Virtual care helps create sound from a distance

December 2, 2021

Audiologist Jowan Lee of St. Paul’s Hospital in Vancouver is working with Interior Health patients to adjust their cochlear implants with digital health technology.


Ponderosa Lodge social worker Shirley Shanks could not believe it when she got a call setting up a virtual audiology appointment for one of her long-term care clients with a malfunctioning cochlear implant.

Rather than going to Vancouver, Cathy, who uses a wheelchair, was transported five minutes away to the virtual care clinic at Royal Inland Hospital in Kamloops. 

By video, an audiologist, located 450 kilometres away at St. Paul’s Hospital, was able to make crucial adjustments to the cochlear implant, an electronic device that is situated under the skin behind the ear to help restore hearing. 

The implants are a miracle for people with hearing impairments who need more than a hearing aid. However, for Cathy, her cochlear implant had not been adjusted since 2018 so she was back to reading notes from people trying to communicate with her.

“I was so excited to get that call,” said Shirley. “I had been wracking my brain trying to figure out how to get Cathy to Vancouver. To be able to have this virtual care appointment is amazing.”

Cathy, sitting, is ready for her virtual appointment with Vancouver audiologist Jowan Lee (on screen). In back is RIH virtual care coordinator Haillie McBoyle.

When Cathy and Shirley arrived at the clinic on Dec. 1, virtual care co-ordinator Haillie McBoyle guided them into a room where audiologist Jowan Lee was smiling at them from a computer screen. Several Tupperware containers filled with programming pods completed the equipment needed for the video appointment, anticipated to last an hour and a half to two hours.

She was the second patient of the day. 

“Our other patient was so pleased at the end of his appointment. He actually cried happy tears that he didn’t have to travel to Vancouver for the adjustments,” said Haillie.

During the appointment, the audiologist directs the patient on which pod to select and attach to his or her sound processor. By using remote access technology, the audiologist is able to take control of the programming software on the RIH laptop, enabling the patient’s sound processor settings to be optimized. 

These Tupperware containers are filled with pods that the audiologist uses to adjust the patient’s cochlear implant.

These local appointments are part of St. Paul’s Hospital’s Cochlear Implant Remote Mapping Service Pilot Project, which began in Island Health but recently expanded to Interior Health where the vast geography makes digital health care crucial technology.

After being contacted by St. Paul’s to participate as a second proof site, Interior Health’s virtual care team chose RIH because of its proximity to northern B.C. and because RIH had staffing in place to support the clinic.

“Kamloops was the best location for a wider range of patients who aren’t able to get to Vancouver. Patients from Prince George will also be able to come here,” said IH Virtual Care manager Shawn Berglund.

Until the virtual option was introduced, the 181 patients in Interior Health and 30 in Northern Health were required to travel Vancouver at least once a year to have their cochlear implants adjusted by the specially trained audiologists.

Cochlear implant testing is the newest addition to the rapidly expanding digital health programs in Interior Health and RIH Virtual Care analyst Bill Demuth is on the team overseeing it at RIH. 

“Much of IT (information technology) is a supportive resource, but with virtual care, we impact patients in a positive way every day,” he said. “These programs that make a direct difference for patients are the ones I especially like.”

At the moment, the appointments take place one day a month, but Bill hopes to see the appointments increase as more audiologists are trained to provide virtual care and patients experience the convenience and effectiveness of video sessions.

Shawn said it’s also exciting to work on a program that is collaboration between several health organizations (IH, Providence and the Provincial Health Services Authority) and also multi-departmental. 

“We are all working together on this supportive way for our clients to make their appointments. A lot of our patients weren’t getting it done for a variety of reasons – COVID-19, damaged highway system and also because they are too vulnerable to travel.”

Cathy is one of those fragile patients who likely would not have been able to make it to Vancouver. 

Instead, she left her virtual appointment with better access to sound then when she arrived – a win for digital health, but mostly a win for Cathy.

Shirley said she also came away with a win as part of Cathy’s care team.

“Dr. Lee was able to educate me on how to help Cathy through more effective speech approaches and by providing information on the static she hears on a regular basis that I was not aware of.” She added that he also gave her other ideas on apps to use for communication.

“All these care plan needs are vital to Cathy’s daily living and I am truly grateful for that.”


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