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PhonakInsightTaking theory to practice: Integrating PhonakeAudiology into clinical practiceTechnologically connected hearing healthcare, termed eAudiology, isreshaping how hearing care professionals connect with their clients.In this article, two early adopters, Dr. Lauren Aramini and Dr. JeffLane, share their experiences introducing eAudiology into theirpractices.Jacqueline Drexler, Au.D., December 2019IntroductionDigital transformation is occurring in healthcare and it ishaving a significant effect on clinical practice and clientcare. Approximately 76% of hospitals in the United Statesconnect with clients and consulting practitioners remotelythrough the use of video and other technology.1 This shiftin healthcare partly stems from changes in society and thedrive for greater convenience. The clients themselves aremore active, health conscious, inquisitive, and expressinggreater autonomy in making decisions in regards to theirown healthcare.2, 3, 4Even further, clients are increasingly tech-savvy. A PewResearch Center survey found that more than 5 billionpeople worldwide have mobile devices, and over half ofthese devices are smartphones.5 Smartphone ownership isnot restricted to younger adults. For example, in the UnitedStates, smartphone adoption among adults ages 50 andolder has risen from 53% to 67% since 2015.5 Whenlooking around at those with their smartphones out, there isno difference between the 55 year old and the 18 year oldteenager sitting beside them.The traditional model of delivering hearing healthcare isface-to-face, which typically involves an assessment, afitting, and then a fine-tuning appointment. However, weneed to be sure we are keeping up with demographictrends. These trends show consumers want more for less,and to make their own evidence-based decisions.2,3 Inaddition, changes in government regulations will allow formore device and service delivery options for clients,including the presence of over-the-counter products.6Consumers want a service approach personalized to theirindividual needs, and holistic hearing care, where they caninteract with their hearing care professionals (HCPs), in amanner convenient for them.

Implementation of eAudiology can allow clients increasedaccess to HCPs and add value to a clinical practice.eAudiology incorporates information, technologies andservices that enable remote provision of audiologic care ateach stage along the client journey.7 Phonak eSolutionsconsists of a suite of smart apps and solutions to supportimplementation of eAudiology in clinical practice. PhonakeSolutions seamlessly and securely connect HCPs withtheir clients.This all sounds good in theory, but how will this affect theway business is run for HCPs, and how do they get started?Is eAudiology for everyone?Arizona we have clients that live two hours away indifferent towns. For them it is nice to offer eAudiologyservices because they don't have to drive all this way justfor a five minute appointment.3. At which point in the clinical pathway do youpresent eSolutions to your clients?L.A.: We talk about eSolutions with every single client. Wemention there is the myPhonak app you can download tokeep track of your listening concerns and experience. Italso helps us as the audiologist. We have an idea of howthey're doing even before they come in for theirappointment, “to give us a heads up”.If they're interested, we have them download themyPhonak app and set them up while they’re in the office.Then, we schedule an appointment to do a remote supporttest run. Once they see it in action, they are just amazedby what we can offer.Dr. Lauren Aramini from Accura Audiology in Buffalo, NYand Dr. Jeff Lane from Trinity Hearing Center in NorthernArizona share their insights and experiences as earlyadopters of eAudiology in the United States. They haveimplemented eAudiology services into the delivery ofhearing care in a manner that utilizes best practices, andleads to clinical efficiency and high service value.Here they share some of their key learnings.1. Tell me about your clinical background and audiologypractice?Lauren Aramini (L.A): I have been at Accura Audiologysince August 2010. I received my Doctor of Audiologydegree from the University at Buffalo.My specialties include audiometric evaluations, vestibularassessments and treatment, and the fitting andprogramming of hearing aids.Jeff Lane (J.L): I began working at Trinity Hearing Centerin June 2018. I received my Doctor of Audiology degreefrom Arizona State University.2. Why did you decide to implement eAudiologyservices into your clinical practice?L.A.: To differentiate ourselves from other practices welook for extra perks for clients to make the most of theirhearing journey. The technology is fantastic, but part of ittoo is the service and what you can add to enhance theexperience. This is where providing eAudiology servicescome in.J.L.: Our clinic is unique in the sense that being innorthern Arizona, it's very spread out. This is in contrast toPhoenix or Tucson where it's very metropolitan. In northernJ.L.: We present eSolutions as an option when we'rediscussing hearing aids. It interests a lot of people,especially the ones who live far away. They say, "Oh, I wishI could come to you. You are a great person to work with,but it's so far away." It's like, "Oh, well, you don't have toworry about that because we can use eSolutions."As far as downloading the myPhonak app to their phoneand the setup, we wait until the first follow-up afterthey're fit. We let them take a week or two to acclimate tothe hearing aids. Once they're more familiar with them, wedownload the myPhonak app and set it up for the clients inthe office. They seem to grasp onto the app really well andenjoy what it offers.4. How do you determine candidacy for eAudiology?L.A.: If clients are interested in learning a new piece ofequipment, then they are a candidate. We let the clientsdecide for themselves.J.L.: We treat everybody as a candidate, as long as theyown or have access to a smartphone or a tablet. For themajority of clients we present it to them and say: "This isan option that we have. Is this something that you'reinterested in?" Most clients say “Yes”. There are howeversome older clients where technology isn't their ’bread andbutter’.5. How do you see remote support influencing yourscheduling and/or staffing needs?L.A.: We treat remote support sessions the same way wetreat face-to-face encounters. We actually find it best toschedule remote sessions in the beginning of the day,during lunch hour, or towards the end of the day.Phonak Insight I Taking theory to practice: Integrating Phonak eAudiology into clinical practiceI2V1.00/2019-10 Sonova AG All rights reservedInsights from early adopters

We also find it beneficial to have an audiology assistant bethe one to instruct the clients on how to download themyPhonak app, set up the remote support session, andassist with troubleshooting, if any connection issue arises.J.L.: We schedule remote support like we would any otherappointment. Rather than coming in to the clinic, you'redoing it over the phone.6. What remote support learnings would be helpful toknow prior to using this tool?L.A.: To ensure a stable remote support connection, it isimportant the clients have the latest software update ontheir mobile phone, enough phone battery life, and astrong WIFI connection. Any other apps that may berunning in the background should be closed as they canslow down the connection.8. Compared to a face-to-face encounter, how satisfiedare clients who utilize remote support? How satisfiedare you with remote support?L.A.: My clients are just as satisfied when using remotesupport compared to a face-to-face encounter. RemoteSupport is easy to use and offers a service that makes lifeeasier for them. I can meet the needs of my clients equallywhether it is through a remote support session or in aface-to-face encounter.J.L.: I find my clients to be more satisfied when utilizingremote support as it offers convenience for them. Remotesupport does not replace face-to-face encounters, but it isanother service clients can take advantage of and stillreceive the same quality of care.We remind clients that a remote support session is nodifferent than a face-to-face encounter, and to be mindfulthat the mobile phone camera will be active during thesession. It is a good idea to do a test run with the client inthe office to ensure the setup works.9. How do you see eAudiology adding value to theservices you deliver to your clients?L.A.: We have clients who travel quite the distance, and ithelps save a trip, a gas tank. We still have the personalaspect of building a relationship with the clients becausewe still see them, while offering a service convenient forthem.J.L.: To add to this, the client should not hang up or walkaway from the phone before the fitting session is saved.We remind clients, "No matter where you go, make sureyou take me with you." Otherwise, any fine tuningadjustments will not be saved and re-establishingconnection between the hearing aids and the fittingsoftware will be challenging.J.L.: Offering eAudiology allows us to fit a wider range ofclients who live further away from the office, havecommuting difficulties or mobility issues. Providing in-situprogramming in clients’ real-world listening environmentshas been beneficial in obtaining immediate feedback. It'snot always easy for clients to get here, but we can make iteasier for them by offering follow-up care remotely.7. Are follow-up fittings ever performed specifically inthe listening environment of concern? Are theysuccessful at addressing client goals?L.A.: We find in-situ programming to be successful as theclient is able to provide immediate feedback on theadjustments made in real-time.10. Do you see eAudiology as a long term solution foryour practice and your clients?L.A.: Absolutely. It's something that is always going to beavailable to us, and we will continue to use it for everysingle client that wants it and feels like they can handle it.J.L.: We have performed in-situ programming while theclient was at home, in the car, in the coffee shop or at thegym. In-situ programming gives a more accurate picture ofthe client’s real-world listening environments as we canactually see and hear what their environments look like.I had a case where a client reported sound quality issueswhen playing racquetball. As I had never been to aracquetball court, it was a great opportunity to do aremote support session in that exact environment. I couldsee and hear the client’s environment, and make accuratefine-tuning adjustments. The client provided immediatefeedback on the changes made.J.L.: It's definitely something that we will continue to useand implement in our practice.ConclusionWe thank Dr. Lauren Aramini and Dr. Jeff Lane for takingthe time to share their learnings and experiences with us.We are entering into an era where audiological care can beobtained in different ways to meet the unique needs ofclients.Some learnings Dr. Aramini and Dr. Lane shared with usinclude allowing clients to decide for themselves if theyare a candidate for eSolutions. Clients want to beempowered to make their own decisions, includingwhether or not to utilize eSolutions as part of their hearingPhonak Insight I Taking theory to practice: Integrating Phonak eAudiology into clinical practiceI3

journey. Even further, Dr. Aramini and Dr. Lane, as well astheir clients are satisfied with the level and quality of careprovided by eSolutions compared to a face-to-faceencounter. With eSolutions, there is still an opportunity tomaintain client trust and a personalized relationship.Technologically connected healthcare is here to stay, andit's exciting to see audiologists embrace this andsuccessfully implement eAudiology into the clinicalpathway, as it offers new opportunities for the consumer,the HCP and the business.For further information about Phonak eSolutions,please visit Phonak eAudiology.Stay tuned as Taking theory to practice will be a new serieson the Phonak Audiology Blog. Audiologists will share theirexpertise on various audiological topics and best practicesfor clinical implementation.References1. Fact Sheet: Telehealth. (2019). In American HospitalAssociation. Retrieved fromhttps://www.aha.org/factsheet/telehealth.2. Topol, E. (2016). The patient will see you now: The futureof medicine is in your hands. New York, NY: Basic Books.3. Maslansky, M. (2011). The language of trust: Sellingideas in a world of skeptics. Upper Saddle River, NJ:Prentice Hall Press.4. Kahana, E & Kahana, B. (2014). Baby Boomers’expectations of health and medicine. AMA Journal ofEthics,16(5), 380-384. Retrieved 55. Silver, L. (2019). Smartphone ownership is growingrapidly around the world, but not always equally.Retrieved from Pew Research Center -theworld-but-not-always-equally/6. S. 670 (115th): Over-the-Counter Hearing Aid Act of2017. GovTrack.us. Retrieved 0.Updated March 1, 2017. Accessed September 9, 2019.7. Montano, J., Angley, G., Ryan-Bane C., Campbell, W.,Eikelboom, R., Gerlach, A., Glista, D., Muñoz, K., Jones,C., Ferguson, M., Swanepoel, D. W., Buerkli-Halevy, O.,Singh, G., Omisore, D., Schuepbach-Wolf, M., & Julita,F. (2018). eAudiolgy: Shifting from theory to practice.Hearing Review. 25(9), 20-24.Phonak Insight I Taking theory to practice: Integrating Phonak eAudiology into clinical practiceI4

Authors and expertsAuthorJacqueline Drexler, Au.D.Jacqueline received her Doctorateof Audiology from the Universityat Buffalo in New York. She gaineddiverse experience in clinicalpractice before joining Sonova in2017. Within Sonova, she has heldvarious roles, and is currently anAudiology Manager at Phonak HQ,Switzerland. She is also a bimodal user with a cochlearimplant in the right ear and a hearing aid in the left. In herfree time, Jacqueline enjoys being outdoors.Subject matter expertsJeff Lane, Au.D.Dr. Lane has been with TrinityHearing Center since June 2018. Dgraduated from Northern ArizonaUniversity with a Bachelor of Artsdegree. He went on to receive hisDoctor of Audiology degree fromArizona State University in 2018.Dr. Lane provides diagnostic andhearing aids services for adult and pediatric patients, alongwith disability evaluations for veterans. He believes in aholistic approach to audiology and values buildingrelationships with patients.Lauren Aramini, Au.D.Dr. Lauren Aramini has been atAccura Audiology since August2010, where she completed herclinical training with the privatepractice. She graduated fromTruman State University with aBachelor of Arts degree inCommunication Disorders andSciences in 2008. She went on to receive her Doctor ofAudiology degree from the University of Buffalo in2012. Dr. Aramini is originally from the Chicago area buthas made Buffalo her home with her husband, daughter,and golden retriever named Wrigley.*Authors have been paid by Phonak for consulting services related to the study.Phonak Insight I Taking theory to practice: Integrating Phonak eAudiology into clinical practiceI5

Remote Support is easy to use and offers a service that makes life easier for them. I can meet the needs of my clients equally whether it is through a remote support session or in a face-to-face encounter. J.L.: I find my clients to be more satisfied when utilizing remote support as it offers convenien