Teleaudiology works

I co-founded a blended channel audiology service, including tele-audiology, where accessibility for clients was a major goal in 2011 (Blamey Saunders Hears). We had not anticipated a COVID-19 pandemic. However, we certainly did consider people who were housebound, not realising that that would be everyone. Several tools were developed, papers published and many thousand data points collected, all of which contribute to audiology in today’s landscape of reduced mobility In numerous presentations, I have pointed out that in audiology, including tele-audiology, clinicians need to be clear whether they are seeking a differential diagnosis or assisting a client to better hearing and communication. Currently, diagnostics is challenging to do remotely, yet the first question other audiologists have asked me over the nearly ten years is “What if you miss a malignant pathology?”. My answer is the same as that today is to use the CEDRA questionnaire and give the client advice as appropriate. Prior to CEDRA we used an in-house version. I would now add “What if they catch Coronavirus?”. I feel strongly that we can only take responsibility for giving advice and do our best to influence action. In the Blamey Saunders model, clients have an accessible and flexible pathway and client cantered assistance remotely, or in person, targeting auditory enablement. And suddenly, we have a pandemic and the model means you can do everything from home.
The clinical and research experience accrued by myself and Peter Blamey, gave a strong experiential base from which to make the following comments.
A speech perception test, that has been clinically validate for use on line, is the Blamey and Saunders Speech Perception Test (SPT) This test has advantages for teleaudiology practice over digits in noise. It provides useful information to the person being tested because it tells them which sounds of speech they have heard well, and which sounds of speech they don’t hear, at normal listening levels, and, correlates with audiometric loss (Blamey and Saunders, 2015). By contrast the test of hearing digits in noise is a hearing screen.
The Blamey and Saunders model is a blended model of client centred care. It was adapted from the work of Goldstein and Stephens (1981), which differentiates recommendations for a client’s path in a model of care based on a combination of hearing complexity and client attitude. We had not anticipated COVID-19, but worked with many clients who would otherwise have found it difficult to access support, due to health, mobility or distance issues. COVID-19 has precipitated interest in teleaudiology, and client choices – the choice, or requirement, being to stay at home. The rationale remains the same. Teleaudiology is here to stay.

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