PP810 - Remote Care for Cochlear Implant Services: Benefits and Considerations

Abstract:
Cochlear implants (CI) are an underutilized treatment option for children and adults who meet candidacy criteria. There is a need to better understand the barriers to accessing hearing healthcare and to develop clinical tools and protocols to mitigate them. The need for numerous in-person appointments has been cited as a barrier for patients attempting to access CI services. The present study evaluates the effectiveness of new app-based tools for asynchronous, remote CI assessment and programming. The study aims to also evaluate the time and cost savings for both patients and clinics.

Summary:
Introduction
The post-operative management of cochlear implant (CI) patients involves multiple in-person appointments. These appointments are used to measure performance with the CI, assess the integrity of the internal and external equipment, and to make programming changes to optimize patient outcomes. While the recommended follow-up intervals can vary across CI programs, it is common for adult patients to return for a minimum of 4 visits within the first year of device use. The frequency of in-person visits can act as a barrier for some patients. Additionally, the high number of appointments needed for each CI recipient can make it difficult for clinics to effectively serve an expanding patient population. There is a growing interest in exploring telehealth services to support CI patients. The present study evaluated the effectiveness of new remote technology for CI services and reviewed the time and cost savings associated with its use for both patients and CI clinics.

Methods
Adult CI patients who were at least 2 weeks post-activation were recruited for this study. Remote technology was used to asynchronously check the device and perform outcome assessments. Outcomes were compared with in-person measures (e.g., aided sound field thresholds, CNC words, and AzBio sentences in quiet and in noise). Participants and audiologists also completed a survey on their experiences with remote technology.

Results
Preliminary data suggest that remote technology may be an effective tool for evaluating the integrity of the device (e.g., impedance measures) and reducing the frequency of in-person clinic visits after establishing optimal map settings. Participants and audiologists reported a preference for this model as compared to conventional follow-up procedures.

Conclusions
There are many barriers that potential and active CI patients face when accessing hearing healthcare. As a field, there is a need to explore alternatives to traditional, in-person appointments for CI patients. The follow-up protocol for adult CI patients may include remote procedures at specific time points to reduce the number of in-person visits – which may benefit patients and improve clinical efficiency.

Brief Summary of Clinical Takeaways:
The clinical takeaways for this session are an understanding and analysis of new remote tools for cochlear implant services and how they can reduce barriers to care for patients and improve clinical efficiency.

Assumptions
A basic understanding of cochlear implant systems and typical follow up protocols.