Teleaudiology Clinical Technicians
Teleaudiology clinical technicians (TCTs) are persons who, after appropriate training and demonstration of competency, provide patient/equipment interface support under the supervision of an ASHA-certified and licensed audiologist using secure real time and/or “store and forward” audio/video technology to deliver audiology services from a site located at a distance from the actual patient testing site. A TCT may also be an audiology assistant or other health care professional (e.g., licensed vocational nurse, bachelor’s-prepared nurse, master’s prepared nurse, nurse practitioner, physician assistant, etc.) who has additional training to serve in the role as a TCT and support teleaudiology service delivery under the supervision of an ASHA-certified and licensed audiologist. TCTs are currently only utilized in the Veterans Administration health care system.
Supervision of Teleaudiology Clinical Technicians
TCTs are either synchronously (during the patient visit) or asynchronously (before or after the patient visit) supervised by an ASHA-certified and licensed audiologist using secure/remote A/V technology (e.g. CISCO, Polycom, etc.) to enable the patient and the TCT to see the audiologist and vice versa, and the audiologist, with the technical help of the TCT, to conduct the following:
- patient history taking and counseling
- video otoscopic evaluation
- hearing screening (which can be done by the TCT with asynchronous audiologist supervision)
- diagnostic hearing testing using digitally based audiometric equipment that can be computer controlled by the remotely located audiologist (requiring synchronous audiology supervision and service delivery and typically requiring a sound-treated booth)
- digital hearing aid programming and real ear confirmation testing computer controlled by the remotely located audiologist
- immittance testing using digitally based immittance equipment computer controlled by the remotely located audiologist
As teleaudiology service delivery is a relatively new form of audiology practice, states may have minimal regulatory language addressing the delivery of teleaudiology services and the use of TCTs in audiologist/TCT teams for the delivery of appropriate teleaudiology services.