teleaudiology

Audiology Technologist Leilani Ramos, seated with a patient at the DiLorenzo Clinic at the Pentagon, serves as the hands and arms of Dr. Georgina Blasco, a staff audiologist conducting the examination remotely from Walter Reed National Military Medical Center.

“We did a hearing test on you earlier. Your hearing is essentially normal but you still feel that you are experiencing difficulty understanding, is that right?” asked Dr. Georgina Blasco, a staff audiologist, speaking at a monitor from her desk at Walter Reed National Military Medical Center (WRNMMC) on Naval Support Activity Bethesda.

Her patient, Army Lt. Col. Darlene T. Pelletier, 20 miles away at DiLorenzo Clinic in the Pentagon, can see the digitized audiologist from another monitor on a special cart in the clinic.

“Yes, ma’am,” Pelletier answered, with Audiology Technician Leilani Ramos standing at her side. Ramos served as the hands and arms of Blasco during the hearing test.

“And how long has that been going on for?” asked Blasco, leaning forward toward her monitor at WRNMMC.

“I don’t know. It’s hard to say because it’s one of those things where I just assumed the problem was with me, like when I go to movies, when I listen to conversations—especially if there are other people around me and it’s noisy, or trying to decipher certain words,” Pelletier said, further explaining her symptoms.

“Sometimes I have to ask the person next to me, ‘what did he say, what did she say’? I think it has something to do with the syllables or the words that are being spoken. Even watching T.V., or when it’s quiet, there are some words that I can’t quite comprehend,” Pelletier added.

Blasco, who serves as lead of clinical Tele-Audiology at WRNMMC, asked, “So predominantly in noisy environments, but also some difficulty in quiet?”

Pelletier clarified, “Or if there are certain words and I can’t quite make them out and I haven’t figured out what those sounds are.” The Army officer, who serves as the analysis branch chief at the Department of the Army Headquarters, said she’d experienced the problem sporadically for several years but didn’t know when it started.

A series of hearing tests, directed by Blasco from her office at WRNMMC, follow.

“I really didn’t hear about Tele-Audiology until I tried to schedule an appointment to participate in a hearing test,” Pelletier said. “I received the same quality care that I could have received in an on-site appointment. The convenience of attending the appointment at my workplace was invaluable.”

Designed to demonstrate proof of concept for the Military Health System, the tele-audiology project began in August 2015, according to Dr. Douglas Brungart, senior scientist for the Audiology and Speech Center at WRNMMC. Brungart, also the associate director of research, explained the project as a collaboration between Walter Reed’s Audiology and Hearing Conservation Clinic, the Army Telemedicine and Advanced Technology Research Center, and DiLorenzo Clinic at the Pentagon. He said the demonstration is expected to continue through the end of Fiscal Year 2016, which ends in September.

So far, the project has saved Pentagon staffers more than 200 work hours by conducting more than a hundred tele-audiology appointments at the beta site for the Department of Defense over the past eight months. Blasco indicated appointments are currently booked until May.

Without tele-health, audiology patients at the Pentagon would lose more than two work hours traveling to and from WRNMMC, as well as the time for the exam, Blasco said.

Patients at other military treatment facilities in the National Capital Region lose even more time, with some traveling more than 60 miles one-way for hearing examinations at the medical center, explained Margaret M. Jylkka, occupations audiology-hearing conservationist at WRNMMC. Julkka, Blasco and Ramos form the heart of the WRNMMC tele-audiology team.

Jylkka said. “Those who can’t travel to the medical center may choose to see a civilian audiologist, who may not know how to address the unique needs of the military population.

“That’s how hearing conservation works. There are all these little clinics out there, and if an audiologist is needed, right now the audiologist has to travel to the clinic or the patient has to travel to the audiologist,” Jylkka explained.

With tele-audiology, the examinations can potentially be conducted internationally, she said. Tele-audiology saves time, money and adds convenience. The project also extends continuity of care because the patients stay within the network.

Access to care is also a plus, Jylkka explained. “If we get an [audiology] consult today, we have 28 days to book that appointment.” Tele-audiology adds efficiency with a consult.

Army Lt. Col. Michael Shawn Bolshazy, senior acquisition staff officer for the deputy under secretary of the Army, Test and Evaluation, at the Pentagon,said he needed an audiology exam because he was diagnosed with moderate to severe hearing loss in his left ear and prescribed a hearing aid.

The ease of access was the main reason he chose to utilize tele-audiology.

“Honestly, it was the convenience,” Bolshazy said.“However, participating in the tele-audiology process was not only more convenient, it saved time, money, and prevented lost work hours that would have been spent traveling to and from the doctor’s location.”

He described his first time utilizing a tele-health system, saying “I was very comfortable with the process.

“I had a great experience. I definitely recommend tele-audiology if it is an option. I believe we will see the increased use of tele-health as more people become aware of its existence.”