Veterans Integrated Service Network 19 Hub-and-Spoke Model for Asynchronous Automated Audiometry.

Purpose: In fiscal year 2020 (FY20), the Veterans Health Administration (VHA) initiated a pilot study to determine whether automated audiometry could be used in conjunction with asynchronous telehealth systems to increase access points for audiologic services to Veterans across multiple VHA locations.

Method: Veterans Integrated Service Network (VISN) 19 was provided funding from the Office of Rural Health (ORH) to take on this pilot project to trial a hub-and-spoke model of asynchronous automated audiometry service delivery. With this care model, the patient and trained telepresenter are in one location utilizing the testing equipment, and the results are collected and transmitted to the patient record. The audiologist then reviews the stored results from within the patient record, diagnoses as able based on results, and provides follow-up care to the Veteran via video or telephone visit, at which time a further care plan is developed.

Conclusions: Although there were many challenges with the equipment procurement and supply chain in the postpandemic world, 16 of the initial 20 sites across the region were launched by the end of FY24. As a result of this pilot, asynchronous automated audiometry was approved as an Enterprise-Wide Initiative in the VHA system with 34 additional sites across VHA receiving ORH funding and multiple additional sites beginning their own asynchronous automated audiometry programs.