The Role of Telemedicine in Auditory Rehabilitation: A Systematic Review
Otology & Neurotology
Bush, M. L., Thompson, R., et al. (2016).
Otology & Neurotology, 37(10), 1466-1474.
This systematic review investigates the feasibility and effectiveness of performing aural rehabilitation (e.g., cochlear implant intraoperative implantation telemetry, device activation and programming, and patient outcomes and hearing aid fitting, device testing, and counseling) via telepractice modality of service delivery with individuals fitted with cochlear implants or hearing aids.
American Academy of Otolaryngology–Head and Neck Surgery Foundation; National Institute of Deafness and Other Communication Disorders, National Institutes of Health
1985-2015
Published English-language studies (not further specified)
12
<div>"Comparisons between studies were difficult.... In spite of these limitations, this review indicates that telemedicine delivery of auditory rehabilitation is feasible and will likely play a meaningful role in the future of healthcare access" (p. 1473).</div>
<div>The following benefits of providing cochlear implantation telemetry, activation, and programming via telepractice were found:</div>
<ul>
<li>"time savings in intraoperative telemetry;</li>
<li>limits travel of patients and providers;</li>
<li>facilitates multinational programming protocols and delivery of care;</li>
<li>similar clinical implant function parameters and hearing outcomes as in-person programming;</li>
<li>no reported serious adverse events; and</li>
<li>programming can be performed without sound treated booths" (p. 1470).</li>
</ul>
<div>The following limitations of providing cochlear implantation telemetry, activation, and programming via telepractice were found:</div>
<ul>
<li>"surgical staff responsible for intraoperative equipment and connection;</li>
<li>[telepractice] connectivity complications; </li>
<li>difficulty in communication between patients and providers;</li>
<li>potential for overstimulation;</li>
<li>appointment times may be increased; and </li>
<li>inferior speech testing results when performed outside of audio booths" (p. 1470).</li>
</ul>
<div>The following other considerations for providing cochlear implantation telemetry, activation, and programming via telepractice were found:</div>
<ul>
<li>"Speech testing results are superior when high fidelity equipment is used at the remote site (controlled by a provider over internet connection)" (p. 1470).</li>
<li>"Customized systems provide superior remote speech testing results" (p. 1470).</li>
</ul>
<div>The following benefits of providing hearing aid services of fitting and maintenance via telepractice were found:</div>
<ul>
<li>"similar patient satisfaction outcomes with in-person delivery of care;</li>
<li>can be used for fitting, verification, and counselling;</li>
<li>similar gain measurements with in-person programming;</li>
<li>similar appointment times for counselling; and</li>
<li>similar hearing aid usage, speech testing, and subjective improvement with in-person care" (p. 1470).</li>
</ul>
<div>The following limitation of providing hearing aid services of fitting and maintenance via telepractice was found:</div>
<ul>
<li>"longer appointment times for programming and verification" (p. 1470).</li>
</ul>
<div>The following other considerations for providing hearing aid services of fitting and maintenance via telepractice were found:</div>
<ul>
<li>"important tool to educate rural audiologists; and</li>
<li>successful delivery of care to very rural areas," therby increasing access to care (p. 1470).</li>
</ul>
