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Reducing Loss to Follow-Up with Tele-audiology Diagnostic Evaluations
Madan Dharmar1,2, Anne Simon3, Candace Sadorra2
11 Department of Pediatrics, University of California Davis , Sacramento, California.
Insights
Tele-audiology effectively reduces loss to follow-up for infants needing hearing evaluations. This approach overcomes access barriers, ensuring timely diagnosis and care for newborns with hearing loss.
Area of Science:
- Pediatric audiology
- Telemedicine
- Newborn hearing screening
Background:
- Infants failing newborn hearing screening face access barriers to diagnostic follow-up.
- Travel distance and limited pediatric audiologists contribute to missed appointments.
- Tele-audiology offers a potential solution for remote diagnostic hearing evaluations.
Purpose of the Study:
- To determine the feasibility and impact of a tele-audiology program.
- To assess the program's effect on reducing loss to follow-up rates.
- To evaluate parental and provider satisfaction with tele-audiology services.
Main Methods:
- A tele-audiology program provided diagnostic evaluations to infants with failed newborn hearing screens.
- Parent and provider surveys assessed satisfaction and perceived quality of care.
- Loss to follow-up rates were compared pre- and post-program implementation.
Main Results:
- 59.1% of referred infants were diagnosed with hearing loss.
- High satisfaction reported: mean quality score >6.5/7 from parents and providers.
- Tele-audiology achieved 0% loss to follow-up, compared to 22% previously.
Conclusions:
- Tele-audiology is a feasible and effective solution for diagnostic hearing evaluations in infants.
- The program significantly reduced loss to follow-up for infants facing access barriers.
- Telemedicine improves access to audiology services for high-risk newborns.
Background:
Infants who do not pass their newborn hearing screen require diagnostic follow-up visits but often face access barriers such as travel distance and shortage of pediatric audiologists. Telemedicine (tele-audiology) is a potential solution to provide diagnostic hearing evaluations for families of infants facing access barriers. We determined the feasibility and impact of a tele-audiology program that provided comprehensive diagnostic evaluations to a region with a high lost to follow-up rate among newborns who did not pass their newborn hearing screen.
Materials And Methods:
We evaluated the tele-audiology program using parent and provider surveys to determine the perception of quality and satisfaction of care. We also compared the lost to follow-up rate of the tele-audiology program with the loss to follow-up in the region before the implementation of the program.
Results:
Twenty-two infants who did not pass their newborn hearing screen were referred to the tele-audiology program for diagnostic evaluation. Among these infants, 59.1% were diagnosed with some form of hearing loss. The mean quality score rated by both parents and providers on the telemedicine interaction was over 6.5 on a 7-point Likert scale. All parents rated the importance of tele-audiology as 7 (extremely important) for their family, whereas the provider rated the mean importance as 6.4 (95% confidence interval, 5.9, 6.9) on a 7-point Likert scale. Almost all parents actively participated or were engaged during history taking and counseling and were comfortable in discussing their child's hearing status remotely over telemedicine. All infants completed their diagnostic evaluation with no loss to follow-up compared with 22% loss to follow-up in the region before the implementation of the program.
Conclusions:
Tele-audiology is a feasible solution that reduces the loss to follow-up among infants who do not pass their newborn hearing screen and have access barriers to qualified audiologists for diagnostic evaluations.
