Need an audiologist but can't travel? Telehealth may be an optionNeed an audiologist but can't travel? Telehealth may be an option
Imagine that you have put off hearing aids because you don’t live near an audiologist. But your primary care doctor now has audiology equipment in her office. She tells you that you could have your hearing tested via computer equipment that connects to an audiologist hundreds of miles away. To pick up your hearing aids, or make adjustments, you simply go back to your doctor's office.
It's an option that's growing in popularity, according to audiologist Suzanne Younker, Director of TeleHealth at Your Hearing Network (YHN). While it may seem impersonal, people often like it. “We find that when patients are talking about their problems to a screen they give you more detail,” she says. “They seem much chattier.”
Later this year, YHN, which supplies services to hearing professionals, is introducing technology with an even more convenient option: Getting tested and fitted at home. A technician would arrive by appointment with a suitcase containing the necessary equipment and you would again interact with the audiologist by video.
Rural areas lack audiologists
Telehealth is expanding to meet a growing need. As Baby Boomers age, more seniors mean more demand for audiology services. But the number of audiologists hasn’t kept up, and especially in rural areas, the nearest audiologist may be far away.
More than half of all U.S. counties do not have any audiologists. Telehealth could be a key solution. While still a new idea, Younker said it could be available for audiology across the country in “the next three to five years."
Helpful for patients with limited mobility
Even in cities and suburbs, telehealth audiology could be attractive, particularly for older adults with hearing loss who are homebound or in a nursing home. On average, a new hearing aid user needs to see an audiologist about three times. For patients with dementia, the adjustment may be slower—but caregivers may not have the time to bring patients in for multiple fine-tuning visits.
Because nursing homes don’t tend to have on-site audiologists, it's the caregivers who have to bring patients back and forth to appointments. The trip itself could be stressful for someone with a disability. In Texas, YHN has supplied a provider that is bringing mobile carts of audiology equipment into assisted living facilities.
The U.S. Department of Veterans Affairs, which has embraced remote technologies for rural health care, is a major hearing aids supplier. More than a third of the veterans it serves live in rural areas and the agency now routinely has eye, skin and radiology specialists reviewing images sent to them electronically. In a pilot program, about 400 veterans have had their hearing tested by audiologists at other locations. Eleven facilities have requested hardware setups to expand their own services, Chad Gladden, an audiology telehealth coordinator for the agency, noted in a July 2019 blog post Audiology telehealth: Helping rural Veterans access hearing evaluations.
Emerging research looks promising
There’s early research to back up Younker’s observation that people tend to like the results of telehealth for audiology. The University of South Dakota is located in Vermillion, a small university town 39 miles from Sioux City by car and more than 130 from Omaha, Nebraska.
For a recent audiology study, researchers recruited 20 study participants with hearing loss, all people with mild dementia who needed hearing aids but didn’t have them. They also lived far from the clinic.
For the study, participants were fitted at the university clinic with hearing aids, which were paired to a smartphone app, managed by their caregivers. The research staff checked the app portal through the work week for messages from a caregiver. They provided advice, and when needed, could make fine-tuning adjustments to the hearing aids.
Researchers monitored wearing time, program use, and the patient’s satisfaction in different real-world listening conditions. The staff could remotely change noise reduction and other algorithms and communicate through real-time video calls, as well as text and voice chat services.
All the volunteers came to the clinic at the beginning and end of six weeks, and once in between. One group of patients received the remote services for three weeks, but not the last three weeks. Another group was not informed of the remote services for the first three weeks, but offered remote services the next three. Midway during the three weeks, when the participants were not able to communicate remotely, they had a clinic visit, along with their caregivers.
The results: Caregivers rated the participants “general comprehension” as 4.5 on average on a 5-point scale in the telehealth period, compared to 2.7 when they weren’t using the remote service. Caregivers said the remote service decreased their stress and improved the patients’ “alertness” and “awareness.”
The university clinic is now using remote services to monitor the auditory brainstem response of babies who didn’t pass their newborn hearing screening, reports study co-author, audiologist and associate professor Lindsey Jorgensen.
A 'truly touching moment'
The current goal of telehealth audiology is convenience. However, over time, it could bring down hearing aid prices, Younker said. Regulations and insurance coverage vary by state, but Younker says the trend is towards more coverage of telehealth.
Patrick Quelhas, a hearing instrument specialist at HearingLife Canada in Toronto, describes a touching experience with a customer who communicated with him from a clinic 83 miles away. The man, who had severe hearing loss, complained that he felt isolated.
“All he wants is to be able to hear his family in the few times he sees them,” Quelhas said. Quelhas suggested the Oticon Opn hearing aid, and technician Colette Doucette found a pair in the clinic that Quelhas could remotely program on the spot.
“As soon he put them on his face lit up and he said 'I can hear. I can’t believe how clear it is!' He started crying and said he was so happy that he had come in to see us. At this point, even Colette and I had to fight to hold back our own tears. It was truly a touching moment, which reminded me why we are in this industry.”