What stops UK audiologists using remote care tools to care for adults with cochlear implants?

Objectives: to identify barriers that audiologists face in adopting telemedicine in adult cochlear implant care, and to determine what is needed to overcome these barriers.Methods: prospective mixed-methods anonymous online survey of cochlear implant audiologists working with adults in the United Kingdom. The questions covered their perception of effectiveness and value of remote care, their technical skills and training, their perception of patient readiness, workplace support and integration, reimbursement, regulatory and privacy concerns, and remote care technical issues. Results: thirty-one complete responses were received in August - September 2024. Eighty-seven percent (27) had used remote care tools in their care of adults with cochlear implants. Twenty-nine percent (9) had never used remote care tools or used them rarely; no respondents used them daily. All respondents felt there were benefits to remote care tools – mostly to both clinicians and patients. Thirteen percent (4) felt the benefit was to patients only (not clinicians), and most felt that patients wanted to use them. Training and workplace support were sufficient, and reimbursement and data privacy were not barriers. Sixty-eight percent of respondents reported frequent technical issues with remote care tools. Respondents were split equally when asked if remote care is less effective than in-person care, but 81% felt that the gold standard of clinical care is in-person care. Barriers to remote care could be overcome by improvements and enhancements to the cochlear implant manufacturers’ tools, and easier and fuller integration into patient pathways and systems. Conclusion: the main barriers to audiologists using remote care were frequent technical problems and the perception that the gold standard of clinical care was in-person care. The technical barriers can mostly be overcome by improvements in the cochlear implant manufacturers’ tools, although hospital managers can ensure better technical support, and easier integration into clinic pathways and systems. When telemedicine offers a seamless, accessible, person-centred care experience, perceptions about the gold standard of care may change.