Permanent hearing loss is a leading global health care burden, with 1 in 10 people affected to a mild or greater degree. A shortage of trained healthcare professionals and associated infrastructure and resource limitations mean that hearing health services are unavailable to the majority of the world population. Utilizing information and communication technology in hearing health care, or tele-audiology, combined with automation offer unique opportunities for improved clinical care, widespread access to services, and more cost-effective and sustainable hearing health care. Tele-audiology demonstrates significant potential in areas such as education and training of hearing health care professionals, paraprofessionals, parents, and adults with hearing disorders; screening for auditory disorders; diagnosis of hearing loss; and intervention services. Global connectivity is rapidly growing with increasingly widespread distribution into underserved communities where audiological services may be facilitated through telehealth models. Although many questions related to aspects such as quality control, licensure, jurisdictional responsibility, certification and reimbursement still need to be addressed; no alternative strategy can currently offer the same potential reach for impacting the global burden of hearing loss in the near and foreseeable future.

Purpose: Worldwide demand for accessible hearing health technology continues to increase while the numbers of hearing health care specialists are grossly inadequate to meet this demand. Proliferation of innovative technology and the advent of greater access to global connectivity, are providing an opportunity to identify and harness new resources that may change current audiological service delivery methods to maximize access, efficiency and impact. Methods: By searching through the most current literature and engaging in discussions with industry experts, it is possible to identify avenues that could increase services to those who have hearing loss with innovative health care technology. This article aims to review the current state as well as future trends of hearing health technology by addressing: Technology as We Know it; and Technology as We Dream it. Results: Some of the newer technologies we have recently witnessed include: micro processors; personalized computing devices (e.g. smartphones); web based applications; an expanding clinical repertoire with integrated test equipment; and globalization of telecommunications that opens the door to telehealth; and self-fitting of hearing aids. Yet, innovation continues scaffolding on recent successes with innovations for hearing health care expected to increase into the future.Technology; Clark & Swanepoel/2 Conclusion: As technology and connectivity continue to evolve so should the practice of audiology adapt to the global needs by capitalizing on these advances to optimize service delivery access and sustainability. Implications for Rehabilitation Capital investment in equipment will be dramatically reduced with smaller, lighter, less costly and more portable equipment.  Individuals who live in remote regions with little or no hearing health care can undergo valid assessments by a professional via telehealth.  Web based applications allow clinicians to expand their repertoire and reach of services.

SummaryWe evaluated the validity of remote pure-tone audiometric testing conducted from North America on subjects in South Africa. Desktop-sharing computer software was used to control the audiometer in Pretoria from Dallas, and PC-based videoconferencing was employed for clinician and subject communication. Thirty adult subjects were assessed, comparing the pure tone audiometric thresholds (125-8000 Hz) obtained through conventional face-to-face and remote testing. Face-to-face and remote audiometry thresholds differed by 10 dB in only 4% of cases overall. The limits of agreement between the two techniques were -8 and 7 dB with a 90% confidence interval of -5 to 5 dB. The average reaction times to stimulus presentations were similar, within -108 and 121 ms. The average test duration was 21% longer for remote testing (10.4 vs. 8.2 min). There were no clinically significant differences between the results obtained by remote intercontinental audiometric testing and conventional face-to-face audiometry. It may therefore be possible to expand the reach of audiological services into remote underserved regions of the world. IntroductionHearing loss is the most common chronic disabling condition globally and in 2005 was estimated to affect 642 million people to some degree.[1,2] A range of interventions can reduce the consequences of hearing loss,[1] but the basis for intervention is early identification and accurate diagnosis.