Teleaudiology Services Research Articles

Uncovering the effects of pandemic conditions on hearing aid experiences: a dual perspective from audiologists and hearing aid users

Purpose: This study examines the effects of the pandemic on hearing aid experiences from the perspectives of audiologists and patients, as well as communication challenges faced by both users and non-users of hearing aids. Materials and Methods: The study consisted of two phases: a longitudinal study examining the services provided by audiologists during the peak of the COVID-19 pandemic and after the first vaccination dose. The second phase involved a survey of 120 elderly individuals with hearing loss, divided into hearing aid users and non-users for assessing communication challenges. Data was collected from comprehensive audiology clinics using a series of checklists. Results: Analysis of the frequency of services related to hearing aids revealed that during the peak period, the majority of visits were for acquiring batteries and hearing aids, while fewer visits were for fitting and fine-tuning the devices. After vaccination the pattern was changed. In the second phase, significant differences were observed between the hearing aid users and non-users with regards to their ability to comprehend speech while wearing mask, communicating at a safe distance, and following TV news. Conclusions: The distribution of requested services differed during the peak period and the post-vaccination period. There was a noticeable increase in the purchase and fitting of hearing aids after vaccination. However, patients encountered difficulties due to the limited availability of tele-audiology services and delayed services from hearing aid companies. The benefits of hearing aids were impacted by the pandemic as many people did not seek adjustments for their devices.

Teleaudiology Services in Australia: A National Survey of Hearing Health Care Consumers Amid the COVID-19 Pandemic.

The aim of this study was to investigate the perspectives of Australia-based hearing health care consumers regarding the (a) provision and utilization of teleaudiology services, (b) experiences with teleaudiology, and (c) barriers and enablers to future teleaudiology use. A national prospective self-report online survey was completed between April and October 2020, amid COVID-19. Data were analyzed using descriptive statistics (closed-answer items) and content analysis (open-text responses). A total of 381 participants (Mage = 72.07 years ± 10.08, 142 females) were recruited from different states and territories of Australia. Despite positive outcomes reported by those who undertook teleaudiology appointments during COVID-19, results indicate low-consumer teleaudiology uptake. It can be inferred that consumers were not aware of teleaudiology as an appointment option, clinicians/clinic staff had not informed and/or supported teleaudiology as an option, and biases existed that prevented teleaudiology being more widely adopted. It is unclear whether consumers who were eligible for government subsidies understood that teleaudiology appointments were reimbursed through government funding. Barriers to future teleaudiology uptake were largely related to concerns regarding confidentiality and privacy. Low consumer uptake of teleaudiology appointments appears to be driven by consumer preference for in-person services, which appears to be driven by lack of knowledge regarding the availability and effectiveness of teleaudiology. https://doi.org/10.23641/asha.25619808.

Development of Teleaudiology Service in Special Education Service Centre in Malaysia: Lessons Learned

Teleaudiology has been implemented in several settings, including hospitals, nursing homes, community-based programmes, and educational institutions. Despite its numerous advantages, teleaudiology is still relatively new in Malaysia and is gaining popularity among audiologists. Additionally, the majority of studies have been conducted on normal-hearing individuals. Thus, as a pioneer in Malaysia, this study established teleaudiology services for students who are deaf or hard of hearing (DHH) at the Special Education Service Centre. The researchers examined two critical factors that contribute to the service's proper operation: internet speed and the audio-visual quality of the ICT applications employed. This study documented the details of the service's implementation, which included 25 sessions of synchronous teleaudiology with DHH school children. Additionally, this study revealed that upload and download speeds exceed prior research-recommended minimums. Meanwhile, most teleaudiology service sessions are done in high-quality audio and video, except for the Skype programme, which has a moderate visual quality. To summarise, teleaudiology services have been effectively deployed amongst institutions and have the potential to be expanded to another location in Malaysia.

Implementation factors influencing the sustained provision of tele-audiology services: insights from a combined methodology of scoping review and qualitative semistructured interviews

ObjectivesThe objectives of the current study were to (a) identify long-term tele-audiology services reported to be implemented beyond the research phase and determine whether they are sustained, (b) map the...

Interprofessional Collaboration in Teleaudiology

Purpose: Teleaudiology, or the delivery of audiology services remotely, can improve patients' access to care by reducing the travel burden required for traditional in-person appointments. Teleaudiology also connects professionals across distances and, therefore, offers unique opportunities to collaborate on interprofessional teams. In health care, interprofessional collaboration (IPC) happens when professionals from different disciplines work together to deliver high-quality health care. In this viewpoint article, we discuss the role of IPC in teleaudiology, including best practices for effective collaboration. We illustrate several examples from rural Alaska to central Texas and the Arizona/Mexico border where teams collaborating across professions is an important element of teleaudiology service delivery. We also describe potential challenges to IPC in the context of teleaudiology and suggest strategies to overcome them. Conclusions: Strong IPCs offer teleaudiology team members the opportunity to achieve more together than they would individually. As teleaudiology grows in use and becomes part of standard of care, there will be a greater opportunity and need for audiologists to work in partnership with individuals from diverse professional backgrounds and share resources to deliver high-quality and accessible patient-centered care.

Exploring teleaudiology adoption, perceptions and challenges among audiologists before and during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic and its associated lockdowns accelerated the uptake of remote services, however, the integration of teleaudiology into regular clinical practice has been slow, with audiologists reporting several barriers and mixed attitudes. To develop effective strategies and solutions to enhance teleaudiology services and facilitate their acceptance beyond the pandemic, a better understanding of the factors influencing audiologist’s attitudes and usage is needed.The purpose of this study was to explore the attitudes towards and usage of teleaudiology by audiologists prior to and during the COVID-19 pandemic.We aimed to uncover underlying factors influencing teleaudiology adoption to identify potential barriers and opportunities that could inform interventions and future developments.Method and resultsTwo cross-sectional surveys were administered to audiologists between September and October in 2018 and 2021. Questions addressed issues regarding quality of care, satisfaction, and perceived benefits of teleaudiology. Survey items based on the COM-B behaviour model were also included in the 2021 survey. Data were analysed using descriptive and non-parametric statistics.Eighty audiologists completed the 2018 survey and 105 audiologists completed the 2021 survey. In 2021, teleaudiology users reported increased quality of care, quality of relationships with clients and client satisfaction compared to non-users. However, among teleaudiology users, there was a decrease in quality of care, relationships with new clients and job satisfaction in 2021 compared to 2018. The COM-B framework helped identify the major barriers for non-users of teleaudiology such as lack of training, unclear guidelines, and concerns about service quality.ConclusionThe attitudes towards teleaudiology for clinicians before and during the COVID-19 pandemic were investigated, revealing a substantial increase in usage and varying effects on client satisfaction, clinician job satisfaction and service quality. Key potential barriers and factors influencing usage were identified. Targeted solutions may include providing training, scheduling regular teleaudiology appointments to build confidence, and developing reliable tools and technologies to improve remote hearing care.

Hearing Health Care Stakeholders' Perspectives on Teleaudiology Implementation: Lessons Learned During the COVID-19 Pandemic and Pathways Forward.

The purpose of this study was to explore how teleaudiology is perceived by Australian-based hearing health care stakeholders (clients, clinicians, students, academics, and industry partners) to inform future teleaudiology implementation. Five cross-sectional online surveys were adopted, and a total of 366 stakeholders responded (173 clients, 110 clinicians, 58 students, 19 academics, and six industry partners). Results show that 55% of clients and over 90% of clinicians, students, academics, and industry partners knew what teleaudiology was. Experience in teleaudiology appointments was shared by 85% of clinicians and 7% of clients. Moreover, 98% of clients were not offered any teleaudiology appointments. Teleaudiology apps were used by 66% of clinicians and 26% of clients. Both clients and clinicians acknowledged the benefits of teleaudiology including convenience and accessibility and identified drawbacks, such as loss of personal interaction and communication difficulty. About 80% of students and academics reported inclusion of teleaudiology within their universities' curriculum but only to a limited extent. Low teleaudiology uptake rates in placement clinics, as well as insufficient funding and staffing, were suggested as barriers to learning and teaching teleaudiology. Industry partners were generally confident in training clinicians to use teleaudiology products and teaching students on teleaudiology, but only one industry partner had been invited by universities for teaching purposes. Low teleaudiology use and reserved attitudes toward widespread teleaudiology implementation were observed among clients. Clinicians, students, academics, and industry partners generally displayed positive attitudes toward teleaudiology use. Increasing awareness of teleaudiology services and collaboration between stakeholders are crucial in promoting teleaudiology uptake. https://doi.org/10.23641/asha.23519292.

Preserving the Role of the Audiologist in a Clinical Technology, Consumer Channel, Clinical Service Model of Hearing Healthcare.

The past decade has been characterized by significant changes in the distribution and sale of hearing aids. Alternatives to the clinical technology, clinical channel, clinical service (i.e., traditional) hearing healthcare delivery model have been driven by growth in hearing aid dispensaries housed in large retail establishments and direct-to-consumer hearing aid sales by internet-based companies unaffiliated with major hearing aid manufacturers (e.g., Eargo). These developments have been accompanied by acceleration in the growth of teleaudiology services as a direct result of the COVID-19 pandemic. The resulting development of nontraditional hearing aid distribution and sales models can be categorized into distinct archetypes as reviewed earlier in this publication. This article will review the Clinical Technology-Consumer Channel-Clinical Service model as exemplified by Jabra Enhance. We will describe a completely digital model of hearing aid distribution and sales that maintains the professional service component throughout the client journey to include an online tone test, the use of a risk mitigation questionnaire, virtual consultations, remote hearing aid adjustments, and the establishment and monitoring of client-centered treatment goals. Furthermore, this article will review the Jabra Enhance model within the context of consumer healthcare decision-making theory with a focus on the Consumer Decision-Making Model.

The effect of remote fitting technology on hearing aid satisfaction

BackgroundTelemedicine is a method of providing remote healthcare services and consultations to patients using communication technology. Tele-audiology is a sub-branch of telemedicine. It refers to providing audiology services using telehealth strategies. This study aims to compare the satisfaction of patients who come to the hearing aid center and receive device fitting service and patients who have hearing aid fitting using tele-audiology service. For this purpose, hearing aid users were divided into two groups. The study group consisted of 17 participants (10 male, 7 females; mean age 65.17 ± 13.88) who continued fitting appointments remotely after the first clinic application, while the control group consisted of 23 participants (10 males, 13 females; mean age 62.17 ± 18.32) who had all hearing aid fittings performed face-to-face in the clinic. The participant’s satisfaction was assessed with The International Outcome Inventory for Hearing Aids Turkiye (IOI-HA-TR) questionnaire because it is practical and can be administered over the phone.ResultsThere were no significant differences in hearing aid satisfaction between those who came to the hearing center and filled out the IOI-HA-TR questionnaire personally and those who completed it through the Remote Care application (p < 0.05). In addition, most of the participants stated that using Remote Care solved their problems (35% very good, 24% good) and they were satisfied with the fitting of their hearing aids with this application (35% good, 29% very good). In addition, 13 out of 17 participants stated that they would pay attention to the “remote fitting” feature when purchasing a new hearing aid (76% very good). Moreover, they would like to continue the fitting using the Remote Care application (65% yes).ConclusionRemote fitting technology via smartphone applications can facilitate the lives of hearing aid users and improve their quality of life in cases of risky conditions such as pandemics, various diseases, and physical limitations.

The Consideration of Tele-Audiology Service Delivery in Korea

The importance of tele-audiology service delivery and accessibility has highlighted with the COVID-19 pandemic. Tele-audiology is an alternative method delivering various hearing intervention services including counselling, evaluation, fitting, and rehabilitation through telecommunication. The essential goal of tele-audiology service delivery is to obtain the best hearing rehabilitation outcomes equivalent to face-to-face service. Even though it has several advantages in aspects of service accessibility and effectiveness, convenience, and cost, still there are many challenges faced by audiologists, clients and administrators in order to implement tele-services in Korea. The present brief communication seeks to raise awareness in preparing and delivering the tele-audiology services with several considerations and challenges. We also focus on professional liability and training, service environment and information technology, and establishment of social system underling the tele-audiology service delivery in Korea.

Barriers and facilitators to tele-audiology service delivery in Australia during the COVID-19 pandemic: perspectives of hearing healthcare clinicians

Objective To explore the utilisation, safety, cost, and patient outcomes of delivering tele-audiology services during the COVID-19 pandemic. Design A national cross-sectional self-report online survey asking participants to reflect on interactions with hearing services between April and October 2020. Data were analysed using descriptive statistics. The COM-B model of behaviour change guided survey creation and the presentation of a subset of the results. Study sample 249 Australia-based hearing healthcare clinicians (age range 23–74 years; 162 female). Results Clinicians reported an increase in the use of tele-audiology services, with key drivers relating to keeping their patients safe and keeping businesses running. Clinicians generally viewed the provision of tele-audiology services as successful and resulting in improved patient outcomes. Overall, clinicians were highly motivated to provide tele-audiology services, and they expressed being confident in their knowledge and understanding of tele-audiology service delivery. Barriers to providing tele-audiology services included concerns about the reliability of the results obtained from remote assessments, as well as concerns around information security and privacy issues. Conclusions Clinicians’ motivations to use tele-audiology services appeared to be driven by their desire to maintain COVID-safe practices during the pandemic and by the COVID-driven increase in availability of funding for tele-audiology services.

Health Behavior and Motivational Engagement Models Can Explain and Modify Teleaudiology Uptake.

The remote delivery of health care services (i.e., telehealth) has steadily increased across the health care landscape over the past decade with a dramatic increase following the onset of the COVID-19 pandemic. Remote audiology delivery (i.e., teleaudiology), by contrast, has traditionally been characterized by relatively low utilization. While teleaudiology services increased during the COVID-19 lockdown period, most of those services were generally limited to follow-up care and postfitting consultations to existing patients. Furthermore, there is reason to believe that, despite the benefits that remote care provides, the use of teleaudiology services has decreased as in-person care has increased following the lifting of mandatory COVID-related lockdowns. The purpose of this viewpoint article is to posit that existing theories of health behavior, usually applied to patient-specific behaviors (e.g., hearing aid uptake) may explain the reluctance of audiologists to "uptake" a teleaudiology model of care. We also explore the potential of motivational engagement strategies as a means to allow audiologists to examine their sources of ambivalence as they consider adopting a remote service-delivery model. Health behavior models such as the Health Belief, Transtheoretical, and capability, opportunity, motivation, and behavior (COM-B) models represent theories that may help to explain audiologists' resistance to adopting remote delivery services. Motivational engagement strategies, such as decisional balance, can provide useful tools for audiologists to examine their attitudes toward the adoption of teleaudiology.

Evaluation of a teleaudiology service in regional Australia

Objective Evaluate accessibility, effectiveness, acceptability and efficiency of a student- assisted teleaudiology model of care in a regional hospital in Queensland, Australia. Design Prospective mixed method service evaluation study. Study sample Demographic, service and satisfaction data were collected from 233 patients (children aged ≥5 and adults) who received teleaudiology assessment. Satisfaction data was collected from 27 hospital clinic staff (medical, nursing and clinic assistants) and 28 university audiology clinical educator participants. Experience and satisfaction data were collected from 16 teleaudiology clinic university students. Quantitative data was analysed using SPSS software. Qualitative data were analysed using inductive content analysis. Results Following introduction of the teleaudiology service in 2017 and evaluation during the first 6 months, 95% of patients were able to access audiology assessments on the same day as their Ear, Nose and Throat appointments. New referrals to the service were seen within a month. The audiology assessment battery was completed 95% of the time within an average of 33 minutes by the end of the study period. Patients, hospital and university staff and students reported high satisfaction with their experiences of teleaudiology, including its convenience and efficiency. Conclusions A student-assisted teleaudiology model of care can deliver accessible, effective, and efficient services with high levels of satisfaction by participants.

Tele-Audiology in India: Current and Future Trends in Knowledge, Attitude, and Practice Among Audiologists.

Background and ObjectivesThe COVID-19 pandemic has led to widespread use of telepractice in hearing health care services. In this study, we investigated the knowledge, attitude, and practice (KAP) of tele-audiology among Indian audiologists. The current study is based on tele-practice guidelines recommended by the Indian Speech and Hearing Association for tele-audiology services in India. Subjects and MethodsAn internet-based KAP questionnaire survey was performed among 108 audiologists. The questionnaire included 33 items categorized under the following domains: demographic information and KAP of tele-audiology. Of the 108 audiologists included in the study, 38 admitted to the practice of tele-audiology previously and during the COVID-19 pandemic (tele-practitioners), and 70 respondents had no experience of tele-audiology (non-telepractitioners). ResultsOverall higher scores were observed with regard to the knowledge domain, and a mixed attitude regarding tele-practice was observed among audiologists. Most respondents acknowledged the advantages of tele-audiology in clinical practice. However, audiologists were hesitant to utilize this technology owing to the challenges associated with tele-practice. ConclusionsDespite adequate awareness and a positive attitude, a gap is observed between available knowledge and its actual application/utilization in tele-audiology. Tele-audiology practice was limited to counseling, hearing impairment treatment, and troubleshooting tips for hearing aids. Evidence-based practices to perform diagnostic test battery in tele-mode, hands-on training to run diagnostic test battery/rehabilitation using a tele-mode approach, and greater understanding of the technical requirements for tele-practice may result in a positive perception and encourage tele-audiology practice among audiologists. Specialized training and regular continuing education programmes are important to promote tele-audiology services in clinical practice.

Utilisation of tele-audiology practices in Australia during the COVID-19 pandemic: Perspectives of audiology clinic owners, managers and reception staff

Objective To canvas the views of Australia-based hearing healthcare clinic owners/managers and reception staff regarding the utilisation, experiences and perspectives of providing tele-audiology services during the COVID-19 pandemic. Design A national prospective self-report survey was completed online. Data were analysed using descriptive statistics. Study sample Twenty-one clinic owners/managers (Mage 54.43 years, 15 female) and 58 reception staff (Mage 42.88 years, 49 female) from Australia-based hearing clinics. Results Clinic owners/managers reported an increase in use of tele-audiology services as compared to pre-COVID-19. Reception staff reported providing more advice and support to clients over the phone. Both clinic owners/managers and reception staff indicated key barriers to providing tele-audiology services to include concerns about their clients’ digital and technological literacy and the perception that in-the-clinic appointments deliver better client outcomes than tele-audiology appointments. Conclusions The increased utilisation of tele-audiology services observed appears to be largely influenced by COVID-19 related factors (e.g. maintaining client and staff safety and increased funding). It is therefore possible that utilisation of tele-audiology service may drop once the threat of the pandemic has subsided. Perceived barriers relating to clients’ digital literacy and the effectiveness of tele-audiology services require attention to safeguard the future of tele-audiology service delivery in Australia.

Tele-Audiology: Current State and Future Directions.

The importance of tele-audiology has been heightened by the current COVID-19 pandemic. The present article reviews the current state of tele-audiology practice while presenting its limitations and opportunities. Specifically, this review addresses: (1) barriers to hearing healthcare, (2) tele-audiology services, and (3) tele-audiology key issues, challenges, and future directions. Accumulating evidence suggests that tele-audiology is a viable service delivery model, as remote hearing screening, diagnostic testing, intervention, and rehabilitation can each be completed reliably and effectively. The benefits of tele-audiology include improved access to care, increased follow-up rates, and reduced travel time and costs. Still, significant logistical and technical challenges remain from ensuring a secure and robust internet connection to controlling ambient noise and meeting all state and federal licensure and reimbursement regulations. Future research and development, especially advancements in artificial intelligence, will continue to increase tele-audiology acceptance, expand remote care, and ultimately improve patient satisfaction.

The use of tele-audiology in ototoxicity monitoring: A scoping review

Introduction Due to the growing burden of disease in South Africa, encompassing conditions such as tuberculosis, human immunodeficiency virus, and cancer, the holistic management of affected patients incorporating ototoxicity monitoring is a necessity. However, ototoxicity monitoring in developing countries may be limited due to a lack of resources and inadequate healthcare facilities. Subsequently, the use of tele-audiology may be a revolutionary technique with the potential to provide audiology services to under-served populations with limited access. Methods The study aimed to describe the use of tele-audiology services in ototoxicity monitoring through a scoping review of English peer-reviewed articles from June 2009 to June 2020. Seventeen articles were purposively selected from the following databases: PubMed, Science Direct, Taylor and Francis Online, WorldCat, and Google Scholar. Data was extracted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram and results were analyzed using deductive thematic analysis. Results and discussion While a minority of the studies indicated that the cost of implementation and network connectivity within a South African context pose as barriers, most researchers reported that tele-audiology provides a reliable, time-efficient, cost-effective, and easily accessible alternative for ototoxicity monitoring. Hardware including the WAHTS, KUDUwave, and OtoID, along with software such as the TabSINT, Otocalc, uHear, and the hearTest, have proven to be useful for ototoxicity monitoring. A need for further investigations regarding the feasibility of tele-audiology implementation in South Africa is evident. Despite this, it provides audiologists with an opportunity to offer contact-less services during COVID-19, thus, confirming its versatility as an augmentative method for ototoxicity monitoring.

A Survey Study of Audiology Services during the Coronavirus Disease 2019 Pandemic in South Korea

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has severely affected public health and people’s lifestyle. The purpose of this survey study is to investigate audiology services during COVID-19 pandemic to understand the current audiology service situations in Korea and to improve audiology services.Methods: A total of 120 participants (60 audiologists and 60 clients visiting audiologists) were surveyed in this study using online or face-to-face methods. The participants answered 24~25 questions including current status of audiology service, communication difficulties with wearing masks, and the provision of tele-audiology services during COVID-19.Results: The results showed that both audiologists and clients with hearing loss still preferred face-to-face audiology services in COVID-19 situation in spite of 56% of visiting schedule delay and cancellation. The primary audiology services they considered in COVID-19 were hearing aid fitting and maintenance &amp; repair services. Wearing masks has led communication difficulties in both audiologists and clients with hearing loss due to speech level reduction, frequency filtering of sounds, and insufficient visual cues during the conversation. Only 30% of audiologists have provided tele-audiology services, and 4.4% of clients received tele-audiology services during COVID-19.Conclusion: The impacts of COVID-19 in audiology services in South Korea are still progressing. The technical and administrative systems and educational support to improve audiology services in South Korea are necessary.

The impact of COVID-19 on provision of UK audiology services & on attitudes towards delivery of telehealth services

Objective To (i) identify the impact of COVID-19 on provision of UK audiology services across sectors (ii) compare teleaudiology service provision between private and public sectors before and after the introduction of restrictions and (iii) identify barriers to teleaudiology delivery amongst UK hearing care professionals in both sectors. Design A mixed-methods cross-sectional survey study design. Responses to the structured questionnaire were analysed using descriptive and non-parametric statistics. Study Sample UK based hearing care professionals (HCP) (n = 323) completed the survey (218 public sector; 89 private sector). Results Changes in working patterns varied greatly between different sectors, with 61% of national employed and 26% of independent HCPs being furloughed, compared with 1% in the public sector. Use of telehealth was under-utilised across all sectors and groups in UK hearing healthcare, despite 92% of public and 75% of private HCPs reporting feeling comfortable conducting remote consultations. Conclusion This study highlights a variation in teleaudiology adoption and key barriers across sector in the UK. A collaborative approach between hearing device manufacturers, research centres, HCPs and professional bodies is required for the creation of targeted guidance and training materials according to sector, to support clinicians in effective teleaudiology provision.

A Review of Contemporary Teleaudiology: Literature Review, Technology, and Considerations for Practicing.

The scope of teleaudiology has been noted with telehealth due to Coronavirus disease (COVID-19) recently. As the notion has been around us for more than 20 years ever since 1999, it is necessary to perceive the knowledge accurately and prepare for the successful implementation of it. Therefore, the literature review including screening and diagnostic audiometry, cochlear implants and hearing aids, and aural rehabilitation, telecommunications technology regarding several fields of teleaudiology, and considerations for practicing were identified. Although overall internet-based audiological services showed benefits in terms of outcome and accessibility, uncertainties of cost-effectiveness, the optimal level of support, and a need for further studies of many aspects for teleaudiology has arisen. In the view of technology, the store-and-forward (asynchronous/hybrid) and a real-time (synchronous) methods were introduced with one applied and nine registered patents recorded from 2004 to 2020 for the invention of teleaudiology in the United States. Also, 10 checklists were suggested for planning teleaudiology practice from prior experience in hosting the teleaudiology program. Conclusively, it is hoped that this review sheds light on recognizing and improving the existing teleaudiology services and helps overcome the challenges faced in the era of pandemic and untact world to come.