GN Hear & Now
TELEAUDIOLOGY: CONSUMERISM DRIVING CHANGE
Telehealth is a growing component of today’s health care system as technology, patient demographics and society evolve. A component that is the focus of much research, discussion and debate as our comfort zones and current practices are challenged and transformed.
Teleaudiology specifically is the subset of telehealth that refers solely to audiological practices. With any change alongside excitement and the opening of new possibilities always comes fear and the unknown. However teleaudiology has the potential to improve our Audiological services and provide greater benefit and satisfaction for our clients.
Krupinski (2015) describes telehealth as the use of telecommunication technologies to reach out to patients, reduce barriers to optimal care in undeserved areas, improve user satisfaction and accessibility to specialists, decrease professional isolation in rural areas, help medical practitioners to expand their practice reach, and minimise patients from having to travel or be transported to receive high quality care.
As hearing health care professionals, we are usually aiming to achieve at least one these outcomes in our daily practice. Singh et al (2014) describes teleaudiology as the provision of audiological services from one location to another using an information communication technology and suggest these services can either be achieved in a synchronous manner where the patients and practitioners meet and communicate in real time, or via an asynchronous manner where the storage of clinical information and data is forwarded to a healthcare professional at a different location for further evaluation at a later time.
A major driving force behind teleaudiology is the changing demographic of our clients. Stender, Groth and Fabry (2017) report that today’s clients tend to be better informed about their healthcare needs and services than previously and are now behaving more like consumers.
Consumerism in hearing healthcare means that hearing aid users want to be more engaged and have more control in the hearing aid fitting process (Fabry & Groth, 2016). Gladden, Beck and Chandler (2015) report that patients as health care consumers want and require access to technological tools to achieve some of the following objectives:
- Expand timely access to care by reducing the amount of face to face visits
- Informed patient decision making
- Promote self-management with individualized patient education
- Enhanced communication and engagement between patient and provider
- Connection to support systems and resources
- Improved access to follow up care
- Improve patient health outcomes and satisfaction
- Reduce costs of care while maintaining quality.
Importantly, the expertise of the hearing health care professional remains highly valued and important, with the emerging teleaudiology solutions providing opportunities for preserving or enhancing the relationship between hearing health care professional and client by improving clinical efficiencies, user satisfaction and successful outcomes (Fabry & Groth, 2016).
Behaving like a consumer engages the recipient of healthcare services in a different way than the traditional health care models, and since patient engagement in healthcare has proven to lead to improved outcomes, it makes sense to embrace this trend, and given this trend in consumerism coincides with the baby boomers reaching the age where hearing loss is common, it affects the hearing healthcare industry (Stender et al, 2017).
With any change or introduction of new systems or practices there are always advantages and challenges to adaptation and implementation.
Krupinski (2015) states that one main advantage of teleaudiology is that it may help to overcome some of the common barriers to getting hearing aids, such as cost and distance from service providers.
Singh et al (2014) list several benefits to adopting telehealth: increasing patient access to health care services, reducing costs and the inconvenience of travel to medical appointments, minimizing stress on family or caregivers providing the transportation to medical appointments, reducing the amount of time family and caregivers take off work to provide assistance with transportation, increasing the ability of practitioners to respond to issues critical to behaviour change and limiting carbon dioxide emissions associated with extra medical travel.
All of these are also relevant to our audiology clients. However the most effective teleaudiology solutions will take into account the balance between providing immediate, improved access for users while ensuring the hearing health care professional maintains engagement and control of the process, data security and improved outcomes through continued client contact (Fabry & Groth, 2016). This would be reassuring to many Audiologists as it seems a big fear among us is job security and redundancy with these technological advances, however the research is showing the importance and value of the hearing health care professional alongside access to teleaudiology.
Attitudes to Teleaudiology
Some barriers to teleaudiology include patient and provider preferences and their reluctance to embrace virtual care, reimbursement and the need for continued development of professional standards (Gladden et al, 2015).
Not surprisingly there are varying attitudes to teleaudiology. Stender et al (2017) state that consumers are open to the trend of telehealth and teleaudiology which requires the provision of services and sharing of information over distance via electronic means, while the hearing health care professionals are very cautious in their attitudes.
They go on to describe an interview based study regarding the perceptions of internet-based hearing instrument acquisition where the participants raised concerns with regard to the lack of clinical services received and how the hearing instruments would be individually adjusted and programmed for their hearing loss.
Despite wanting the benefit of some fine tuning adjustments to be able to be made over the internet, the participants showed a preference to be treated by a knowledgeable and experienced expert.
In the Singh et al (2014) study they also observed that the success of telehealth is dependent on the attitudes, perceived usefulness, and acceptance of the technology by health care professionals, patients and administrators.There was a greater willingness to use teleaudiology if it resulted in a decrease in wait times or costs for appointments and less willingness from those individuals who preferred face to face consultations.
Singh et al (2014) found that a large portion of the respondents thought teleaudiology would have a positive effect on the hearing healthcare industry in terms of accessibility: access to audiological services, the ability to quickly meet with patients and decrease the need for patient travel. The acceptance and adoption of teleaudiology may be led by individuals who exhibit less discomfort with risk and who are more open to new experiences.
The importance and relevance of teleaudiology is currently being driven not only by rapid technological advances but also the transformation of client to consumer. This will only be enhanced as the baby boomer generation reach the age where hearing loss becomes more common.
There are several ways in which teleaudiology can be utilised to enhance client outcomes but from the studies reviewed we have learnt that the importance of the audiologist is not to be underestimated, and while clients may want to take ownership for their health care and have flexibility they still value and require the expertise and experience of their hearing health care professional.
So how can we increase user satisfaction utilising today’s technological advances without diminishing or disrupting the hearing heath care professional/client relationship?
ReSound Expert, Caitlin O'Sullivan
Area Manager (VIC,TAS & SA)
Fabry, D.A (2016) The Future of Private Practice in Audiology. Seminars in Hearing, 37(4): 369-378
Fabry, D & Groth, J (2016) Teleaudiology: Friend or Foe in the consumerism of hearing healthcare? GN Hearing A/S
Gladden, C, Beck, L & Chandler, D (2015) Tele-audiology: Expanding access to hearing care and enhancing patient connectivity. Journal American Academy of Audiology, 26:792-799
Krupinski, E.A (2015) Innovations and Possibilities in Connected Health. Journal American Academy of Audiology, 26: 761-767
Stender, T, Groth, J & Fabry, D (2017) Teleaudiology: Promoting better fit-to-preference and efficiency. GN Hearing A/S
Singh, G, Pichora-Fuller, M.K, Malkowski, M, Boretzki, M & Launer S (2014). A survery of the attitudes of practitioners toward teleaudiology. International Journal of Audiology 53: 850-860