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Hearing Journal:
doi: 10.1097/01.HJ.0000422349.77502.3b
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Teleaudiology Brings Better Hearing Healthcare to Australia's Outback

Lawrence, Greg

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Mr. Lawrence is the media manager at HEARnet in Melbourne, Australia.

Delivering healthcare services to Australia's remote and indigenous communities is regarded by many as inadequate, especially compared with its urban populations. Consequences, such as traveling long distances to and from these communities and the limited access to specialized healthcare facilities and infrastructure, make it difficult to attract and retain staff in these areas.

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This situation is not unique to Australian healthcare providers, but the demand for experienced hearing healthcare professionals in rural and remote Australian communities is on the rise due to an aging population, changes in the environment, the gray nomad phenomenon where people over age 50 travel for an extended period of time within their country, and the continuing needs of our indigenous population. The HEARing Cooperative Research Centre (HEARing CRC), an Australian-based consortium of 26 members from universities, industry, healthcare service delivery, and professional organizations, is currently investigating how to best use information technologies to deliver better hearing healthcare to isolated and rural communities.

Some Australian innovations that apply information and telecommunications technologies in the healthcare sector are among the best in the world. These applications not only create opportunities for innovative delivery of healthcare services but new opportunities for upskilling workforces based in remote Australia. “Several of our projects are currently applying these new technologies to the field of hearing healthcare, developing new audiological capabilities such as the ability to remotely map cochlear implants, undertake pediatric hearing assessments, or deliver specialist pediatric habilitation,” said Bob Cowan, PhD, HEARing CRC's chief executive officer and an associate professor.

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Remote Cochlear Implant Mapping

HEARing CRC's Management of Cochlear Implants Using Remote Technology Project develops procedures by using software on a computer in an implant clinic that can remotely access another computer in a rural or remote area. Those with cochlear implants (CI) can receive their follow-up consultations remotely by using standard video conferencing technologies or a specialized Australian telehealth support interface developed at the University of Queensland (UQ) called eHAB.

Researchers from UQ and the Hear and Say Centre in Queensland have established eHAB's reliability for the remote mapping of CIs in children 3 to 12. Another part of the team based at the Sydney Cochlear Implant Centre has already had success in providing CI mapping support to patients in Samoa in the South Pacific. Preliminary results from this work have shown that 83 percent of the 70 clients who had their CIs mapped remotely were pleased with the outcome. HEARing CRC is now developing guidelines and user case studies to help remote hearing healthcare clinics achieve similar outcomes and to test approaches that support rural pediatric clients in New South Wales and Queensland.

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Professional Upskilling

HEARing CRC is also developing a new Internet-based rural and remote supervision and mentoring program developed in collaboration with Audiology Australia. This will, for the first time, enable new audiology graduates to work in remote areas. These online learning resources, which were developed by HEARing CRC's Remote Training, Supervision and Up-Skilling of Clinicians Project, will be featured on HEARing CRC's new Hearing Education and Research Network (HEARnet) website. Audiologists working in rural and remote communities can broaden their skill base and fulfill continuing professional development obligations to maintain clinical certification. Modules are being specifically designed to provide audiologists with a greater awareness of Aboriginal and Torres Strait Islander cultures and how to interact effectively in delivering services to these communities. Other modules are intended to provide specific training in video-otoscopy and advanced diagnostic and advanced middle ear disease management skills. They will be accessible to audiologists and other hearing healthcare providers.

“To ensure the content is relevant and accurate, these modules have been developed in collaboration with various rural and remote health groups, including Services for [Australia] Rural and Remote Allied Health. The HEARing CRC has also consulted with the rural and remote community-based audiologists who have a wealth of experience in terms of what additional skills are required,” Dr. Cowan explained.

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Remote Audiological Assessments

Another challenge for hearing healthcare providers in remote Australia is finding ways to provide timely and effective audiological assessments in areas where audiologists or test facilities are scarce. HEARing CRC's Remote Assessment of Hearing-Paediatric Hearing Assessment Using Tele-Audiology: An Investigation in Rural and Remote Populations Project, based at the Royal Institute for Deaf and Blind Children in Sydney, has been investigating how telecommunications and remote access software can provide initial pediatric hearing screening and, more importantly, full audiological assessment for children who require follow-up.

This project has included trials using different combinations of technology to establish the validity of remote assessments in nonsound-treated environments, with extremely encouraging results. The procedures being developed stand to increase access to pediatric audiological assessment in remote areas and to reduce the time delay between screening and diagnosing hearing loss. Findings will steer clinical guideline development and potentially create a training module, which will be made available through HEARing CRC's forthcoming HEARnet website.

The findings from HEARing CRC's teleaudiology research projects are likely to be highly relevant to countries where large distances and a lack of audiologists affect the quality of healthcare services. HEARing CRC intends to make available a series of guidelines and training modules from the HEARnet website to ensure the outcomes of these research projects are fully utilized. (See FastLinks.)

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FastLinks

* Visit HEARing CRC's website at www.hearnet.org.au.

* Click and Connect! Access the links in The Hearing Journal by reading this issue on our website or in our new iPad app, both available at thehearingjournal.com.

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© 2012 Lippincott Williams & Wilkins, Inc.

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