A team at Manchester VA developed a TeleAudiology program to fill a gap in audiology care for Veterans living in rural New Hampshire. They wanted to reduce Veterans’ two-hour commute to the closest audiologist at Manchester VA.
In September 2022, the team launched their program, which included establishing two TeleAudiology clinics at the Tilton and Conway community-based outpatient clinics.
TeleAudiology clinics provide visiting Veterans the technology and resources they need to connect with an audiologist and receive care remotely. Since the launch, around 300 Veterans have received TeleAudiology care.
The team is led by Audiologist Dr. Nicole Carbone. Team members include Jane Michaud, advanced telehealth clinical technician; Sheri Lamoureux, telehealth clinical technician; and Jodi Witt, LPN and telehealth clinical technician.
“You get that sense of impact, that you’re making a difference for Veterans,” said Witt. “Every week I have Veterans tell us, ‘I’m so glad you offer this up here now. You saved me the drive and I can do it here.’”
Expanding access to specialty care
In her eight years as a VA audiologist, Carbone saw that Veterans in northern New Hampshire were not getting the specialty care they needed. The lack of audiologists in the rural areas of New Hampshire created a significant barrier to care. Carbone and Michaud worked together to develop their program.
Michaud coordinated equipment testing in both Tilton and Conway clinics. Carbone trained telehealth clinical technicians Witt and Lamoureux on using telehealth equipment for remote audiology patients.
Carbone describes TeleAudiology as the “perfect solution.” Her team expanded care to Veterans in rural areas while keeping their care in the VA system. VA TeleAudiology caters to hearing issues common among Veterans, such as noise-induced hearing loss and blast injuries.
At the TeleAudiology clinics, a Veteran meets with a telepresenter who helps the Veteran connect with an audiologist remotely. The telepresenter uses a telehealth cart and various tools to present the Veteran to the audiologist. This enables the audiologist to evaluate the Veteran remotely.
When serving as a remote audiologist for the clinics, Carbone evaluates the Veteran’s condition and checks for blockages in their ears. When necessary, she also directs the telepresenter to conduct hearing exams, hearing aid fittings, adjustments and repairs.
“I’m here to be Dr. Carbone’s hands,” Lamoureux said. “The Veterans are amazed by the technology, how far it’s come and they leave so impressed. They are so excited to do everything remotely and off-site.”
Veterans spread the word about TeleAudiology
The team’s TeleAudiology services have restored hearing to hundreds of Veterans. Carbone describes Veterans who cry joyfully after being fitted with a hearing aid. The device greatly impacts their day-to-day life and enables them to better communicate with their family and friends.
The work is even more meaningful for Michaud because she also wears a hearing aid. She recalled how she often relates to hard-of-hearing Veterans and wants to get them the care they deserve. When she received her hearing aid it began a new chapter in her life.
The team received a Service to the Citizen Award for their transformative program providing care to northern New Hampshire Veterans. The award recognizes public servants and industry partners who show excellence in providing services and care to the public. The team was honored to be recognized by the award.
“We strive to provide excellence and care in service for all Veterans and to their families as well,” said Carbone. “Being able to restore their hearing so they can hear us say ‘Thank you for your service’ is the least we can do for Veterans.”
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Will other CBOCs be getting this and does it include testing? Patient at Ocala CBOC.
Hi. Yes this Tele Audiology includes hearing exams, hearing aid fittings, hearing aid adjustments, and repairs. Currently in New Hampshire this is being offered in the remote areas of the state to include Tilton and Conway areas. To see if this is offered in the Ocala CBOC area please reach out to the Telehealth Connected Care team at that CBOC.
Respectfully,
Walter Davis, MSN, RN
Chief of Connected Care
Manchester VA Medical Center
Will other CBOCs be getting this and does it include testing?
Tilton CBOC and Conway CBOC NH.
Hi David. TeleAudiology includes hearing exams, hearing aid fittings, hearing aid adjustments, and repairs. Currently in New Hampshire this is being offered in the remote areas of the state to include Tilton and Conway areas. To see if this is offered in your local area please reach out to the Telehealth Connected Care team at your nearest VA.
Respectfully,
Walter Davis, MSN, RN
Chief of Connected Care
Manchester VA Medical Center
Since it is a 2-hour drive, all of the veterans are eligible for community care based on the access standard of a 60 minute drive. Why did you not state that in the article and why did you not offer community care to the veterans as required by the Mission Act and the VCCP regulation? Also, veterans to not have to do telehealth or TeleAudiology unless they want to do it, instead they have the right to an in-person appointment and community care. I used to work at the VA on this, so I know what I am talking about.
Because the rural nature of where our catchment area lies, sometimes there are no closer alternatives to the Veterans. They are always made aware of their available options. The closest community option to them might be 3+ hours from their homes. Care in the community is not always the best option for everyone. When the Veteran’s here are offered the opportunity to do TeleAudiology they are willing to give it a try. The majority of the Veterans that we see via Telehealth are relieved that they have a closer option available. Every site is different.
Hi Darin. In the state of New Hampshire since we don’t have a full service VA hospital, each and every VA enrolled veteran no matter where they live in the state is offered Community Care and VA care as per the Mission Act. These veterans using Tele Audiology have selected care in the VA over the community. A challenge that we find in the remote areas of New Hampshire is that many medical specialties are not available in the community so the VA is using Telehealth Medicine to connect with these veterans to provide them with care that is not available in the community.
Respectfully,
Walter Davis, MSN, RN
Chief of Connected Care