Virtual-collaborative cochlear implant care: From candidacy to surgery to programming

Introduction: Cochlear implant (CI) patients require appointments with multiple providers prior to and following surgery. Visits include otologic and audiologic assessment, medical clearance, imaging, and postoperative programming. For patients living in rural areas, long travel times pose a barrier to efficient, safe care, especially considering the age and restricted mobility of many CI patients. The COVID-19 pandemic has accelerated expansion of telemedicine and has increased cooperation between local providers and distant specialists. This report describes a virtual-collaborative model of CI patient care (VCCI) in which surgeons at a major metropolitan CI center coordinate pre- and postoperative visits through telemedicine and remote collaboration with local audiologists, otolaryngologists, primary care physicians, and radiologists to improve the overall efficiency of managing CI patients. Method: Medical records for patients undergoing VCCI were reviewed. Data collected included number of virtual and face-to-face visits, estimated total driving time, and time from initial consultation to implantation. These results were compared with a similarly sized sample of CI patients undergoing standard management. Results: Patients undergoing VCCI showed >50% decrease in both face-to-face visits and average driving time when compared with standard pre-CI evaluation. Time to implantation was similar, although time required for evaluation was reduced substantially. Conclusion: A virtual-collaborative model for CI patient care using virtual visits and collaborative efforts between local providers and remote specialists was effective in reducing the number of required face-to-face visits, as well as total distance traveled. This study adds to a growing body of literature describing strategies for increasing the efficiency of caring for cochlear implantation patients.