Can you hear me now? Telemedicine and the future of care for the deaf

Winn_Army_Community_Hospital_Pharmacy_Stays_Online_During_Power_OutageNicky Newnham, born profoundly deaf, was given hearing aids when she was a year old and they worked – for a time. But in her mid-twenties, Newman’s hearing started to decline further, and she began to struggle understanding any kind of speech. Facing isolation, Newman’s doctors urged her to try cochlear implants: a surgically-implanted device which stimulates the cochlear’s hearing nerve, bypassing the damaged cells that cause hearing loss.


By Steven Blum


“With the cochlear implants, I was able to socialise with friends, meet new people, go to the cinema and pick up my phone, which I was never able to do before,” Newnham said in an interview.


For many deaf people, Cochlear implants dramatically increase the range of sounds they can hear as well as their quality of life. But the procedure, which costs anywhere from $45,000 to $125,000, isn’t cheap, and the need for repeated visits to doctors for adjustments can end up causing patients further financial strain – especially those who don’t live near major hospitals.


New research, however, suggests that the use of telemedicine for cochlear implant patients could dramatically decrease the financial and logistical strain of rehabilitation. Monika Bombol-Lagha, upcoming speaker at ONLINE EDUCA BERLIN, is an e-learning specialist at the Institute of Physiology and Pathology of Hearing, and believes telemedicine can be especially effective for following up with those who’ve had cochlear implant surgery.


One procedure Bombol-Lagha focuses on is called “Tele-fitting” – a remote fitting of the cochlear implant system. The procedure must be performed every one to four months after the operation, but telemedicine allows for everything to be done from home, thus eliminating travel time and increasing the number of patients audiologists can help per hour.


Bombol-Lagha sees telemedicine as the future of care not just for hearing implant patients, but also the rest of the healthcare industry. “Telemedicine is becoming an essential factor influencing the development of contemporary health services,” she told the News Service. “It aims to lower costs of diagnostics, rehabilitation and also medical therapy, while at the same time improving the access of patients to experienced and qualified staff.”


According to InformationWeek, the global telemedicine market is expected to reach $27 billion in 2016, with current year over year growth estimated at 18.6%. In the US, the Center for Medicare and Medicaid Innovation (CMI) has been directed to test new models of care using telemedicine to improve the care of hospitalised patients, as well as patient-based remote monitoring systems to coordinate care over time and across settings.


Where doctors are few and far between, telemedicine can play a vital role. Using anything from a simple webcam to a sophisticated electronic stethoscope, doctors can now make remote diagnoses and engage in two-way video conferencing with patients from thousands of miles away – from villagers living in Tibet to workers on an oil rig.


But it’s not just those in far flung locales that can benefit from telemedical care. Even in the U.S., it’s been estimated that a fifth of the population live in places where primary physicians are scarce. In the developing world, the numbers are much worse. This is especially problematic in the early detection of hearing problems, as newborns who do not pass initial hearing screenings are often “lost to follow ups,” especially in rural areas where many families live far from audiology centres.


So far, one study of the use of telemedicine for those with cochlear implants has been particularly promising. The Complejo Hospitalario Universitario Insular Materno-Infantil on Gran Canaria found that remote cochlear implant programming was a “viable, safe, user-friendly and cost-effective procedure, equivalent to standard programming in terms of efficacy and user’s perception.”


New software may even allow patients with cochlear implants to repair their devices from home; users of a system under development by Ear Science Institute of Australia can plug their implants into their computer, and an audiologist at the treatment facility is able to test their device for problems in real time.


Bombol-Lagha has great ambition: she’d like the entire hearing community to be trained in telemedicine, from those in the fields of medicine, to clinical engineering, speech therapy and experts in deaf psychology. At ONLINE EDUCA BERLIN, she hopes to explain to a broader audience how telemedicine can “improve diagnosis, treatment and overall health” of those with hearing loss.


Monika Bombol-Lagha’s work will be presented at an ONLINE EDUCA BERLIN session entitled “The Best of Telemedicine”, appearing alongside representatives from the Medical University of Graz, Leiden University, Kasseler Stottertherapie, and COREP. To register for the conference or find out more, click here

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