Implementation Strategy for Highly-Coordinated Cochlear Implant Care With Remote Programming: The Complete Cochlear Implant Care Model. Issue 8 (September 2022)

• Record Type: Journal Article
• Authors: Nassiri, Ashley M.; Saoji, Aniket A.; DeJong, Melissa D.; Tombers, Nicole M.; Driscoll, Colin L. W.; Neff, Brian A.; Haynes, David S.; Carlson, Matthew L.
• Is Part Of: Otology & neurotology. Volume 43:Issue 8(2022)
• Page Start: e916
• Page End: e923
• Publication Date: 2022-09
• Subjects: Cochlear implant -- Coordinated care -- Healthcare delivery -- Patient-centered care -- Remote programming -- Telehealth -- Telemedicine; Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000003644
• Languages: English
• ISSNs: 1531-7129

Abstract

Abstract : Objective: To introduce and discuss implementation strategy for the Complete Cochlear Implant Care (CCIC) model, a highly-coordinated cochlear implant (CI) care delivery model requiring a single on-site visit for preoperative workup, surgery, and postoperative programming. Study Design: Prospective, nonrandomized, two-arm clinical trial. Setting: Tertiary referral CI center. Patients: Adults who meet audiologic criteria for cochlear implantation. Interventions: Cochlear implantation, coordinated care delivery, including remote programming. Main outcome measures: Care delivery model feasibility and process implementation. Results: Patients determined to be likely CI candidates based on routine audiometry are eligible for enrollment. The CCIC model uses telemedicine and electronic educational materials to prepare patients for same-day on-site consultation with CI surgery, same or next-day activation, and postoperative remote programming for 12 months. Implementation challenges include overcoming inertia related to the implementation of a new clinical workflow, whereas scalability of the CCIC model is limited by current hardware requirements for remote programming technology. A dedicated CCIC process coordinator is critical for overcoming obstacles in implementation and process improvement through feedback and iterative changes. Team and patient-facing materials are included and should be tailored to fit each unique CI program looking to implement CCIC. Conclusion: The CCIC model has the potential to dramatically streamline hearing healthcare delivery. Implementation requires an adaptive approach, as obstacles may vary according to institutional infrastructure and policies.