Remote cochlear implant candidacy assessment, activation and speech perception testing in northern communities: a...

This quality improvement (QI) case study conducted at a large adult CI centre aimed to improve access to cochlear implant (CI) care for northern communities. By adapting existing infrastructure using tele-audiology in novel ways, we were able to complete CI candidacy assessments, CI activations and CI speech perception testing remotely.

Two remote sites were trained and equipped to facilitate remote sessions for expanded CI care services. These collaborating sites were outfitted with CI software, adaptors, and standardized speech testing WAV sound files. CI audiologists from the implant centre, with the support of the local Facilitator, used remote desktop control to complete CI activations, plus streaming technology to evaluate aided speech perception for CI candidacy assessments and CI outcomes.

Five remote CI candidacy evaluations and activations were successfully completed, along with three cases of follow-up remote CI speech perception testing without any adverse events. Post-activation surveys indicated a high level of satisfaction among participants. Case studies demonstrated evidence of a high level of agreement as well as a case of high variability between remotely assessed speech recognition scores and those obtained in-person.

These case reports highlight tele-audiology's potential to enhance access to CI care for underserved regions. Future expansion to include additional CI models and adaptations to other applications such as bone conduction aids is anticipated.