Services & Support
by Cochlear Guest Author

Optimizing clinic care with tele-health solutions

April 20, 2020
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By Michelle Kraskin, AuD

Given the unfamiliar nature of the current COVID-19 pandemic, professionals have been forced to rethink how to handle patient care when confronted with limitations of face-to-face contact. Our center has continued to maintain our “patient first” philosophy with the use of customized tele-visits based on individual needs.

Virtual pivot

Through the use of our online system, we have been utilizing video visits to see patients. Many of our existing Baha® and Nucleus® cochlear implants recipients have reached out to us for assistance with current device settings, troubleshooting inquiries or with aesthetic/positioning questions.

By adopting tele-visits, we can walk the patients through step-by-step troubleshooting actions regarding their device(s). For example, I recently used a tele-visit to support the parent of a 4-year-old bilateral cochlear implant recipient who noticed her son wasn’t as responsive as he typically had been. I instructed her to hold the processor close to the screen for me to look at the microphone covers. I immediately noticed they needed to be changed! Further, I instructed her how to “test” the microphones using her Nucleus Smart App and provided her with the respective online resources.

For a separate patient, I programmed a clinic stock Baha 5 Sound Processor and Softband for a newly diagnosed infant with unilateral microtia atresia and mailed the items directly to the family. Cochlear’s robust recipient education and support materials such as instructional videos, links and smart app made this a viable option. Prior to the actual video visit with the family I sent a “cheat sheet” with all key items to aid the conversation. I look forward to dispensing more bone conduction systems during the stay-at-home period and employing the Baha Lend an Ear Program.

Relying on resources  

My clinic department is still functioning, albeit some areas remotely, and able to process insurance approvals and upgrade requests alongside Cochlear’s Reimbursement and Insurance Services. The secure portal, myCochlear™ Clinic, allows me to upload the upgrade forms and email these over to the patients’ parents to complete.

Continuing a patient story, I received approval from my department and placed an order with ProCare. Luckily, we use Cochlear Link and this child’s new Nucleus 7 Sound Processors were shipped directly to the home, pre-programmed with the MAPs the Cochlear team had converted for me.  The patient is scheduled for an upcoming video visit where I will dispense his upgraded devices.

The tools and resources Cochlear provides, along with some creativity, has made for what some would view as a challenge, less challenging. The ability to continue to serve patients even without being physically present has been so rewarding, particularly in the current heightened global climate. The look in the parents’ eyes when their baby heard from the Baha for the first time and another child’s expression when he could hear his teachers directly into his processor are memories I choose to take away from this professional learning opportunity.

To learn more about available remote resources, subscribe to Cochlear ProNews.

About the author:

Michelle Kraskin, AuD

Dr. Michelle Kraskin, an Assistant Director of Audiology at Weill Cornell Medicine received her Doctor of Audiology (Au.D.) degree at the Graduate Center of the City University of New York. She obtained her Bachelor of Arts degree from the State University of Stonybrook and her Masters of Science in Communications Science from Hunter College, City University of New York. Dr. Kraskin is licensed in Audiology through the New York State Department of Education and holds the Certificate of Clinical Competence in Audiology (CCC-A) from the American Speech Language Hearing Association (ASHA). She maintains membership in ASHA.  

Dr. Kraskin has been affiliated with New York-Presbyterian Hospital/Weill Cornell Medicine since 2003. She is responsible for the coordination of the day-to-day activities for audiology and speech and for infant screening services as part of the Hearing and Speech Department. Her clinical expertise is in the area of pediatric assessment of hearing including audiometry, auditory brainstem response (ABR), otoacoustic emissions (OAE) testing, hearing aids and cochlear implantation.

The Cochlear Nucleus Smart App is available on App Store and Google Play. For complete smartphone compatibility information, please visit www.cochlear.com/compatibility.

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Cochlear Guest Author

In an effort to keep our content fresh and reflective of a diverse industry, Cochlear Americas features a mix of employees and professional partners to contribute to Cochlear ProNews as Guest Authors.

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Tips for patients working remotely

April 13, 2020

With the recent COVID-19 events across the world, many are using homes as offices or classrooms.

Those experiencing hearing loss or who are cochlear implant recipients may be seeking guidance on the best way to communicate in this virtual space.  They are likely considering these things: Will I be able to hear the speaker, follow along with the team meeting or present with confidence?

Here are some suggestions that may help set the stage for your patients’ success in a virtual environment:

Utilize the computer camera

Use the camera for identifying who is speaking during a group conversation. Seeing body language gives additional context to the conversation. Employing video removes much of the guesswork and allows focused attention on the conversation at hand.

Quality surroundings

Audio environment is another important factor for success in a virtual workplace. A noisy meeting environment increases listening processing (and fatigue), so finding a quiet office or section of the home where distractions, such as background tv, are mitigated should be considered. 

Also, encourage your patients to advocate for themselves. For example, if on a call with one or more people, they can ask all others to mute themselves when they are not talking. This helps to focus on the speaker’s voice without competing sounds drowning out the conversation. It also may lessen exhaustion.

Have an agenda, presentation materials and meeting invite list

Having an agenda will give more context about what is being discussed.  A clear understanding of the meeting’s goals and objectives can keep the meeting on topic and allow for appropriately- timed contribution. Asking for the presentation materials ahead of time also gives your patients a chance to prepare and have context of the upcoming discussion. Lastly, understanding who has been invited to the meeting prior to the call can signal whose voices may be heard.  

Clarifications

When starting on a new project/account or when communicating with a new group of people, transparency regarding hearing loss is important. Your patients can delineate that they can communicate well if able to see, but may on occasion ask for repetition or clarification.

This can break the ice and create the space to collaborate. The team can become comfortable with the candidness and embrace the supportive atmosphere. They too may feel welcome to raise any issues they may anticipate, such as a kid potentially running into the room during the call.

Embrace technology

As well as utilizing video calls, your patients can make the most of device technology such as direct streaming to your Cochlear™ Nucleus® 7 Sound Processor or use the Cochlear Wireless Phone Clip. Further, chat features on the video call or instant messaging programs can be beneficial when asking for clarification from an internal colleague.

Take action

When the meeting is winding down, your patient can suggest that the group define action items.  This can be an opportunity to state your responsibilities as understood, or to bring up those clarifying points if there wasn’t an opportunity to do so earlier.

Finally, asking for a copy of the meeting notes, either in formal format within a company folder or even an email, can be a beneficial recap of the main points and action items.

Pre-planning virtual collaborations can be key for successful interactions online. 

For more tips while working at home, visit Cochlear ProNews.

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Cochlear Link connection

June 1, 2020

Interview with Mila Duke, AuD

Manager of Audiology Employee & Student Development at Hearts for Hearing

What initially drew you to field of audiology?

I have always had to desire to work in medicine and/or with children. I was initially introduced to this field by my aunt who is a speech-language pathologist and thought it would be a nice combination of my interests. As with most audiologists, after taking my first introduction to audiology course as an undergraduate, I quickly discovered that audiology would be my calling instead. The rest is history!

What Cochlear resources or services do you and your patients find most helpful during their cochlear implant journey?

Many patients who are either just starting their cochlear implant journey or have been implanted for a while thrive by talking with other recipients about their experiences. Some ways patients can do this is through engaging in the Cochlear volunteer program, attending Cochlear Celebration or attending local Hearing Loss Association of America meetings. We feel that the patients who are most successful with their cochlear implants have a strong working knowledge of their technology and realistic expectations. Further, I offer any resources or services that I feel will best educate my patients.

How has the current global environment changed the way you deliver care? How will telehealth change the clinical care landscape?

We live in an area where patients typically drive on average an hour each way to our clinic. Telehealth will provide us the ability to serve patients who may not have the resources to make the trip to see us before, during and after this global pandemic. Many of our older and/or immunocompromised patients may be nervous to return for needed programming, and telehealth will provide us with an opportunity to help serve these patients.

How has Cochlear provided remote support to you and your patients during this time?

During the COVID pandemic, we have been able to request new equipment for patients using the myCochlear Clinic professional portal. With Cochlear Link, there is hardly any delay sending the processor(s) to the patients’ homes. We have also watched many professionally-based online webinars that have provided wonderful learning experiences while working remotely. 

How long has your clinic utilized Cochlear Link?

We were fortunate to be a part of the pilot program and started using Cochlear Link in 2015.

What are the benefits of Cochlear Link?

Cochlear Link has been critical in our efforts to provide the best care for our patients. Our clinic has grown extensively in the last few years which has led to an even greater need for a program like Cochlear Link. It has also saved our clinic precious resources by cutting down on the time needed to upload MAPs, register processors, etc.

How has Cochlear Link saved time?

In the second year using Cochlear link, we saved approximately 260 clinic hours and reinvested this time with our patients. This is huge and the number has only grown as we’ve added more audiologists and patients to the clinic.

Does it allow you to see more patients?

Absolutely. Audiologists and audiology assistants can now spend more time counseling and educating patients on cochlear implant equipment, which as I mentioned previously, is one of the factors that we feel helps patients succeed.

For more information, subscribe to Cochlear ProNews.

About the author:

Dr. Mila Duke is an audiologist at Hearts for Hearing in Oklahoma City, OK. Dr. Duke received both her Bachelor’s degrees in Speech and Hearing Science and her Doctorate of Audiology (Au.D.) at the University of North Texas. Dr. Duke completed her externship at Hearts for Hearing where upon graduation, she joined the team full time in 2013. At Hearts for Hearing, Dr. Duke sees a variety of clinical patients including adult and pediatric evaluations, hearing aids and cochlear implants. Dr. Duke serves as a coordinator for audiology students who complete clinical rotations at Hearts for Hearing.

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