WHY DO WE NEED TELE-AUDIOLOGY? Frances Lockhart

LEARNING OBJECTIVES Goal : To understand why tele-audiology is an important part of a modern audiology clinic This time the goal is to understand why tele-audiology is an important part of a modern audiology clinic. 1.1.2019

GLOBAL HEARING LOSS WHO estimated in 2005: – 278 million people (>40 dB HL) • 4.3 % of global population – 647 million people (>25 dB HL) • 9.9 % of global population In 2008: – 288 million people (>40 dB HL) – 664 million people (>25 dB HL) And In 2017: – 466 million people have disabling hearing loss, of these 32 million are children Let's start first with some background on the demand for hearing care. This global burden of hearing loss was becoming obvious to all who worked in healthcare back in 2005. This prompted a re-think by service providers as to how we can address this epidemic in ways that would allow everyone to access the care and support that they needed. WHO estimated in 2005: – 278 million people (>40 dB HL) • 4.3 % of global population – 647 million people (>25 dB HL) • 9.9 % of global population • In 2008: – 288 million people (>40 dB HL) – 664 million people (>25 dB HL) And In 2017: -466 million people worldwide have disabling hearing loss, and 32 million of these are children. See the WHO “Deafness and Prevention” website to learn more: http://www.who.int/deafness/en/ See the WHO “Deafness and Hearing Loss” factsheet: http://www.who.int/mediacentre/factsheets/fs300/en/ 1.1.2019

GLOBAL HEARING LOSS WHO estimates that by 2050 over 900 million people (one in every ten) will have disabling hearing loss. More than 90% of people with a hearing loss can benefit from hearing aids, but less than 1 in 40 receive them WHO factsheet It is estimated that by 2050 over 900 million people – or one in every ten people – will have disabling hearing loss. See for more information: http://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss The urgency of audiological service provision is increasing the burden of care on each country’s health care system. Its relationship to other chronic diseases is now well known, and improving hearing health has become a priority for many countries. WHO estimates that unaddressed hearing loss poses an annual global cost of 750 billion international dollars. This includes health sector costs (excluding the cost of hearing devices), costs of educational support, loss of productivity, and societal costs. Spend a few minutes now reading the WHO fact sheet by clicking on the link in the PPT. http://www.who.int/mediacentre/factsheets/fs300/en/ 1.1.2019

GLOBAL HEARING LOSS Disabling hearing loss is unequally distributed across the world Disabling hearing loss is unequally distributed across the world, so access to services is now a key area of focus. 1.1.2019

GLOBAL HEARING LOSS The prevalence of disabling hearing loss could be up up to 5 times higher in adults 65 and older, as compared to people 64 years of age and younger Disabling hearing loss is unequally distributed across the world, so access to services is now a key area of focus. 1.1.2019

HOW DO WE RESPOND? How do we reach more people? How do we ensure that those in countries who don’t have well- established hearing health care systems receive services? What do we do in countries that have services but are unequally distributed? So, what do we do as hearing care professionals? How do we reach more people? How do we ensure that those in countries who don’t have well- established hearing health care systems receive services? What do we do in countries that have services but are unequally distributed? 1.1.2019

ACTIVITY Explore: World Hearing Day WHO Telehealth in audiology: The need and potential Telepractice delivery of family centred early intervention for children who are deaf or hard of hearing Survey of ENT services in sub-Saharan Africa: little progress between 2009 and 2015 Public awareness of audiology, hearing and hearing health in the Limpopo Province, South Africa With the global burden of hearing loss increasing, the population increasing and people living longer. Hearing loss services are needed in much greater numbers than are currently available in most countries. Both Audiology and ENT services are in great demand. In addition, awareness of hearing loss rehabilitation services and the importance of maintaining good hearing and communication to maintain quality of life and prevent functional disability is low. Activity: In addition to reading the latest WHO statements, read and explore the following resources. You can request copies from the authors or your institution for the articles. World Hearing Day WHO Telehealth in audiology: The need and potential Telepractice delivery of family centred early intervention for children who are deaf or hard of hearing Survey of ENT services in sub-Saharan Africa: little progress between 2009 and 2015 Public awareness of audiology, hearing and hearing health in the Limpopo Province, South Africa 1.1.2019

PATIENT OF THE FUTURE People with hearing loss will expect care that is: Personal Flexible Involving Cost-effective Transparent Focused on quality of life Integrates personal technology It is also important to note that the types of patients we are now seeing has drastically changed over the last 10 years and will continue to do so. The millennial parents and baby boomer generation, who are our main patient groups, are very different from previous generations in that they are generally more demanding of services that fit in with their lifestyle and for the most part are more tech-savvy. They expect care that is: Personal Flexible Involving Cost effective Transparent Focused on quality of life Integrates their personal technology 1.1.2019

SERVICE DELIVERY CHANGES There is also a shift in how all services are delivered, worldwide. We have to allow for and incorporate these changes as that is what our patients want and expect from us. We have to consider our services in terms of: Shifts in ageing (people are living longer) Emerging technology (the connected world) A variety of market disruptors such as online hearing aid sales, or large multinationals driving services Online and social media influencers and providers of knowledge and connection.

Hearing Care Professionals BENEFITS Patients Remain in the comfort of their home Reduced travel time Allows for remote and rural access Increase visits Opportunity to consult non-local professionals Improved outcomes due to specialist access Hearing Care Professionals Deliver traditional sevices in new ways Extend fitting beyond hearing aid fitting Reach new hearing loss groups Offer more personallized care Increased inclusion of communication partners Provide new services not previously possible More flexible service delivery model Many of our patients now expect hearing services to be available in a form that is familiar to them. Some wish to gather knowledge in the comfort of their own home They may not be willing to travel far for appointments They may need specialist services that aren’t available locally and so will just do without if it isn't provided. We need to be willing to provide services in a different way . We need to realize that our services are more than just hearing aid fittings and need to be personalized in a way and at a time that our patients require and request it. Flexibility in service delivery is the key and that is what tele-audiology can offer. 1.1.2019

Ida’s 2020 Vision Identified That We Need to Be Ready A couple of years ago Ida ran a workshop to try and anticipate what a hearing care manager of the future might look like. The skills identified were: -Being able to provide a 24 hour on demand service -They needed to be multi disciplinary -They needed to be tech-savvy and be able to operate across different platforms -They needed to have great interpersonal skills -And understand that hearing loss is lifelong journey that requires different approaches at different stages of that journey.

ACTIVITY Investigate the demographics and resources of your local clinic area. You can do a survey of your patients, look for public information like census data, or consult a market research firm. Don’t assume, explore. So thinking about those things, let’s do an activity. Investigate the demographics and resources of your local clinic area. You can do a survey of your patients, look for public information like census data, or consult a market research firm. Don’t assume, explore. Consider: What is the average age of your patient now? Compare it to what it would have been 10 years ago What form of social media is being used by your patients? How many have smart phones? How many online audiology services/products are now available in your local area? 1.1.2019

A TOOL FOR THE FUTURE Combining traditional face-to-face services with tele-audiology can enhance not only our reach of services, but ensure that we see our patients where and when they are ready, in a way they are comfortable with. Flexibility in service delivery has to be at the core of what we do in order for us to remain person- centered. Combining our traditional face-to-face services with tele-audiology can enhance not only our reach of services but ensure that we see our patients where and when they are ready, and in a way they are comfortable with. Flexibility in service delivery has to be at the core of what we do in order for us to remain person-centered. 1.1.2019

THE VALUE OF TELE-AUDIOLOGY An important tool of person-centered care A way to assist people in a context that suits them and in an environment that they are comfortable with, no matter where they live in the world. Enhances face-to-face care, does not replace it Why we need tele-audiology as part of our person-centered audiological care plan is clear. It is an important tool in audiology. It is a way to assist people, in a context that suits them and in an environment, a time, and a place that they are comfortable with, no matter where they live in the world. It is there to enhance face-to-face care, not replace it See this video from ASHA for a concise summary of why we need tele-audiology in a modern practice: https://www.youtube.com/watch?v=CgxH69CqPbM&feature=youtu.be 1.1.2019