1First, tell us a little bit about your professional background.
I’m a Doctor of Audiology and have been practicing since 1976. I’ve worked in a number of clinical settings and have helped develop future audiologists as a professor at Arizona State University and A.T. Still University. I’m also a member of The American Speech-Language-Hearing Association (ASHA), the Arizona Speech-Language-Hearing Association (ArSHA), and the American Auditory Society (AAS). I joined the teleaudiology team at Prime Eye Care in 2019.
2For those who are not familiar with Your Hearing Network’s Your Tele Care and what 360º audiology entails, tell us more about your role and the role Your Tele Care plays in your office?
The staff at the vision center handles booking most of the appointments. I work entirely from home in Scottsdale, AZ, and my appointments are conducted in Prime Eye’s office in Mesa, AZ with the assistance of my dedicated technician who devotes part of her working hours to the hearing practice. So, the patients are still physically seen in an office setting. There is another teleaudiologist who remotes into Prime Eye’s West Valley location.
3Walk us through a typical appointment.
A typical appointment starts with the usual introductions and the questions we all ask patients, including a self-assessment of their hearing abilities and questions about the FDA ‘warning signs’ for medical referral. We talk about using telehealth and ask the patient to sign a waiver stating that he/she understands this is not a face-to-face appointment. The HIPPA agreement is then reviewed and signed. After performing a video otoscopy and, if necessary, tympanometry, I’ll review and counsel the patient on his/her test results. If there’s a medical concern, the patient is referred to an ENT clinic in the area and we follow up with him/her two-three weeks later. If the patient is a hearing aid candidate with no medical contraindications, an in-office demo is offered. If the patient decides to move forward, I then fit and order the hearing aids. Finally, I counsel the patient on the realistic expectations with hearing aids, including how to insert and remove them, care and maintenance, Bluetooth operations, etc.
4Are there any tests or procedures that you can’t perform virtually?
The only thing you can’t do through teleaudiology is ear wax removal. Cerumen management will be referred to other medical professionals. Right now, we also don’t have a real-ear measurement system set up, which I feel is important, but it’s on our list of things to do in the next few months.
5What are the biggest perks of being a teleaudiologist and is there anything you miss about working in a physical practice?
Number one: working from home and the flexibility it allows. Working in a different practice environment is another perk. I’m a big people person, so I do miss interacting with others—just like most of us are feeling right now not being able to see our parents and friends in person due to the pandemic.
6From a clinical perspective, did you have any initial reservations about teleaudiology?
Yes. I had never done remote care before, so it was a whole new world. I wondered how patients would adapt to a telecare experience, especially our older population.
7So how do patients typically react to the virtual clinic experience?
Remarkably well, actually. This might be due largely in part to the emergence of COVID-19. Because we don’t tell them ahead of their appointment, some patients are initially surprised when they find out the audiologist isn’t going to actually be in the exam room with them. But once the audiologist establishes rapport and explains the process, the majority of patients respond positively. At the end of their appointment, I hear a lot of patients say things like, "That was really fun! It was just like having the doctor in the room with me!” and “It’s amazing what you can do with computers these days!”
8What are some of the advantages of offering hearing care within a vision clinic?
Our demographic is exactly the same. Because the vision clinic has been in business for over 20 years now, the patients already have a good working relationship with the office, the doctors, and the staff. They like being able to take care of both vision and hearing in one place with people they trust.
9On average, how many patients do you see a day?
Right now, we’re set up to see four patients in the morning for a complete evaluation and hearing aid discussion, and three in the afternoon for a one-hour appointment. Returning patients will be scheduled for 30 minutes and we’ll then take a new patient appointment and split that into two, 30-minute appointments. As we get busier, we may add another appointment in the afternoon.
10What are some key things audiologists should know and consider before implementing teleaudiology in their own practices?
First, obviously, you need to be organized and excellent with communication because that’s a big part of teleaudiology. You also need to establish clear expectations for yourself and the remote staff. It’s important to think about the personalities of the individuals you’ll be working with remotely. You want to be compatible. Lastly, you must have the fastest internet possible.
11What would you say to colleagues who have reservations about implementing teleaudiology or aren’t sure it’s right for them?
I think it’s a great way to have an office in an area that you’ve wanted to expand into but are hesitant because of staffing issues. It’s also a great way to see if that location is going to be viable for you and your practice. Look at it as an opportunity to branch out to a second or third office with no travel time for the audiologist. There is a learning curve involved—it can take time to become fluent in the technology, but it’s very doable. And it’s easy once you get used to it…as long as the Internet cooperates.