Audiology Telepractice Moves From Theory to Treatment

Abstract

You have accessThe ASHA LeaderFeature1 Nov 2005Audiology Telepractice Moves From Theory to Treatment Mark Krumm Mark Krumm Google Scholar More articles by this author https://doi.org/10.1044/leader.FTR6.10152005.22 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Telepractice or telepractice-the provision of health services from one location to another using a telecommunications medium-is becoming ubiquitous as many states have developed wide area networks (WANs) that connect rural and metropolitan communities. Most hospitals focusing on rural outreach provide health services via telepractice using dedicated WANs or the Internet. Professions engaged with telepractice include speech-language pathology, nursing, cardiology, radiography, otology, pharmacology, psychology, psychiatry, and dermatology (Nickelson, 2000; Perednia & Allen, 1996; Stamm, 1998). Telepractice services that health care professionals may provide include video otoscopy, counseling and diagnosis with interactive video, cognitive retraining, radiology interpretation, surgery via robotics, and bioterrorism monitoring. Although audiologists have been slow to adopt telepractice, there are compelling reasons to use this medium. Specifically, audiology telepractice may offer a solution for service gaps in rural or underserved urban areas. Using telepractice, audiologists in regional clinics could offer sophisticated hearing tests to infants, children, and adults in rural communities. Aural rehabilitation, digital hearing aid programming, and cochlear implant programming or mapping also could be achieved through telepractice technology with few software modifications. An effective audiology telepractice program could further promote a family-friendly atmosphere as well as continuity of services for people of all ages (Krumm, Ribera, & Schmiedge, 2005). Specifically, telepractice technology could provide a link between the records at client medical homes and clinicians providing hearing health care services from a distant location. Information that could be shared via telepractice includes relevant case history information, scheduling, client treatment plans, and the professionals responsible for service delivery. In response to the potential benefits of telepractice, ASHA recently developed a position paper that supports the use of telepractice by audiologists (ASHA, 2004a, b). State of Practice The benefits of telepractice are very real, but many issues central to audiology telepractice need to be resolved. Issues such as connectivity, accessibility to telepractice systems, convergence of technology, and clinician acceptance illustrate the current state of practice-and the challenges that remain. Connectivity. The primary considerations of connectivity include bandwidth capability and the information transmission medium (such as cable, digital subscriber lines, or modem). Broadband connections provide the capacity to transmit the most data in the least amount of time. Not surprisingly, broadband is the gold standard in the world of telemedicine. Recently, investigators at the American Telehealth Association (ATA) annual meeting described the use of portable satellite technology. This is the same technology that many television networks use to broadcast events from locations around the world. Although satellite technology is not new to telemedicine, the use of portable satellite technology is an important advancement that opens doors to virtually any geographic location. While satellite technology has historically provided slower connectivity speeds than other forms of broadband (due to the long distance that transmitted information must travel), portable satellite technology can still be used for interactive video and other “live” telepractice services. Therefore, at least limited telepractice services can be delivered to rural communities that do not have broadband infrastructure. Connectivity innovations are not limited to the satellite technolog