The COVID-19 pandemic provided hearing care professionals an opportunity to review the provision of hearing services. We hear from Lise Lotte Bundesen, Managing Director of the Ida Institute, about the potential of tele-audiology and how it can help to maintain the quality of care through a client-first philosophy that puts people at the centre of their care. The Ida Institute offers a free course on tele-audiology and the article provides examples of how it has been used by hearing care professionals from all over.
Telehealth is no longer the distant future of hearing care, and offering remote services to bolster traditional ones can no longer be considered icing on the cake. Tele-audiology has arrived, and we are just scratching the surface of its potential. The question is not whether to embrace telehealth, but how to do so while maintaining the quality of care that clients have come to expect from their hearing care professionals.
And the answer is: through a client-first philosophy that puts people at the centre of their care. The Ida Institute was a pioneer in promoting and facilitating person-centred hearing care. We develop ways to strengthen the communication and relationships of professionals and their clients and have many tools and resources to support hearing care professionals in a person-centred manner.
Tele-audiology: Person-Centred Care from Afar
As part of our tele-audiology offering, the Ida Institute teamed up with Frances Lockhart, Clinical Leader and tele-audiology subject matter expert at Hearing Australia, to create the free Learning Hall course, ‘Tele-audiology: Person-Centred Care from Afar’. It’s an in-depth exploration of why tele-audiology is an important part of a practice and how to incorporate it in daily work. Lockhart leads viewers through the changing expectations of consumers, how the patient journey fits with tele-audiology, and how to use Ida’s suite of Telecare tools. The course can be taken in bite-sized pieces, allowing learners to take the course when and where is convenient for them.
Tele-audiology: Person-Centered Care from Afar is guided by the stages of the hearing journey. From pre-contemplation to managing hearing loss or relapsing, there are tele-audiology techniques and tools available to support clients in a person-centred way.
“Tele-audiology isn’t about your audiological clinical skills, as is commonly assumed” Lockhart says. “The most needed skill in tele-audiology is being able to take the perspective of what your client is seeing and experiencing from their end. That lets you guide the client remotely through any scenario in your mind’s eye and fully understand their situation.
Lindsay Gray, Sandton Hearing and Balance.
Upgrading skills during lockdown
Bianka Niebuhr, at Sandton Hearing and Balance in South Africa, decided to take the tele-audiology course during lockdown because she was frustrated by being unable to help patients while they were at home. “I was trying to find ways to use technology to help patients remotely, and to save time during the in-person consultation” she said.
Her colleague, Lindsay Gray, also took the course during lockdown. “I felt tele-audiology was an appropriate and necessary extra service we could provide to our patients to make sure they felt supported during these unprecedented times” she said. “It was an aspect of our audiology practice that needed more work, and I wanted some guidance as to how we could implement tele-audiology during the lockdown and beyond.”
Better prepared means better care
Tele-audiology is frequently thought of quite narrowly — often as no more than video conferencing. In fact, it can be something as simple as an SMS or as technical as a remote fitting. But regardless of how it is being delivered, there are opportunities to support each stage of treatment, including prior to the first appointment.
Ashish Shah, an Audiologist at Leightons Opticians & Hearing Care in the UK books phone calls with clients prior to assessment to understand their motivations. This, he says, allows him to be more prepared for their appointments and better able to tailor his clients’ care.
Niebuhr also found value in reaching out to clients ahead of appointments, saying she was surprised at how many Ida tools are available online and how much can be done before the initial patient consultation: “I was impressed by how much information you can gain from patients by using these tools.”
Ida tools help clients and hearing care professionals prepare for appointments in advance. When everyone is prepared, they can more easily focus on the things that matter most to the client during the appointment, leading to greater patient satisfaction and improved outcomes.
Zoryana Greskiv at Hidden Hearing.
Telecare tools to support person-centred appointments
At Hidden Hearing clinics in Ireland, Tele-audiology: Person-Centred Care from Afar has been widely used in training to strengthen their tele-audiology programme. Audiologist, Zoryana Greskiv, who works in their Louth clinic, says that since the end of Ireland’s first lockdown on 18 June, tele-audiology has become their typical method for delivering care. Testing is still done in-clinic, but aftercare, whenever possible, is done remotely.
Greskiv uses many of the Telecare tools featured in the tele-audiology course to guide her appointments: “I use the Tinnitus Thermometer the most, both prior to appointments and for follow-ups. I also use The People I Talk To for identifying the correct third party who can attend the appointment with the client. And Living Well is an important tool to help my patients identify where and when they feel it’s most important for them to communicate well, and to describe their lifestyle and how they manage their hearing loss. I found it especially useful for young clients.”
Misconceptions about tele-audiology
During the pandemic, it may be necessary to replace in-person appointments with remote appointments, but Lockhart stresses that it shouldn’t always be an either-or approach. “Tele-audiology doesn’t mean you never see a client face-to-face or that they are always on the end of a computer or screen” she says. “Tele-audiology is an enhancement of face-to-face care. It is a great skill to have and tool to use, to add a level of connection with clients in a way and at a time and place that they are most comfortable.”
Melanie Gregory, Leightons Group Head of Audiology says: “We don’t see our care as either tele-audiology or in-practice care. Rather it’s a continuum of care based on professional and government guidelines and patient preferences. It affords professionals additional choice in the delivery of their services and more opportunity to stay connected with our patients.
The surprise for us in this process has been how well this blended care has been received by many of our patients, even though they are mostly over 65. As a profession we should be vigilant of our own pre-conceptions. Blended care does not limit the value of our care, it augments it, giving both patients and professionals more choice and greater connectedness.”
Lockhart also wants to dispel the misconception that tele-audiology is only for the young or tech-savvy, saying “although computer literacy is a great thing for our clients to have, it is our job as audiologists to offer a range of ways our clients can connect with us, so even clients with fairly low digital literacy can benefit from having additional touchpoints with their audiologist.”
Offering tele-services has never been easier
Until recently, barriers to telehealth were significant. But as awareness, knowledge, technology, policies, and attitudes have advanced — accelerated this year by COVID-19 — obstacles to offering tele-services have crumbled. As evidence for the effectiveness of tele-audiology and person-centred care builds, reasons for not offering tele-services become increasingly scarce.
Resources like Tele-audiology: Person-Centered Care from Afar and Ida Telecare tools can make delivering quality, person-centred care via tele-audiology easier and better, but it’s up to hearing care professionals to take the initiative, for themselves and their clients.
To access all of the free courses in Ida’s Learning Hall, visit
learninghall.idainstitute.com (sign-up required).