Tele-audiology is the delivery of audiological services from a distance and a new research project in Western Australia will investigate how it can be used to help people with cochlear implants manage their own hearing health.
The project, which will involve a team of audiologists, will monitor people with cochlear implants regularly self-checking the function of their implant, as well as self-monitoring their hearing and implant management.
Dr Cathy Sucher, Clinical and Research Audiologist at the not-for-profit ear and hearing organisation, Ear Science Institute Australia in Western Australia, is leading the project from the institute’s head office in Perth.
The project’s launch in 2021 follows an expansion of telehealth in the hearing sphere. This growth was due in part to COVID-19, and also the Australian Government’s inclusion of telehealth items for audiologists delivering services via telehealth as part of the Hearing Services Program – a government-funded service for pensioners, children, the disabled, veterans and defence personnel.
Ear Science Institute Australia is Western Australia’s largest provider of cochlear implants, with more than 1,300 clients – all of whom require annual check-ups for the rest of their lives.
Dr Sucher says more than ten percent of Ear Science Institute Australia clients travel more than 100km for their annual check-up at the clinic, and some patients are travelling up to 1000km to make their appointment.
“Every year, they have to come to Perth whether they need it or not; so, we are looking at how we can change the delivery of services for people with cochlear implants,” said Dr Sucher.
“Our objective is to be smarter about this and to develop some tools so people can do some remote self-checking and self-monitoring. They will be encouraged to do it regularly through a system of prompts.”
Based on the results of the remote monitoring, an audiologist may decide to speak with the client over the phone or via video conference, or they might request a face-to-face visit at the clinic.
Ultimately, says Dr Sucher, the outcome of the project will be to reduce the number of unnecessary visits to Ear Science Institute Australia clinic and to improve the clinic’s effectiveness in managing the growing number of people with a hearing implant.
Remote monitoring at home
The program will require clients to regularly conduct a simple hearing test by directly connecting their cochlear implant via an app to a smart phone. Test results are then forwarded through the app directly to the audiologists at Ear Science Institute Australia for review.
Ear Science Institute Australia Research Manager, Professor Robert Eikelboom, likes to quote the famous 20th century activist and educator, Helen Keller, who was herself deaf and blind. She said, “Blindness cuts us off from things; deafness cuts us off from people”.
“That’s why I think hearing is so important,” said Professor Eikelboom. “Being unable to hear properly can significantly affect a person’s ability to socialise and their employment and education opportunities. We know that the quality of life of many children and adults can be dramatically improved once they start using a hearing aid or an implant.”
Ear Science Institute Australia is one of country’s largest providers of cochlear implants and has been recognised by the World Health Organization as the world’s sixth Collaborating Centre for Ear and Hearing Care.
Last year, the Australian Government recognised the benefits of tele-audiology by budgeting part of a A$21.2 million funding package to implement the key initiatives in the inaugural Roadmap for Hearing Health. This includes A$400,000 for the development and adoption of new tele-audiology standards for hearing services; and A$200,000 to support rural service delivery through a workforce audit and a rural hearing workforce summit.
Professor Eikelboom believes that for tele-audiology to become an integral tool in the delivery of ear and hearing health, it will require ongoing government support.
“History shows that the government has tended to undervalue telehealth services: The half hour you spend with a patient on the phone or on Zoom call, is considered less valuable than the half hour you spend with a patient face to face. That is a problem,” said Professor Eikelboom.
“While we have seen the Australian Government’s inclusion of telehealth items for audiologists delivering services via telehealth through the Hearing Services Program, funding has not been made available for hearing impaired people who do not hold pensions.
“Ideally we need government to continue to support telehealth consultations with a Medicare item number.”
Professor Eikelboom says the pandemic has opened the door for tele-audiology and the Federal Government has revealed its appetite for it by commissioning Ear Science Institute Australia to report on the evidence for ear telehealth services. The government is also in the early stages of commissioning the creation of Australian clinical practice guidelines for tele-audiology services.
Ear Science Institute Australia took part in an international survey of audiologists during June and August 2020**.
The responses from Australian audiologists showed that:
57% used some form of tele-audiology before COVID-19*
84% indicated they they used tele-audiology post COVID-19
*This increased by 75% during the time of the survey. **Tele-Audiology: An opportunity for expansion of hearing healthcare services in Australia; Ear Science Institute Australia, January 2021. Report commissioned by the Australian Government Department of Health and supported by the Hearing Health Sector Alliance. You can read the full report here.