Multi-stakeholder perspectives on models of in-person and remote cochlear implant aftercare and the opportunities and challenges for change.

Abstract

Objective: To explore stakeholder perspectives on current adult cochlear implant services and potential integration of remote assessment tools.

Design and study sample: Semi-structured focus groups were conducted with four stakeholder groups: adult cochlear implant users with (n = 5) and without (n = 5) experience using a remote assessment tool, implant audiologists (n = 8), and implant clinic administrative staff (n = 4). Participants were asked what they valued most in CI aftercare and how remote care could be integrated to meet their needs. Transcripts underwent inductive qualitative analysis.

Results: Stakeholder perspectives coalesced around four themes: bias towards the status quo (connection to current practices, resistance to change); opportunities for change (willingness to incorporate improvements for quality and accessible aftercare); complexity as a barrier (grappling with diverse and complex considerations for implementation); influence from external networks (support and information from outside the direct patient-clinic relationship). All groups acknowledged the benefits of current services and remote care, while attitudes about implementation and accessibility differed between groups.

Conclusions: This study juxtaposes stakeholder preferences to both embrace and restrict uptake of remote care in CI services. The potential for remote care to address shortfalls in existing service delivery will remain unfulfilled unless organisational and financial aspects of implementation are resolved.