Best Practices With Cart-Based Synchronous Audiology

The purpose of this clinical focus article is to summarize the processes used at the San Francisco Veterans Affairs Health Care System (SFVAHCS) for cart-based synchronous audiology. This system involves a provider located at a main facility where they use a web-based teleconferencing platform to work with a patient at a community-based outpatient clinic with the help of a telehealth technician using a Clinical Access Station (CAS; GlobalMed) cart.

The components of a successful cart-based synchronous audiology service are presented. These include a description of the problem of serving patients who live at great distances from Veterans Affairs (VA) hospitals, how to arrange the facility for use with the CAS cart to achieve maximum organization, and technician roles and training.

Veterans may live in cities 15 to over 250 mi from the SFVAHCS in their California network. The SFVAHCS also serves Veterans outside their California network. Cart-based synchronous audiology offers an opportunity to provide services originating from San Francisco. Arranging the technician's workspace with the CAS cart is critical for efficient patient care, and examples of organizational tools are provided. Finally, a key to success is the capability of the telehealth technician. Suggestions are provided for technician training and skill assessment defined by the VA central office to promote nationally standardized, evidence-based practice with this modality of care.

The goal of cart-based synchronous audiology at the SFVAHCS is to provide the Veterans with the same quality of care that they would receive in a face-to-face appointment. This goal is being met by the SFVAHCS audiology service well outside of its defined catchment region or the designated area or areas from which a health care facility can expect to receive patients needing their services.