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Published on: April 1, 2022
Telehealth-enabled auditory brainstem response testing for infants living in rural communities: the British Columbia
Jennifer L Hatton1,2, John Rowlandson3, Alison Beers1
1a British Columbia Early Hearing Program , Vancouver , BC , Canada.
Insights
Telehealth-enabled auditory-brainstem-response (TH-ABR) programs improve hearing loss detection for remote infants. This efficient and accurate method is cost-effective and highly satisfactory for caregivers.
Area of Science:
- Audiology and Hearing Science
- Telehealth and Health Services Research
Background:
- Remote communities face significant barriers to audiology services, including travel distance and limited access to specialized ABR testing.
- The British Columbia Early Hearing Program (BCEHP) sought to address these challenges for families in northern areas.
Purpose of the Study:
- To outline the design and implementation of a telehealth-enabled auditory-brainstem-response (TH-ABR) program.
- To summarize the equipment, procedures, and outcomes of the TH-ABR program.
- To evaluate the cost-effectiveness, accuracy, efficiency, and caregiver satisfaction of TH-ABR.
Main Methods:
- Described the implementation of the TH-ABR program.
- Compared TH-ABR results with behavioral follow-up to assess test accuracy.
- Collected caregiver satisfaction surveys post-appointment.
Main Results:
- The TH-ABR program proved suitable, sustainable, and scalable.
- The service achieved cost neutrality for BCEHP, averting significant expenses.
- TH-ABR demonstrated accuracy and efficiency comparable to in-person assessments, identifying hearing loss in 50 infants.
- Caregiver surveys revealed high satisfaction with the TH-ABR experience.
Conclusions:
- TH-ABR is an efficient and accurate method for early hearing loss detection.
- The program is valued by parents, optimizes audiology resource availability, and builds local service capacity.
- TH-ABR significantly reduces costs for remote communities in Northern British Columbia.
Abstract:
Objective: The present study investigated a telehealth-enabled auditory-brainstem-response (TH-ABR) programme provided by the British Columbia Early Hearing Program (BCEHP) to families in a remote northern area who face barriers such as travel distance and access to audiologists trained in ABR testing. Objectives were to: (i) outline the design/implementation of a TH-ABR programme, (ii) summarise equipment/procedures, and (iii) report on results for the TH-ABR programme (cost/time effectiveness, testing accuracy/efficiency, and caregiver satisfaction). Design: TH-ABR implementation was described and TH-ABR results were compared to behavioural follow-up findings to evaluate TH-ABR test accuracy. Caregivers were invited to complete TH-ABR satisfaction surveys following their appointment(s). Study sample: One hundred and two infants (mean age: 2.3 months) were assessed via TH-ABR at four points-of-care; 41/66 caregivers completed surveys. Results: The TH-ABR programme was suitable, sustainable and scalable. After 29 TH-ABR events, the service was cost neutral to BCEHP ($91,250 averted after 102 TH-ABRs). Fifty infants were identified with hearing loss and TH-ABR accuracy and efficiency were comparable to face-to-face assessments. Parent survey results indicated a high level of satisfaction with the TH-ABR experience. Conclusions: TH-ABR is efficient, accurate, valued by parents, optimises availability to audiology resources, builds local service capacity, and reduces costs for northern BC communities.
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