analysis and make a business plan - This is probably the most important step! It will give you a clear idea about who your target audience is and whom do you actually want to reach out to. Also, try analysing the demands of your target market and try to devise plans to cater to their various requirements. A business plan will also help you identify the resources required and the funds to be allocated to each department. This will enhance the growth of your organisation as well as help build up a good client-organisation relationship.
- Make sure that there is a clear need and whether there is a significant demand for your services in the particular geographic areas/regions you are targeting. Also, one important aspect to keep in mind while analysing your target market is that although there may a great need of your services in a particular location, but the people residing there may not have enough financial support to pay for your services.
- Don’t make the mistake of basing your strategies solely on speculation. Look beyond the present time!
- Identify and widen your revenue sources and opportunities and develop your fiscal estimates
- Make sure that your plan includes timelines, the list of deliverables, the technical requirements, the milestones, and the potential challenges.
3. Build a strong team which will take the team forward - Any great program cannot be taken forward without a strong team and a good coordination amongst the team members. So consider everything well while hiring professionals, who will understand your organisation/clinic’s mission well.
- Hire a coordinator who would oversee all your activities associated with the teleaudiology program, such as scheduling, billing, the technical operations and who would see that the whole process works seamlessly
- Make sure that all your staff are tech savvy and everyone has the ability to operate the technical aspects of the program. Also make sure that everyone is knowledgeable enough about the teleaudiology program and its various applications.
- Make sure that each one of them is flexible enough and has the will to adapt to changes and new clinical methods and approaches
- Make sure that a healthy and comfortable workplace atmosphere is created so as to make the program more productive
- Develop and implement a training program from time to time to help the staff update themselves
4. Make sure you have the right equipment
- Identify which would be the right equipment for meeting your teleaudiological needs.
- Buy instruments and equipments only from trustworthy sources.
- Check whether your video equipments and other communication systems are providing high-speed and an uninterrupted internet connection.
- Keep on testing your instruments regularly and make sure that they are working well.
- Replace or repair them in case of breakdowns. Also keep on upgrading them from time to time, and don’t forget to do warranty renewals.
- Most importantly, test all of your equipments before announcing and starting your teleaudiology program.
5. Create an effective and a professional environment -
Even if you are not having to meet your clients faced-to-face, make them feel as if they have visited a professional clinic.
Make the whole system user-friendly and easy to access.
Make the clinic atmosphere such that both you and your clients feel comfortable. Give your clients enough support and make them feel reliable.
Pay close attention to the clinic interior such as room space, furniture, lighting, wall colour, as well as the room location. Give a professional touch to everything you plan and do.
Take care of your patient privacy. Make use of good IT security services and assure your clients that their data and information such as videos, sound clips, etc. are safe with you.
6. Plan for a seamless integration between various teleaudiology sites - Teleaudiology services are meant to complement the standard and traditional practices - it should not in any way complicate and interrupt with it. They must exist and work in tandem with each other. Plan a workflow analysis which would fit in with your standard clinical practices. Treat teleaudiology as the same thing as that of the traditional face-to-face system - with the only difference being a lack of a face-to-face encounter.
7. Make sure seamless and uninterrupted IT facilities are available at all your clinics
Hire a IT personnel at every centre to oversee whether communication technologies are working smoothly at everywhere
Educate and familiarise all the IT staff about the various networking systems and communication technologies.
8. Set long and short term goals and establish protocols and policies - The clinical policies and protocols should be available to all in written format.
- Create protocols that are similar to those followed in a traditional audiological set-up. As mentioned above, make the clinical set-up such that enhances the comfort zone of both the professionals (Audiologists or other hearing health specialists) and the clients.
- Follow standard protocols which will go at par with the clinical and market requirements and which will be vital for evaluating and monitoring the program.
- Think long-term and establish your goals accordingly. Consider all the aspects and think about the possible outcomes including clinical, business and financial, and look into the future down to several years.
- Make sure that the protocols and policies you are setting-up are self-sustainable and ensure your organisation/clinic’s productivity.
9. Develop and implement an evaluation, monitoring and a quality-improvement plan - Establish a separate quality-control team which would check and monitor the clinic’s performance on a day-to-day basis. Think about this right from the planning stage. Make sure to establish a assessment methods and evaluation strategies, as well as a routine performance monitoring. Also, search and find out new innovations in your clinical practices and implement new ideas to make your business graph grow higher.
10. Understand and keep in mind the legal and regulatory issues of teleaudiology - Make sure that your business policies comply with the various regulations and legal aspects associated with teleaudiology. Also, keep up-to-date with changes in the laws and regulations and implement them in your clinical practices. Consulting with a legal counsel or advisor from time-to-time can be a good idea.
The key to a successful teleaudiological program is a strong team of qualified and skilled professionals, separate departments for controlling each aspects working in strong collaboration and coordination with each other, having a professional outlook towards everything, and most importantly PATIENCE and PERSEVERANCE.
In a nutshell, it can be said that teleaudiology has much greater scope and has the potential to open more windows towards taking the field of audiology to a all new level, thus helping the people with hearing problems live a much better quality of life like never before. Teleaudiology is continuously growing and emerging as a new field each day with more and more innovations being implemented by skilled Audiologists and other hearing healthcare professionals. So are you ready to accept teleaudiology as your preferred medium of hearing loss treatment? Try it and see the changes, and let us know in the comment section below!