A Scoping Review of Technology and Infrastructure Needs in the Delivery of Virtual Hearing Aid Services

Abstract

Purpose: The digital health revolution has brought forward integral technological advancements enabling virtual care as a readily accessible delivery model. Despite this forward momentum, the field of audiology still faces barriers that impede the uptake of virtual services into routine clinical practice. The aim of this study was to gather, synthesize, and summarize the literature around virtual hearing aid intervention studies and the related technology and infrastructure requirements. Method: A scoping review was conducted using MEDLINE, CINAHL, Scopus, Nursing and Allied Health, and Web of Science databases. Objectives, inclusion criteria, and scoping review methods were specified in advance and documented in a protocol. Results: The 11 studies identified through this review related to virtual hearing aid services delivered by a licensed health care provider and/or facilitator(s) specific to hearing aid management, programming, verification, and validation services. Service delivery models varied according to patient population, technology experience, type(s) and time course of care, type of remote location, and technology/support requirements. Barriers and facilitators to implementation-related themes including technology access and function, client sociotechnical, convenience, education and training, interaction quality, service delivery, and technology innovation. Conclusions: This scoping review provides evidence around the technology and infrastructure required for full integration of virtual hearing aid services into practice and according to care type. Low-tech versus high-tech requirements may be used to guide virtual service delivery triaging efforts. Research and development efforts in the areas of pediatrics, clinical support tools, and hearing aid/app-based solutions will support further uptake of virtual service delivery in audiology.

Is Teleaudiology Achieving Person-Centered Care: A Review

“…While there is clear evidence that teleaudiological methods have been validated, there is no clear answer as to whether teleaudiology should be considered as a complement or auxiliary part of clinical audiological best practice. Infrastructure constraints have been recognized as an important factor that will determine possible and appropriate teleaudiology use [ 51 , 52 ]. In addition to practical needs, clinician preferences that will influence adoption and use of teleaudiology have been identified, which may act as a barrier of access for clients who are offered teleaudiology as part of their hearing care [ 51 , 53 ].…”

“…The Australian Audiology standards do not recognize culture in the same context, instead emphasizing professional safety, learning, and behavior across three of the six domains listed [ 25 ]. Despite repeated evidence of clinical efficacy, the use and adoption of teleaudiology in audiological care has been clearly documented as being limited by clinician attitudes and reluctance [ 50 , 51 , 52 , 53 , 54 ]. This review revealed a small number of studies describing the application of teleaudiology in intervention.…”

Phase 1 of collaborative action around the implementation of virtual hearing aid care: Development of a clinical practice guideline

“…As a preliminary step, the co-creation team met virtually to determine the scope of literature reviews needed. Two systematic searches contributed to the development of the CPG: (1) a systematic scoping review of technology and infrastructure needs in the delivery of virtual hearing aid services, 10 and (2) a rapid review of evidencebased documents specific to virtual audiology care (described below).…”

“…In brief, the systematic scoping review, completed in August 2020, summarised and synthesised peer-reviewed literature describing virtual hearing aid services delivered as part of intervention studies to offer evidence around the integral components and implementation factors that contribute to virtual hearing aid service delivery. 10…”

“…Within the field of hearing healthcare, virtual care now includes intervention and (re)habilitation specific to the provision and/or maintenance of hearing aids, across all patient populations. 10 Recent evidence suggests that virtual care can improve access to family-centred care in the management of pediatric hearing aid fittings, including greater appointment flexibility, convenience, and the ability to include multiple caregivers in appointments. 11,12 In the adult literature, virtual care has been found to significantly improve outcomes for communication, hearing aid fitting, and quality of life, as part of follow-up hearing aid appointments, alongside improvements in timeliness of care and reduced travel needs.…”