In Rural Areas Where Audiologists are Rare, Telemedicine Can Help

In November, the FDA issued a ruling that will make life easier for cochlear implant recipients living in rural areas.

Implant surgery and immediate follow-up for mapping and programming must be done at a medical center or specialized clinic, but the new FDA ruling would allow remote programming for later adjustments. The audiologist and patient communicate via two-way video, with the audiologist programming the implant via computer just as he or she would in person.1495316546168 copy

The new ruling applies to Cochlear America’s Nucleus Cochlear Implant System, but other implant companies will probably follow with similar features. The ruling may eventually apply to programming hearing aids as well.

The FDA approved remote programming for patients age 12 and over who have had their implant for at least six months and who are comfortable with the programming process.

The FDA based its ruling on a clinical study of 39 patients, each of whom had had an implant for at least one year. The study included one in-person programming and two remote programming sessions for each patient. “Speech perception tests one month after each session showed no significant difference between in-person and remote programing,” the FDA said.

Twenty percent of Americans live in rural areas, while only nine percent of physicians practice there, according to an article by Greg Slabodkin in the online newsletter Health Data Management.

This comes to about 62 million Americans, for whom access to affordable healthcare is a major concern, according to an earlier article in Health Data Management. David Schmitz, M.D., president of the National Rural Health Association, testified to a congressional committee last July. He added that broadband providers must invest in the necessary technological infrastructure to make telemedicine possible.

Audiologists in rural areas are even rarer than physicians. Telemedical programming allows qualified audiologists to reach far more patients than they would ordinarily be able to do.

Speaking of the November FDA ruling, Malvina Eydelman, MD, director of the Division of Ophthalmic, and Ear, Nose and Throat Devices in the FDA’s Center for Devices and Radiological Health, said that telemedicine can “reduce the burden to patients and their families, especially those who must travel great distances or need frequent adjustments.”  Cochlear implants need adjustments not only as the user’s hearing adjusts to the implant, but as new technology becomes available. Since programming is done via the external processor, telemedicine is an easy and appropriate tool.




6 thoughts on “In Rural Areas Where Audiologists are Rare, Telemedicine Can Help

  1. This is fantastic news. I live a 2 and a half buss/train ride from Boston where my clinic is. Add that to a 45 minute commute to the station in Portland and that all adds up to a full day. I am sure it will be a while before such a service is available for all devices.

    Also, AB has announced the imminent activation of chip that is already in the Q90 processor that contains communication protocols including blue tooth that will supposedly connect to any BT enabled device without a streaming device involved. It’s called SWORD – for: Sonova Wireless One Radio . This is probably old news but I just became aware of it. A mere twenty years ago stuff like this would be considered science fiction. Twenty years hence – a time that is beyond my “use by date” – will be mind boggling indeed.

    Liked by 1 person

  2. Jerry, I didn’t know about that Advanced Bionics chip. It’s great news. I have an AB c.i. and use the phone (and recorded books and GPS and everything else on the smartphone) via a streamer, which I frequently forget to take with me, or else I forget the charger.
    Can’t wait for the AB chip!


  3. I am just at the stage of thinking about having a cochlear implant with a bilateral loss having continuously decreased over the past 30 or more years, primarily have lost lower frequencies but now at age 65 high frequencies have been going as well. Hearing aids with Roger Pen are barely keeping me able to function in a hearing world. I would appreciate thoughts, recommendations of blog postings etc. about deciding when to investigate a cochlear implant and the experience and the adjustment. I live in Baltimore so have good access to services. Katherine greatly enjoyed your presentation to our HASA a few years back. I shared a workplace encounter at that presentation about a colleague imitating me at a meeting. Many many thanks for the work you are doing.


    • Thanks so much for this nice comment. Sorry I didn’t see it earlier. the standard advice is that a cochlear implant is something you should turn to when a hearing aid is no longer adequate. That sounds like your situation. You are very lucky in being so close to such a great hearing center. I’m sure they will give you the best advice.


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