Each year around 1,400 people in the UK have a cochlear implant, an electronic medical device that replaces the function of a damaged inner ear. These patients need lifetime annual follow up at one of 18 specialist centres in the country. The nearest centre for some patients may be several hours away from their home, meaning there can be significant financial costs, travel time and inconvenience for patients. 

A team from the University of Southampton has designed, implemented and evaluated a remote care pathway. Patients receiving remote care have access to a personalised online support tool, home hearing test and support to adjust their device themselves, and can upgrade sound processors at home rather than in a clinic.

The trial of this pathway resulted in a significant increase in patient empowerment, as well as improvements in hearing, suggesting that the remote care makes patients better able to keep their hearing stable. 

This Scaling Up Improvement project will support roll out of the pathway in a number of centres across UK. It is estimated that there may be up to 800 patients enrolling for the service a year, which would result in significant cost savings.

This new care pathway means patients are unlikely to need routine appointments. Instead, they will use the remote care tools in their own homes and only attend the clinic if there is a clinical need, for example if access to specialist resources is needed. 

The patients will be able to monitor their hearing at home, fine-tune their hearing to suit their own environment, and manage the majority of their care needs through a personalised online support tool. 

Shared decision-making about when the tools are appropriate and beneficial will be promoted, recognising that remote care will not suit all patients.

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