SPECIAL FEATURE
Finding Open Doors During the Pandemic Telehealth Becomes Reality
By Melissa Wikoff, AuD
Telehealth has long been considered a wonderful healthcare option but something for the future, and then came the global coronavirus pandemic, which upended everything. According to McKinsey & Company, the number of U.S. patients who have used telehealth rose from 11 percent in 2019 to 46 percent in 2020.1 I am among the thousands of healthcare providers who offers telehealth options for my patients to ensure they feel safe and are able to maintain continuity in their healthcare. Some types of audiology appointments must be done in person, but others can be done virtually, which saves time and money and increases accessibility and flexibility for patients. This is wonderful news for tinnitus patients, who often struggle to find qualified healthcare providers in their area. For many people with tinnitus, treatment is key to improving quality of life and is necessary no matter what the circumstances are. Fortunately, tinnitus therapy can be done remotely. As someone specialized in tinnitus care, telehealth has enabled me to work with patients – existing and new ones – across the United States and from around the world.
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TINNITUS TODAY WINTER 2020
What Should You Expect During a Telehealth Visit? Each patient’s journey to relief from tinnitus is different, but it typically starts with a thorough intake, which includes filling out various questionnaires and forms; these can be completed and returned electronically or through the mail for telehealth visits. The next step, which is a critical component in diagnosing and resolving the negative effect of tinnitus, is documenting your hearing health story. How did the tinnitus start? How is it disrupting your life? What fears and anxieties are weighing on you? Such information is the beginning point so a healthcare practitioner can know where to start and how to move forward with treatment. Traditionally, such conversations are done in person during an appointment, but this step, too, can be done remotely by telephone or using a secure online video conference call. The tinnitus evaluation usually comes next but cannot be done reliably via telehealth. So patients should complete an in-person appointment with a local hearing care provider to rule out any underlying medical conditions that might be causing tinnitus, have an audiogram to determine hearing acuity, and complete tinnitus pitch matching, when possible. Such information combined with questionnaires, helps the tinnitus telehealth provider develop an action plan.
An exciting development in tinnitus treatment is the ability to program hearing aids over the internet. Hearing aids are often used in tinnitus management or for management of tinnitus and hearing loss. Remote programming means I can help patients via a telehealth appointment while they relax in the comfort of their home. In most cases the patient’s hearing aids must include this remote-programming feature, and a smartphone is used to unlock hearing aid access. Different types of hearing aids give audiologists remote access to a range of features, from simple actions such as adjusting the overall gain to more complex actions across the entire fitting menu such as activating masking noise or shaping other aspects of sound quality. Other components of tinnitus treatment can also be done remotely. These include counseling and tinnitus rehabilitation training, mindfulnessbased stress reduction therapy, and cognitive behavioral therapy.
If You’re Beginning Tinnitus Treatment Ideally, your treatment would begin with an in-person appointment with an audiologist trained and specialized in diagnosing and treating tinnitus. An initial tinnitus evaluation involves several questionnaires and tests, including a thorough hearing examination and diagnostic tests for tinnitus that include pitch and loudness matching. In many cases, this appointment is essential www.ATA.org