Telemedicine for Audiology and ENT in Alaska: 10 Years and a Pandemic Later.

Purpose: Telemedicine can increase access to services, reduce wait time, and decrease patient travel. The COVID-19 pandemic revolutionized telemedicine with the rapid removal of barriers that have historically challenged the implementation and adoption of telemedicine. Yet, despite this evidence, telemedicine utilization is declining postpandemic, and barriers have been reinstated, such as lack of payment parity and more stringent regulation. Alaska is dependent on telemedicine services to provide care with the majority of the state's population living in remote communities. Innovation in the early 2000s resulted in a cutting-edge customized telemedicine solution that created a network of specialty care access across the Tribal Health System in Alaska and was one of the largest telemedicine programs in the world. A shift in focus away from telemedicine to electronic health records stalled innovation, and reduced investment in funding, equipment, and research. This created a lack of clarity around system integration and functionality that eroded the utilization and effectiveness of telemedicine solutions. Today, there is much we can learn from renewed research efforts in innovative applications of telemedicine that can be used to inform policymakers and drive adoption.

Conclusions: If hearing health care professionals are to address the public health crisis of a lack of access to care for the majority of the one in five individuals with hearing loss today, technology solutions such as telemedicine will need to be leveraged. This will require provider training and education; implementation of integrated telemedicine services; continued generation of evidence; and advocacy for regulatory, reimbursement, and payment reform.