Tips for Optimizing Your Teleaudiology Techniques & Environment

Over the last year, businesses have faced the daunting task of trying to keep their doors open while remaining profitable during the pandemic. This has forced many to change their practices to accommodate customers safely in the new environment. A significant change in the hearing healthcare industry has of course been the utilization of remote and virtual appointments.

These types of appointments are more common than ever. In fact, the number of telehealth visits in the U.S. increased by 50 percent during the first quarter of 2020 compared with the same period in 2019. In the Hearing Review’s second Covid-19 Impact Survey last April, 51 percent of hearing care providers said they have used telehealth for follow-ups and counseling while 45 percent said they have used it for hearing aid adjustments and fine-tuning.

To clarify, audiology practices have three ways of providing this service to patients:

  1. Virtual appointments via phone or video (Facetime, Zoom, Microsoft Teams, etc.)
  2. Remote programming and/or troubleshooting via a smartphone app
  3. Full-service teleaudiology (such as Your Tele Care)

 These are all great options but may not be suitable for every situation, every type of patient or appointment, or every practice. What’s important is that you figure out how to make these offerings a reality for your patients where appropriate.

Whether your practice has already implemented teleaudiology or is still considering it, here are some key points to consider as well as tips for enhancing patient care, virtually:

Wi-Fi:

If many of your patients live in remote areas with poor Wi-Fi or your practice itself has poor Wi-Fi, you could experience audio and video issues that are not ideal for video-based appointments. Having high-speed internet is critical and should be the first thing you consider before implementing any type of teleaudiology services.

Comfortability with technology:

Even if a patient isn’t tech-savvy, a virtual appointment could work if they have someone at home who can assist them such as a child, grandchild, or caregiver. Plan ahead and ask patients to have someone with them during their appointment (just like you’d ask them to bring a third party to an in-person appointment). On the other hand, don’t underestimate your patients—the pandemic has forced many to learn and embrace technology in ways they never have before, especially video chat.

Camera placement:

While you cannot control the patient’s camera placement, you can and should make sure the patient is able to clearly see you and anything you may need to demonstrate. Position your camera in a way that provides an up-close view of your head and shoulders and minimizes reflection (e.g., facing a wall instead of a window or mirror). Also, make sure any equipment you may need is within easy reach (tip: hands-free telephone access can maximize both audio and video-based communication).

Proper lighting

Conducting video-based appointments in a well-lit space will help to ensure patients aren’t straining to see you. According to American Telemedicine Association’s publication, Let there be Light: A Quick Guide to Telemedicine Lighting, which is a go-to resource for virtual care lighting and techniques, appropriate lighting is linked to greater patient satisfaction, which contributes to clinical engagement and reimbursement.

Environment and etiquette:

The ideal environment for any type of virtual appointment is a quiet, private space free of distractions, disruptions, and competing sounds (somewhere you won’t run the risk of people walking past your screen or a conversation or ringing telephone being picked up by your microphone). Remember: experience is still important. Remove any clutter from your desk and choose your backdrop wisely (a wall covered in photos, flyers, and/or artwork might seem nice but could also compete for a patient’s attention). When conducting audio-based appointments, know that pauses will simply be heard as silence, so let patients know when you are stopping to think or take notes. Lastly, if you’re going to be on video, be sure to look presentable and try to avoid clothing with loud colors and prints.

Test and confirm:

Before any type of virtual appointment, it’s crucial that you do a trial run (actually, multiple trial runs) to make sure you are comfortable and that your equipment is working properly. Enlist the help of your coworkers—do a few mock appointments and ask for their feedback. In addition, you should check your equipment regularly and confirm at the beginning of every appointment that the patient can see and hear you clearly.

With the demand for hearing healthcare on the rise, there’s never been a better time to think about ways your practice can grow and evolve to meet the needs of more patients, more efficiently.

If you’re still on the fence about adopting a multifaceted teleaudiology solution, let’s talk briefly about the benefits. Aside from reducing travel time and related stress for patients—many of whom have mobility issues—teleaudiology allows practices to expand their reach beyond the confines of their physical location to help more people (most importantly, those who may not have access to quality hearing healthcare otherwise). Teleaudiology has also been shown to reduce the cost of hearing care and increase efficiency through better management of patients, shared clinic staff, reduced travel times/expenses, and fewer cases of patient dissatisfaction.

So, do your research. Listen to what colleagues who have gone virtual have to say. And doggonit, talk to your Account Manager! 

About the Author

Diana Dobo joined Consult YHN in 2011 as an Account Manager before being named Divisional Vice President, West in 2014. Since May 2018, she has served as Vice President, Strategic Accounts. Prior to joining Consult, Diana was a Senior Sales Manager in healthcare IT with Acusis and served as an adjunct faculty member for several colleges facilitating business courses. She has over 20 years of experience in sales, marketing, and business development and is passionate about helping her team and her customers achieve outstanding results.

Six Easy Tips for Conducting an Effective Hearing Aid Evaluation

The most challenging aspect of addressing hearing loss is counseling the patient through the acceptance process of amplification. Even in countries where price is not a barrier, acceptance rates are still poor. Denial, cosmetics, stigma, and financial concerns remain the biggest barriers keeping more individuals from seeking treatment for their hearing loss sooner, before it takes a toll on their relationships as well as their physical and mental health.
Research shows that having a process for how you approach this important step can improve the likelihood your patient will accept the recommended help in the form of hearing aids. As hearing health professionals, we follow a process for conducting otoscopy, impedance, and the audiogram. Providers also need a process to guide their patients to accept the treatment of amplification. Here are six easy tips to try during your next hearing aid evaluation that will help you do just that:

1. Allow the patient to verbalize his/her difficulties by asking the right questions in the best order.

This creates ownership and identifies future objections to accepting help. Asking a specific question like “Tell me what you have noticed about your hearing” allows for the patient to verbalize their perspective. Alternatively, asking a vague question like “What brought you in today?” can often lead you down a less productive rabbit hole.

2. Use your “why” and the power of storytelling to establish trust, credibility, and a connection.

Conveying who you are and why you do what you do is a proven way of building rapport and establishing credibility. Trust and credibility are key in compelling reluctant patients to take the next step.

3. Involve the companion.

This should be a decision-maker with whom they communicate regularly. We are evaluating communication (“Who is it you communicate with the most?”) Typically, any medical or financial decision is discussed with family members, spouses, or close friends before moving forward. We know hearing loss also affects not only the patient but everyone around them.

4. Set the stage by explaining the diagnostic process to build credibility and expectations of results.

The power of visuals is even stronger than you may think. Simply show the blank audiogram and normal range of hearing in advance of the testing. By doing this, you are establishing expectations and reducing test anxiety that the patient might be feeling.

5. Demonstrate the technology.

When you allow patients to try the amplification, within noise, it empowers them to understand the impact of their hearing. Everyone should be given the chance to experience how amplification can make a difference.

6. Transfer your enthusiasm with a strong recommendation.

Excitement is contagious- patients are looking to you as the expert to tell them what they should do. Remember options can prolong action. They are coming to you because you are the professional who knows the best treatment for THEM.
I know what you might be thinking: “Six steps? Easier said than done!” The good news is that you don’t have to do it alone. Part of Consult YHN’s staff training and employee development program is helping providers deliver more effective hearing aid evaluations. Learning more about the many details within each of these steps will ensure that you or your provider(s) are helping more patients every day. So, if I could add a seventh step it would be: 7. Act now, ask for help! That’s why we’re here!  

Click here to learn more about the Consult Employee Development Program (EDP) or talk to your Account Manager today!

About the Author

Dr. Kari Londo joined Consult YHN in 2019 with more than 12 years of experience as a clinical Audiologist. She received her doctoral degree in Audiology from Nova Southeastern University in Florida. Kari has a deep understanding of the hearing industry, having previously worked directly with patients in private practice and ENT, as an Account Manager for a hearing aid manufacture, and now on the business side as a Consult YHN Account Manager. She is passionate about improving the lives of individuals with hearing loss and helping hearing practices grow by helping these individuals. When she’s not working, Kari can be found playing volleyball, socializing with friends, or enjoying the outdoors.

About the Author

Dr. Heather Carter, AuD., FAAA, is an Account Manager for the Northeast Region and brings a unique perspective to Consult YHN as a clinical audiologist with over 20 years of experience. She received both her master’s and doctoral degrees in Audiology from Gallaudet University, the only liberal arts college for the Deaf in the U.S. Through her graduate studies and clinical work, Dr. Carter has gained the expertise to help patients with all levels of hearing loss improve their communication skills. By providing practice development support and bridging the clinical aspects of hearing healthcare with the necessary business skills as a Consult YHN Account Manager, she helps her clients remain viable and relevant. Dr. Carter has two CODA children who are fluent in American Sign Language (ASL) and recently enjoyed a trip to her alma mater where they all were able to use their fluency in ASL to communicate on campus!

Consult YHN Announces New Partnership with ReSound

CHADDS FORD, PA — Consult YHN partners with industry-leading manufacturers to provide their members with access to the latest and most advanced hearing technology and devices. Today, Consult expands its portfolio by welcoming a new partner, ReSound, whose hearing aids set worldwide standards for quality and intuitive technology helping people Hear More, Do More, Be More.

“We’re excited to work with ReSound and expand our hearing aid offering. Together, we will continue to help our members grow their practices and help more patients,” said Consult YHN President, Bill Urwin. “Our partner relationships are essential to keeping practices ahead of the curve in this competitive market.”

Consult YHN is the nation’s leading network of hearing healthcare professionals dedicated to business growth and development. Since 1995, Consult YHN has elevated and united hearing care providers across the nation and services private practices, ENTs, hospitals, universities, and not-for-profits.

“This is an awesome opportunity! We look forward to working with Consult YHN members to bring ReSound technology to more people with hearing loss, helping them communicate better with family, friends, and colleagues,” says Tom Woods, ReSound U.S. President.

ReSound has long been recognized as a global leader in innovative hearing care solutions, including being the first to offer hearing aids Made for iPhone and with direct streaming to Android devices using Bluetooth Low Energy (BLE). It also pioneered the development of 2.4 GHz wireless technology, now an industry standard. It’s leadership in remote care through ReSound Assist Live also makes it possible for hearing care professionals to provide patients with advanced at-home hearing care during this COVID-19 pandemic.

Together, Consult YHN and ReSound look forward to growing hearing healthcare practices in 2020 and the years ahead.

For more information, visit: www.ConsultYHN.com or www.ReSound.com.

Four Considerations to Better Serve the Culturally Deaf and Hard-Of-Hearing

Approximately 48 million Americans (20 percent) report some degree of hearing loss. Within this population exists a subset of individuals that identify as Culturally Deaf (notated by a capital “D”) or Hard-Of-Hearing (HOH). This group doesn’t focus on the medical diagnosis of a certain degree of hearing loss but rather their cultural identity. They often share a belief system, history, traditions, and a common language (American Sign Language).

This identity makes them unique to most clinical audiology/hearing practices (between 1-3 percent of patients seen annually in hearing clinics). As an Audiologist working closely with this community for over 20 years, below are four key considerations that my patients and I find helpful:

#1. Educate yourself on and understand the beauty of Deaf history and culture

It’s important to be aware that there exists a rich Deaf culture that can be experienced at Deaf school museums, Deaf organizations, Deaf theater, and Deaf groups all over the country. It’s diverse and filled with art and technology and infused with the beauty of sign language.

According to the National Association for the Deaf (NAD), there are three key moments in American history for the Deaf: the 1988 Deaf President Now protest, the 1864 signing of the Gallaudet University charter by President Lincoln, and the 1817 establishment of American School for the Deaf in West Hartford, CT as the first permanent public school for the Deaf. It’s important to understand that historically, many families with Deaf children were told not to use sign language, fearing it would interfere with their ability to learn how to speak. This led to a perception by some in the Deaf community that all Audiologists were simply trying to “fix” or change deafness. Thankfully, as society has evolved, research has made it clear that Audiologists can provide useful tools such as amplification or other assistive technology to support the individual as a whole and not just in terms of their hearing.

#2. Provide access for effective communication for a positive patient experience

Rights: It’s important to know the rights afforded to patients covered by the American with Disabilities Act (ADA) Title III. This law mandates that “covered entities” (businesses and nonprofit organizations that serve the public) provide effective communication for individuals who have communication disabilities. This is by means of “auxiliary aids and services” when needed.

Expectations: In the past, many audiology practices would rely on companions attending appointments to interpret for Deaf patients, but the ADA only allows this when either there is an emergency involving “imminent threat to safety” or if the individual requests this and the companion is not a minor. The ADA ultimately places responsibility on the “covered entity” for providing effective communication and defers to the individual to have primary consideration of the choice of “aid or service” they need unless it results in an “undue burden” (significant difficulty or expense). The key point: consult WITH the patient, don’t dictate TO them.

Communication: Be cautious of using outdated terms such as “hearing impaired,” which is often perceived as derogatory. My friends and patients often prefer Deaf or HOH. Regarding access, the ADA states that you should provide a “qualified” notetaker, sign language/oral/tactile interpreter, real-time captioning, written materials, or printed script of any stock speech. A “qualified” interpreter means someone who can interpret effectively, accurately, and impartially (receptively and expressively). In addition, “aids and services” are defined as a wide variety of technologies such as Assistive Listening Devices (ALDs), amplified phones, videophones/captioned phones, or video relay service (VRS), or telecommunications relay service (TRS) which can be reached by calling 711. Video remote interpreting (VRI) is another option but be sure to have a high-speed connection for a quality signal and a large enough screen for optimal viewing.

It’s important to note that not all patients in this community use the same form of sign language. Some use American Sign Language (ASL) and others use a more English-based sign language or even prefer to read lips with visual cues. Don’t just assume—ask the patient directly how they prefer to communicate. Knowing some basic sign language to introduce yourself and guide the patient to the test area is also a nice way to establish rapport and trust.

#3. Consider modifications to your test protocol

  • Common sense prevails here but make sure to provide visual cues and/or show clear written explanations of the test process and directions when possible.
  • Try using hand-raising/button-pushing for obtaining responses and consider Speech Detection Thresholds instead of Speech Reception Thresholds to avoid forcing spoken answers or having closed set picture/visual response options.
  • Have expectations, test instructions, and recommendations written in advance or write them during the visit on a whiteboard or tablet.

#4. Make recommendations carefully and without bias or assumptions

When providing options for amplification to Deaf or HOH patients, there are several things to keep in mind:

  • Power aids are often but not always preferred with a more linear approach to match any possible previous experience with amplification.
  • Do not assume that they’re not interested in the latest technology or that they don’t care about quality sound or features like rechargeability and Bluetooth connectivity. Many of my Deaf friends LOVE listening to music and would appreciate streaming options (with a lot of bass).
  • Do not assume that they want to conceal their devices as some may be proud and want bold colors.
  • Show coupling options with tangible samples so that they can actually see the different sizes available and feel the different weights and materials.
  • Be knowledgeable about state funding agencies (i.e. vocational rehab) for coverage of hearing aids as well as Medicare plan coverages for those with “disabilities.”

These are just a few key considerations and suggestions. By simply being prepared and educated, I promise these appointments will be much easier and more enjoyable. There is a long list of agencies and resources available where you can find information and answers to any questions you have. I encourage you and your staff to undergo basic training about the ADA requirements and perhaps even learn a few basic signs!

Find out how Consult YHN can help you provide a better patient experience and increase revenue – contact us today!

About the Author

Dr. Heather Carter, AuD., FAAA, is an Account Manager for the Northeast Region and brings a unique perspective to Consult YHN as a clinical audiologist with over 20 years of experience. She received both her master’s and doctoral degrees in Audiology from Gallaudet University, the only liberal arts college for the Deaf in the U.S. Through her graduate studies and clinical work, Dr. Carter has gained the expertise to help patients with all levels of hearing loss improve their communication skills. By providing practice development support and bridging the clinical aspects of hearing healthcare with the necessary business skills as a Consult YHN Account Manager, she helps her clients remain viable and relevant. Dr. Carter has two CODA children who are fluent in American Sign Language (ASL) and recently enjoyed a trip to her alma mater where they all were able to use their fluency in ASL to communicate on campus!