Making Person-Centered Care a Reality With Telehealth
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
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
activation is an important first step toward building a culture of engaged
patients that help to co-create their own health care plans.
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.
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.
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
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
The Crucial Family Perspective
The Ida Telecare tools are designed to encourage
another important aspect of person-centered care—family involvement.
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.
Services Beyond the Appointment
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
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
- 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
- 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
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.
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.