Exploring the Feasibility of Tele-Audiology in Rural Communities to Reduce Care Disparities for At-Risk Newborns.

Abstract

To evaluate the efficacy and feasibility of a Utah Department of Health and Human Services (DHHS) program providing telehealth auditory brainstem response (tele-ABR) testing to rural families in order to reduce disparities in hearing loss (HL) diagnosis. This was a retrospective analysis of infants born at the Uintah Basin Medical Center from 2006 to 2021 who failed the newborn hearing screen (NBHS) and underwent ABR. In-person ABRs were conducted at Primary Children's Hospital in Salt Lake City, UT. Tele-ABRs were conducted at the DHSS satellite site in Roosevelt, UT. Outcomes measured included demographics, age at testing, and distance traveled. t-Tests and χ² tests were used to compare in-person and tele-ABR groups. Of 125 infants who failed the NBHS, 66 (52.8%) underwent tele-ABR. Tele-ABR participants were more likely to be American Indian (P < .05). Distance traveled was lower for the tele-ABR group: 13.1 miles vs. 102.8 miles (P < .001). Age at testing was earlier for the in-person group (35.7 vs 47.2 days, P = .04), but there was no difference in adherence to the Early Hearing Detection and Intervention (EHDI) guideline of testing within 3 months (P = .19). Tele-ABR participants benefited from shorter travel distances compared to in-person participants while still receiving timely diagnosis. Given that the tele-ABR group included more American Indians, this approach may enable evaluation of an underserved population. Tele-ABR is a viable diagnostic tool to reduce barriers to timely testing.