Abstract:
BACKGROUND : Globally, access to hearing health care is a growing concern with 900 million people estimated to suffer from
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 Web-based (voice calling, messaging, or emailing) service delivery into current treatment pathways
could improve access and allow for better scalability of services. Current electronic health 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 aimed to investigate a hybrid (Web-based and face-to-face) hearing health service in terms of uptake,
experience, and satisfaction in adult patients with hearing loss.
METHODS : A nonprofit 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 an online Web-based
hearing screening test. Web-based and face-to-face care pathways included assessment, treatment, and rehabilitation. To evaluate
the service, an online survey comprising (1) a validated satisfaction measurement tool (Short Assessment of Patient Satisfaction),
(2) a process evaluation of all the 5 steps completed, and (3) personal preferences of communication methods used vs methods
preferred was conducted, which was sent to 46 patients who used clinic services.
RESULTS : Of the patients invited, 67% (31/46) completed the survey with mean age 66 years, (SD 16). Almost all patients, 92%
(30/31) reported that the online screening test assisted them in seeking hearing health care. Approximately 60% (18/31) 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 (27/31, 87%), and most patients (25/31, 81%) preferred to use this method of communication.
The patients continuing with hearing health care were significantly older and had significantly poorer speech recognition abilities
compared with the patients who discontinued seeking hearing health care. A statistically significant positive result (P=.007) was
found between age and the number of appointments per patient. Around 61% (19/31) of patients previously completed diagnostic
testing at other practices, with 95% (18/19) rating the services at the hybrid clinic as better. The net promoter score was 87, indicating that patients were highly likely to recommend the hybrid clinic to friends and family.
CONCLUSIONS : This study applied Web-based and face-to-face components into a hybrid clinic and measured an overall positive
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 to be a scalable hearing health care model, addressing the needs of
adults with hearing loss globally.
