JMIR Publications

ABSTRACT

Background:

Access to hearing health care globally is a growing concern with an estimated 900 million people with disabling hearing loss by 2050. Hearing loss is one of the most common chronic health conditions, yet access to hearing health care is limited. Incorporating online (telephone/WhatsApp/email) service delivery into current treatment pathways could improve access and allow for better scalability of services. Current eHealth studies in audiology have focused on technical feasibility, sensitivity and specificity of diagnostic hearing testing and not on patient satisfaction, experiences and sustainable models along the entire patient journey.

Objective:

This study investigated a hybrid (online and face-to-face) hearing health service in terms of uptake, experience and satisfaction in adult patients with hearing loss.

Methods:

A non-profit Hearing Research Clinic using online and face-to-face services was implemented in Durban, South Africa. Using online recruitment from the clinic’s Facebook page and Google AdWords which directed persons to a web-based hearing screening test. Online (telephone/WhatsApp/email) and face-to-face care pathways included assessment, treatment and rehabilitation. To evaluate the service an online survey was conducted, consisting of; i) a validated satisfaction measurement tool [The Short Assessment of Patient Satisfaction (SAPS)] ii) a process evaluation of all the five steps completed and iii) personal preferences of communication methods used versus preferred, and HHC experiences compared to previous care were sent to 46 patients who used clinic services.

Results:

Of the 46 patients invited, 31 patients (67%) completed the survey (mean age 66.0; ±15.7SD). Almost all patients (92%) reported that the online screening test assisted them in seeking hearing health care. Close to 60% of the patients accessed the online hearing screening test from an Android device. Patients stayed in contact with the audiologist mostly through WhatsApp instant messaging (87%), and the majority of patients (81%) preferred to use this method of communication. Patients continuing with hearing health care were significantly older and had significantly poorer speech recognition abilities compared to the patients who discontinued seeking hearing health care. A statistically significant (P = .007) result was found between age and the number of appointments per patient. 61% of patients previously completed diagnostic testing at other practices, with 95% of those rating services through the hybrid clinic as better. Two main themes emerged for the differences between prior experiences and the hybrid clinic; clinician engagement and technology. Overall, patient satisfaction was 97%. The Net-Promoter-Score (NPS) was 87, which indicates that patients were very likely to recommend the hybrid clinic to friends/family.

Conclusions:

This study applied online and face-to-face components into a hybrid clinic and measured a positive overall experience with high patient satisfaction through a process evaluation. The findings support the potential of a hybrid clinic with synchronous and asynchronous modes of communication as a scalable hearing health care model to address the needs of adults with hearing loss globally.