Scaling up telemedicine for adults with cochlear implants.

Objectives: 1. Roll out telemedicine tools to adults using any cochlear implant device in the UK 2. Commission a formal evaluation to establish whether the new care model improves: • patient empowerment • equity of access • patient and staff experience • clinic efficiency Methods We will introduce a remote care pathway choice to adults using cochlear implants in participating centres in the UK. Benefits will be available to users of any device. This is a complex intervention comprising four components successfully trialled together previously: • personalised responsive web app (hearing rehabilitation, music, advice, troubleshooting, training, ordering spares, goal setting, questionnaires, reminders, monitoring of implant site photos) • home hearing test • self device adjustment at home (with appropriate device) • upgrading of sound processors at home Clinicians will access an online dashboard to monitor their patients, and will receive alerts if patients are not interacting with the tools or other indicators are achieved. Conclusions : We previously completed an RCT of remote care tools. We examined patient preference using conjoint analysis; the main outcome evaluated was patient empowerment. The remote care group had a significant increase in empowerment after using the telemedicine tools. Their hearing improved, suggesting better ability to take action to keep hearing stable. Patients and clinicians were very positive about remote care and wanted to continue. We need high quality evidence that a remote care pathway delivers our aims. An independent evaluation will be done to establish if the new care model improves: 1. patients' confidence to self-manage 2. stability of hearing as a result of self-initiated monitoring and action 3. equity of access to follow-up care 4. patients' experience of care 5. staff experience 6. use of resources [ABSTRACT FROM AUTHOR]