Feasibility And Satisfaction Of Remote Programming Recipients In Their Homes

Transcription

1 Feasibility And Satisfaction Of Remote Programming Recipients In Their Homes Allison Biever, Au.D. David Kelsall, M.D. Rocky Mountain Cochlear Implant Center Colorado Neurological Institute!! Rocky Mountain Ear Center;!! Rocky Mountain Cochlear Implant Center, P.C.! Disclosure: Audiology Advisory Board for Cochlear Corporation

2 Background u Remote programming has been shown to be a reliable and effective means of programming patients who live significant distances from their implant center. u Speech perception results obtained after remotely programming are equivalent to those obtained when programming face-to-face. u Historically, remote programming has required expensive video conferencing equipment and high speed, state-of-the-art internet connectivity.

3 Clinical Research Questions u 1) Can remote programming be delivered using a less costly, readily available technology? u ) Are patients satisfied with the delivery of services? u 3) Are clinicians satisfied with the delivery of services? u 4) Can the service be reimbursed?

4 Study Design

5 Demographics Groups Subjects Age (years) Child/ Adult Phase I (Remote Site) N= 17 Range: Mean: 3 yrs Mean Distance from Implant Center Mean Dura@on of Device Experience 1/5 36 miles ~6.3 years Phase II (Recipients Home) N= Range:.5-41 Mean: 15 yrs 9/1 3 miles ~.9 years TOTAL N=7 Range: Mean: 19 yrs 1/6 63 miles ~7.3 years

6 #1: Can remote programming be delivered in a cost savings model? u Windows tablet: $400 u Go To Meeting: $46/year u Pod with cables: $1,55 (assuming clinic doesn t have extra pod and cables) u Fed Ex charges: $0

7 #1.Time Savings 30 6 HOURS Phase I Phase II All Subjects

8 #1: Financial Savings 69 MONEY ($) Phase I Phase II All Subjects

9 SUBJECTS #: Patient Satisfaction Able To See Audiologist Clearly SA A N D SD Total

10 SUBJECTS #. Patient Satisfaction Able To Hear Audiologist Clearly SA A N D SD Total

11 SUBJECTS #. Patient Satisfaction Interaction Same As In Person SA A N D SD Total

12 #. Patient Satisfaction As Good As Last In Person Session SUBJECTS SA A N D SD Total

13 SUBJECTS #. Patient Satisfaction I Am Satisfied With Telehealth SA A N D SD Total

14 #. Patient Satisfaction Rather Use Telehealth Than Travel SUBJECTS SA A N D SD Total

15 SUBJECTS #. Patient Satisfaction Recommend Telehealth To Others SA A N D SD Total

16 #3. Clinician Satisfaction Able To See Patient Clearly SESSIONS SA A N D SD Total

17 #3. Clinician Satisfaction Able To Hear Patient Clearly 9 SESSIONS SA A N D SD Total

18 #3. Clinician Satisfaction Time Similar To In Person Session 9 SESSIONS

19 #3. Clinician Satisfaction Satisfied With Telehealth SESSIONS SA S N D SD Total

20 #4. Reimbursement u Phone conversations with payers critical u Use of GT modifier utilized (960GT): via interactive audio and video telecommunication systems

21 Conclusions u Remote programming could be administered in a feasible, inexpensive model. u Patients were extremely satisfied with the service provided. u The provider was extremely satisfied with the service provided. u The remote programming session was reimbursed through insurance in only a small number of cases.

22 Future Research? u Speech perception testing administered remotely through the software? u Could password protected software be installed on recipient s tablets? u Joint speech therapy and programming sessions? u Reimbursement considerations?

23 Acknowledgements u u u u u Cochlear Americas Colorado Neurological Institute Special Education Center (Casper, WY) Laramie County School District 1 (Cheyenne, WY) Health One IRB

24 References u u u u u Rodriguez, Ramos et al. 0; Wesarg, Wasowski et al. 0; Hughes, Goehring et al. 01 Hughes ML, Goehring JL, Baudhuin JL, et al. (01). Use of telehealth for research and clinical measures in cochlear implant recipients: A validation study. J Sp Lang Hear Res, 55, McElveen JT, Blackburn EL, Green Jr. D, et al. (0). Remote programming of cochlear implants: A telecommunications model. Otol Neurotol, 31, Ramos A, Rodriguez C, Martinez-Beneyto P, et al. (009). Use of telemedicine in the remote programming of cochlear implants. Acta Oto-Laryngol, 19, Wesarg T, Wasowski A, Skarzynski H, et al. (0). Remote fitting in Nucleus cochlear implant recipients. Acta Oto-Laryngol, 130,