Each year around 1,500 people in the UK have a cochlear implant – an electronic medical device that replaces the function of a damaged inner ear. These patients need lifetime annual follow up at one of 18 specialist centres. The nearest centre for some patients may be several hours away from their home, meaning there can be significant financial costs, travel time and inconvenience.
We have designed, implemented and evaluated a remote care pathway. Patients receiving remote care use a personalised app including a home hearing check, ordering spares, listening in noise and music practice, advice, check up questionnaires, reminders, monitoring of implant site photos, and other resources to allow them to care for their hearing at home rather than in a clinic.
The trial of this pathway resulted in a significant increase in patient empowerment, as well as improvements in hearing, suggesting that remote care makes patients better able to keep their hearing stable.
This Scaling Up Improvement project supports roll out of the pathway in eight centres across the UK. It is estimated that there may be several hundred patients enrolling for the service a year, which would result in significant cost savings.
The new care pathway means patients are unlikely to need routine appointments. Instead, they will use the remote care tools in their own homes and only attend the clinic if there is a clinical need, for example if access to specialist resources is needed.
Patients will be able to monitor their hearing at home and manage the majority of their care needs through the personalised CHOICE app. Shared decision-making about when the tools are appropriate and beneficial will be promoted, recognising that remote care will not suit all patients.
Please watch our video about the project:
Project lead: Dr Helen Cullington, principal clinical scientist at University of Southampton H.Cullington@southampton.ac.uk
Project manager: Dr Mark Pickering Mark.Pickering@southampton.ac.uk
RUBIS.Qi improvement coach: Anna Burhouse