Cost Benefit and Carbon Emission Saving Analysis of Remote Cochlear Implant Programming

To assess the financial benefits and carbon emission savings associated with performing virtual-synchronous remote programming and troubleshooting following cochlear implant (CI) placement for patients who live in remote regions.

CI users living ≥ 100 km from the implant center with ≥ 1 month CI experience were included. Participants were either assigned to home visits using a portable laptop (Remote Laptop; n = 20) or attended visits through the nearest Remote Hosted Site (n = 34). Direct costs in Canadian dollars from a Ministry of Health perspective and carbon emissions were compared between remote and in-person appointments at the implant center.

Median distances between participants' homes to the implant center were 574 km (Remote Laptop) and 999 km (Remote Hosted Site). Average costs for both groups of remote care were lower compared with in-person appointments at the implant center (Remote Laptop: $180.70 vs. $431.61, p = 0.002; Remote Hosted Site: $155.34 vs. $1110.89, p < 0.001). Total cost reductions were $5018.23 and $32,488.76 with cost-to-benefit ratios of 2.39 and 7.15 for Remote Laptop and Remote Hosted Site groups, respectively. Net carbon emission benefits were 2200.00 kg and 5691.50 kg with net carbon benefit ratios of 512.63 and 5.25 for Remote Laptop and Remote Hosted Site, respectively.

Virtual synchronous remote CI programming and troubleshooting generates cost savings in post-surgical care. Additionally, it achieves remarkable carbon emissions savings. More widespread adoption is expected, especially for those who reside far from implant centers.