Evaluation of a mobile-based remote aftercare application in cochlear implant users

INTRODUCTION: Clinical follow-up for cochlear implant (CI) users is typically carried out in a face-to-face session in a clinical site. Users must travel to the site, which incurs burdens of travel time, expenses, and time lost from work or education. To help alleviate this, a mobile health application, Remote Check, has been developed to facilitate the remote evaluation of both the functionality of the CI system and the hearing performance of the user. Here, we report the results of a real-world field test of Remote Check with a cohort of 29 CI users across two clinics. METHODS: Paired Remote Check and face-to-face clinical follow-up session were performed with a cohort of 29 experienced CI users. A psychometric instrument for the evaluation of mobile health applications (the mHealth App Usability Questionnaire, MAUQ) was administered to both users and clinical professionals, along with an ad-hoc survey to evaluate users' experiences regarding travel distances, travel times, costs, and other parameters associated with different types of clinical follow-up sessions. Professionals were also surveyed on the performance of the tool. The durations of Remote Check and face-to-face follow up sessions were compared, and the agreement rate of post-session follow-up actions was determined. RESULTS: Both technical checks of the CI and evaluation of hearing performance were possible with Remote Check. Both users and professionals rated the tool highly on the MAUQ instrument. This tool facilitated shorter session times and had strong agreement with face-to-face follow up in terms of further actions. Users also perceived Remote Check as offering the possibility of saving them money. CONCLUSION: MED-EL Remote Check is an adequate tool for the remote evaluation of both the CI system and the users' hearing performance. Remote Check may reduce barriers to care, particularly for rural populations.