Making Person-Centered Care a Reality With Telehealth
January 2019
Cherilee Rutherford, AuD
Person-centered care (PCC) empowers hearing care professionals to better understand people’s unique experiences of hearing loss and how it impacts their relationships to the world. Major health care systems and organizations around the world, including ASHA, the U.S. Department of Veterans Affairs, and the National Health Services in the United Kingdom, have integrated person-centered care into their official strategies and standards. Meanwhile, a growing body of research points to the benefits of this approach in terms of better clinical outcomes, improved client satisfaction and loyalty, and even increased employee satisfaction. [See ASHA's resources on person-centered care in audiology.]
Although person-centered care theoretically is becoming more and more accepted, the question is: To what extent is it actually applied in hearing health care today? In effect, delivering person-centered care is more than just establishing good rapports with clients—it’s about empowering people by involving them in their own care and accompanying them on every step of their hearing journey.
Conceptual definitions of person-centered care vary, but some of the common ingredients are respect of the individual’s preferences and needs; dialogue that is based on open-ended, reflective questions; empathy and active listening; involvement of family and friends; and shared goal setting and decision making. For practitioners across the private and public sector, integrating these principles into their busy daily routines may seem a daunting task.
However, it doesn’t have to be that way. Telehealth technologies are evolving rapidly to provide health care professionals with new, efficient ways of delivering hearing care. The Ida Institute has developed a suite of free online resources that make it easy to implement person-centered care in your practice using telehealth. This suite is known as Ida Telecare.
A Person-Centered Patient Journey
Ida Telecare allows hearing health care professionals to bridge the gap between person-centered care and telehealth. The platform offers people with hearing loss easy-to-use tools and resources to help them prepare for appointments and successfully manage daily communication and important decisions related to hearing.
Addressing different situations and types of patients—from adults, to children, to teens and tweens and people with tinnitus—the tools help structure the conversation between patients and hearing health professionals. The tools also allow the professionals to deliver care that is designed around the needs of the individual and extend their services beyond the appointment.
The platform contains resources for the three main phases in the patient journey: preparation for the first appointment, preparation for follow-up appointments, and everyday life with hearing loss.
Patient Activation
Patient activation is an important first step toward building a culture of engaged patients that help to co-create their own health care plans.
By engaging with patients and families ahead of their first appointment, audiologists have an opportunity to set the tone and help them prepare for the appointment. Tools like Why Improve My Hearing provide opportunities for the patients to explore the reasons why they are seeking help, whereas tools like Living Well Online and My Turn to Talk help the patients and their families to identify important and challenging communication situations together.
Using these tools to activate patient engagement before the first session also helps clinicians use their time differently and more efficiently in the appointment. They can spend more time reviewing the patient’s perspective, rather than simply following a traditional appointment trajectory of case history, testing, explanation, and hearing aid recommendation.
Allowing patients and their families to reflect on their challenges and needs before attending their first appointment paves the way for a much richer and deeper engagement in the first meeting. It sends the message that the hearing health professional is attuned to the unique needs of each individual patient and the patient’s family.
Used in connection with follow-up appointments, the tools allow the hearing health professional to revisit and evaluate important situations and strategies discussed at the previous appointment. Patients value these conversations and the fact that they contribute to setting the agenda for the appointment through their reflections and input.
When using the tools over time, it is particularly important to encourage the patient and their family to fill out the tools before the appointment and explain why they are asked to respond to questions that they have answered before. Without these explanations, patients may not understand the relevance and need to do this again.
The Crucial Family Perspective
The Ida Telecare tools are designed to encourage another important aspect of person-centered care—family involvement.
Designate time in the appointment to include the family/communication partner perspective. It is not enough to simply invite family members to tag along. Let the patient and their communication partner know that you will be asking them to share their thoughts during the appointment.
Use the My Turn to Talk tool to help the patient identify those family members or other communication partners who are important to them, and encourage them to prepare for the appointments together using Living Well Online.
Extend Your Services Beyond the Appointment
Most patients will leave the appointment with the invitation to contact their hearing health professional if there are any problems or if they need further help and support. But there are also person-centered ways to continue supporting patients and families once the patient has been discharged. Ida Telecare includes tools that allow you to extend care beyond the appointment and encourage self-management.
The tools include Top Tips for Managing Conversations Well, a resource that offers patients communication strategies and includes videos of people with hearing loss explaining what they do to communicate well. The Dilemma Game allows the patient and family members to explore and discuss concrete communication challenges and possible strategies for managing these situations. By introducing patients and families to these support tools for use after the appointment, you can continue building deeper relationships with your patients.
Toward a Culture Change
Working in a person-centered way is quite different to the audiologist-centered way in which many hearing health care professionals have been trained. It represents a culture change, or a mindset shift, and internal motivation to infuse person-centered care into every aspect of clinical contact.
To work in a person-centered manner is a team effort that involves not only the hearing health care professional—it is important that every person who has contact with a patient and their family understands the principles of person-centered care and engages with them in that way. This applies to everyone from front-desk staff, to hearing health care professionals, to administrative staff and managers.
To develop your practice, you can also allow yourself a moment of reflection after each appointment or at the end of the day by asking yourself the following questions:
To what extent did I express empathy in my consultation?
- Did I encourage an ongoing dialogue with my patient and their family by using more open-ended than close-ended conversation techniques?
- Do I have an up-to-date understanding of my patients’ goals?
- What am I doing to help my patients self-manage their hearing loss?
- Did I involve the family/communication partners?
- How would I rate my listening skills, and what can I do differently next time to gain deeper appreciation of the spoken and unspoken needs of my patients and their families?
Reflecting on your practice can help you become more person centered, reduce stress in your workday, and become more time efficient with clients.
About Ida Telecare
Ida Telecare was developed in collaboration with hearing health care professionals from around the world.
All tools are optimized for mobile phones, and users can email their results to their hearing health care professional directly or save the results as a PDF. Read more at Ida Telecare.
About the Author
Cherilee Rutherford works as an audiology consultant for the Ida Institute. Her professional qualifications include a bachelor’s degree in speech-language therapy and audiology (University of Stellenbosch), a master’s degree in health science and a professional doctorate in audiology (Nova Southeastern University), and postgraduate certificates in teaching (certificate in learning for higher education from University College London and certificate in online facilitation from the University of Cape Town). Before joining the Ida Institute, Rutherford was the course director for the master of science in advanced audiology programme at University College London and lectured at the University of Cape Town, where her course topics included a focus on amplification technology and aural rehabilitation. She is a fellow of the American Academy of Audiology, is a member of the International Society of Audiology (ISA), and is registered with the Health Professions Council of South Africa.
