Evaluating the Feasibility of Using Remote Technology for Cochlear Implants

The use of remote technology to provide cochlear implant services has gained popularity in recent years. This article contains a review of research evaluating the feasibility of remote service delivery for recipients of cochlear implants. To date, published studies have determined that speech-processor programming levels and other objective tests (electrode impedance and electrically evoked compound action potentials) are equivalent to those obtained in the face-to-face condition. Despite these promising findings, speech perception using remote technology has proven to be more challenging. Previous investigations have evaluated speech perception with recipients of cochlear implants using videoconference (Polycom) equipment in nonsound-treated rooms (due to lack of access to audiological sound booths in rural areas). Results have revealed poorer speech perception scores using remote technology compared to face-to-face results. Additionally, it has been shown that Polycom transmission of a speech stimulus does not cause significant compression for adequate evaluation; rather, poorer results are due to testing performed in nonsound-treated environments. Based on the literature, telepractice is a feasible option for cochlear implant service delivery. Barriers to the wide-spread use of remote services for recipients of cochlear implants include a uniform system for the evaluation of speech perception, validation of services for pediatric recipients and initial activations, license reciprocity, and reimbursement for services.