Dr. Dr. h.c. Monika Lehnhardt

EFAS Budapest, June 2013

Time for Paradigm Change

in Clinical Care

Situation Analysis

World population is

growing

World population is

ageing

Technological advances at an increased

speed

Open, easy, cost free access

to information via Internet

Participative decision making

in health care

Incidence of deafness

unchanged

Quality of life an important

factor

Macro Level

Situation Analysis

Indication broadening constantly (e.g. elderly population, severely

hearing impaired, single sided deafness …)

Awareness of availability of effective treatment for deafness

spreading (candidates, parents, children of parents searching in the

Internet for objective information and exchange experience on social

Platforms)

Self-confidence of candidates and their spokesmen improving based

on acquisition of knowledge and social interaction

Establishment of CI programs in countries with a high population and

lack of infrastructure

Increasing number of CI candidates every year

Exponential growth of existing CI recipients pool demanding life-long care

Micro Level

Impact on traditional Clinical Care

Lack of specialized therapists

Overload on

clinics

Too many new clinics

with small

numbers

Neither efficent

nor sufficently effective

any longer

Poorer outcomes

Developments of Internet-based technologies

Organizational models

New dimensions of scalability

Do nothing = unacceptable damage CI concept

Add personnel and equipment = unrealistic too expensive

Call for Clinical Care Innovations

Faster, safer and cheaper Internet connections

Tele-Practice

Swanepoel & Hall 2010:

Teleconsulation is feasible and reliable for hearing sreening,

diagnosis and intervention

Definition by ASHA

Todd Houston:

“Rapid advances in the evolution of telecommunication and distance

technology are creating new opportunities to provide direct services to

meet the audiological, speech and language needs of young children

and adults with hearing loss”

Tele-Practice is a Videoconferencing Service Delivery Model

Registration Online

Share intra-opertive data

Tele-fitting

Failure Reporting Online

Remote support

Exchange of experience

Online Consultation

Tele-Practice The Future has begun

Tele-Practice

Registration Online

￭ No need of manually filling in cards,

mailing, collecting, copying …

￭ Central Computing of data at an

independent organization to get

reliable statistics about CI recipients

(e.g. Switzerland, Belgium,

Netherlands, Denmark, Sweden)

Tele-Practice

Cooperation between clinic / operating

room and fitting centre

Share intra-operative measurement data to create first maps

Tele-Practice

Experienced expert maneuvers the

software programme on the hardware

of the less experienced in another

location

fitting of new speech processor via

Internet

connection between the experienced

and less experienced audiologist

Upgrades

Tele-fitting

Visualisierung aus einem Beitrag von Medincus Group auf YouTube

Tele-Practice

CI systems will report about their functionality and

about eventual problems online and will receive

online instructions how to fix the problem or suggest

competent resources where to find a solution

Failure Reporting Online

Tele-Practice

Experienced therapist counsels less

experienced via Skype and video

camera

Remote Support

Visualisierung aus einem Beitrag von Todd Houston

Amongst parents via Skype or in

LiveOnline Rooms across countries and

language barriers.

Voskresnyj Poldnik – Sunday meetings

for Russian speaking parents

Tele-Practice

Exchange of experience

Weblogs – Interactive Communities

Amongst experts via Skype or in Live

Online Rooms across countries an

language barriers

PORA Live Online Seminars for

Russian speaking therapists

Tele-Practice

Exchange of experience

Increase the sustainability of conferences by

continuing in the Internet environment

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Online consultation of surgeons, therapists and

other experts for parents, patients and

stakeholders seeking advice

Tele-Practice

Teaching how to use Tele-Practice Service Delivery Models

Preparing a Platform for Special Interest Goups

PORA! Live Online Seminars for Russian Speaking Therapists since 2009

Voskresnyj Poldnik for Russian Speaking Parents since 2010

The Lehnhardt Foundation

Access for patients/parents to highly qualified and experienced experts from remote

places

Support for less experienced professionals with all modes of communication

(speaking/listening; writing/reading; seeing/demonstrating;)

Virtual presence of world renowned personalities in conferences

Increase sustainability of conferences, work-shops and other meetings

Parallel interpretation into several languages

Higher level of team-work

Whole family can participate in therapy sessions without disturbing

Reduction of costs for travel

Time savings

Reduction of therapy cancellation due to health problems

Easy establishment of special interest groups

Tele-Practice Benefits

Access to high-speed bi-directional Internet connection for video links

(upload speed)

Costs for equipment – laptops, monitors, cameras, loudspeakers

Training for experts to feel comfortable with handling the technology

Basic knowledge for patients / families to make them feel confident

Additional time effort to prepare tele-practice sessions

Tele-Practise Obstacles / Challenges

Provision of additional material / toys for the remote place

Resolve reimbursement issues

Tele-Practice

Accept that Tele-Practice is not for everybody!

Conclusion & Appeal

EMPATHY

Tele-Practice is not meant to replace but to complement traditional clinical

care to enhance quality and ensure a broader reach and coverage at

reasonable costs

Todd Houston:

„Looking forward we can foresee that

tele-practice service delivery models will become

standards of care for families seeking early

intervention and / or speech and language

services“.

Free human resources and

have them concentrate on providing

what can only be provided by human

beings: Empathy for people in need!

Thank you for your attention and

please feel free to comment

in my personal weblog

www.monika-lehnhardt.net