Doing TeleHealth? ProJECT!!

telehealth audiology hearing care
Paul Teie
September 21, 2021

I recently had a remote appointment with one of my specialist MDs.  Since I am involved in training for our Remote Care initiative, I paid close attention.  I really like this doctor.  He has always impressed me in-person with his compassion, personableness, expertise and care.  Online, not so much

His hair was a little mussed, the camera was fuzzy, his shirt was a bit wrinkled, and he was slumped in the lower left hand corner of the screen and just looked a little schlubby.  Had I not known him, he would have made a very poor impression.  

When we are online with our patients, we are essentially on TV.  So as any actor is told repeatedly, we have to project!  We must propel ourselves past the screen to the patient beyond.  

A little story about projection: 

My brother is a very fine professional cellist.  Early in his career he entered a number of cello competitions, one of which took him to Budapest, Hungary.  He prepared for this competition like a man possessed and was eliminated in the first round.  With nothing else to do in the city for the next two weeks, and no money to do it with, he settled in watching later rounds of the competition.  At one of the performances he noticed that the woman in front of him had written the word “semmi” in the margin next to his bio in the program.  He asked his accompanist what the word meant.  “Oh, that means ‘nothing’.”  All the work he had done to make sure his music made it all the way to the audience, and it had petered out right in front of his cello.  The rest of the story is that he used this insight to become an even better cellist.  

I recently saw some patient satisfaction data that was very interesting.  When asked about the friendliness of their provider, in-person patients gave an average 96% positive rating, while online patients gave a 73% positive rating. 

I do not believe providers were 23% less friendly online than in person.  That 23% represents “personality” that is lost in cyberspace between transmission and reception.  It is energy that vanishes when communicating through a screen.  


Improving the Telehealth Experience in Hearing Healthcare 


No one expects us to become Jimmy Fallon or Carol Burnette when we are online with our patients.  But there are some simple steps that can be taken:

  • Use a good quality camera and microphone.
  • Assure that the background is tidy and appropriate
    • Close the door – you do that for your in-person patients!
  • Center yourself in the screen.  Don’t cut off your hair or your chin.
  • Sit up straight and lean in.
  • Have the camera at least at eye level, perhaps a bit above (like your daughter does her selfies) not below.  You don’t want your patient looking up your nose.  
  • As much as possible, look into the camera, not the screen.  When you are looking into the camera you are making eye contact.
  • Lose the mask and don’t hang it on your ear or below your chin. 
  • Speak with an active voice:
    • LOTS of prosody
    • A bit more intensity than normal vocal effort
  • Take advantage of the extra time you have.  Since a hearing test is usually not part of the online hearing aid evaluation, you have more time to establish rapport (you don’t have to get right down to business) and do a very thorough needs assessment.  
  • Oh – and SMILE.  As Victor Borge used to say, “The closest distance between two people is a smile.”

Telehealth is the future of hearing care.  Doing it well will take a bit of extra effort, but it will be worth it.  

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