Adopting Advancements in Audiology

In this interview, Joe Dansie, AuD, shares his experiences and insights on the early adoption of innovative tests and technologies in audiologic testing. He describes benefits to being first, as well as strategies to navigate challenges and ultimately the positive impact these advancements in audiology have on his practice.

 

AudiologyOnline: There have been a lot of advancements in audiology over your career. What was the first big advancement that you adopted in your audiology practice?

Joe Dansie, AuD: This may date me some, but proof that even an old dog can still learn new tricks. Back when I was in graduate school, I knew I loved new and upcoming technology—anything that could improve me as a professional and improve access and care for my patients. My first time adopting advancements in audiology was during my capstone project, which focused on the use of telehealth for training early interventionists and SLPs to perform OAEs in early childhood preschool settings. Let’s just say that 15 years later, that research project would be much easier to perform with today’s technology.

Another more recent example would be when the practice I was working in wanted to switch over to electronic medical records and electronic audiograms. I performed handwritten audiograms all through graduate school and for about 6-7 years of clinical practice. The idea of changing to digital audiograms was a little intimidating.

AudiologyOnline: What was it that compelled you to take the leap?

Joe Dansie, AuD: This transition was motivated by necessity, due to a problem in workflow. The paper audiograms were not being scanned into the EMR as consistently as needed, and it would take a thorough search in the billing department to track down the original. The concept of having the audiogram digitally stored, so it could be more easily moved into the patient’s chart, recreated when needed, with more legible notes and ultimately more professional-looking results, was exciting.

AudiologyOnline: Can you describe the benefits and challenges that came with this change?

Joe Dansie, AuD: The benefits of doing this were huge. As I previously mentioned, we had fewer problems with records in our EMR, the results looked much better and cleaner, and the office appeared more cutting-edge. The ENTs could read the audiologist’s notes and interpretations more easily, and ultimately, there was better clinic efficiency because we were no longer hunting down paper audiograms. I will admit that at first, I had some reservations about possible lost data or something not saving correctly, but once I jumped in with both feet, there was no looking back. I wish I had done it sooner.

AudiologyOnline: Why do you want to continue to be an early adopter of new tests and technology?

Joe Dansie, AuD: Ultimately, I have seen how early adoption of new tests and technology helps me improve my skills as an audiologist, improves the care my patients receive, and improves the flow of clinic work. All of which saves time, and right now, the world is short-staffed, so time is valuable.

AudiologyOnline: What interested you about Grason-Stadler AMTAS? Any benefits or challenges?

Joe Dansie, AuD: Grason-Stadler AMTAS and the concept of automated testing seemed like they could save me time. There was a lot of research done by Robert Margolis, PhD, on the method used by AMTAS and its validity. I was able to see and effectively implement AMTAS with the non-profit foundation "Hear For A Purpose.”  In the Dominican Republic there is a lack of trained professionals with experience in performing diagnostic audiometry, including masking, bone conduction, and advanced principles of testing. Our team travels down once a year and has limited resources/time for training. We implemented AMTAS in the Audiology and Speech Clinic with a small amount of training. It has been beneficial in obtaining more advanced testing than the local team was capable of. They see a variety of cases, and we were unsure if it would be appropriate for this setting. Would patients embrace automatic testing? Now, we have gotten more comfortable with the interpretation and the accuracy of the results. We trust it to be the first step in diagnostics for many patients in this clinic. The biggest benefit is the time saved for the local team, and they now have the resources to perform more advanced diagnostic testing on patients. We can interpret the results of the AMTAS and make decisions about the next steps.

AudiologyOnline: What interested you about Wideband Tympanometry? Any benefits or challenges?

Joe Dansie, AuD: When I first learned that the Grason-Stadler TympStar Pro had Wideband Tympanometry, I was excited because I was working in a busy otology clinic that saw a lot of complicated cases with all kinds of middle ear pathologies. Traditional tympanometry didn’t always make sense or align with the patient’s symptoms, complaints, or audiometric results. I was always looking for more information and details to help the ENTs with diagnosis. According to the research, Wideband Tympanometry would provide a lot of information about the function of the middle ear. With just a click of the stimulus, the results would show "absorbance" over a frequency range, rather than just a pressure tracing at a single frequency. The biggest challenge with WBT was interpreting the absorbance graph (for both the audiologists AND the ENT physicians), but luckily, the results also include the traditional measurements we have been using since tympanometry became available. There is a lot to gain and no downside to Wideband Tympanometry. Also, new research is being published every month on WBT.

AudiologyOnline: What interested you about the ACT test?

Joe Dansie, AuD: The ACT test is interesting because it is a newer test that provides an alternative way to test for speech in noise. I like it because, as audiologists, we often see patients who struggle with hearing speech in noise, and the ACT is a way to get valuable predictions of a patient’s performance in complex listening environments. While it hasn’t been out for very long, the recommendations that are provided based on the patient’s ACT thresholds are good counseling tools and give us more information than just the audiogram.

AudiologyOnline: How has being an early adopter of advancements changed the way you approach your patients?

Joe Dansie, AuD: In my career, being willing to be an early adopter of advancements in technology has been a huge benefit. When telehealth with hearing aids became integrated into the manufacturer’s software, I made sure I was familiar with it and comfortable using it. When the world came to a standstill during COVID, I was not afraid to put the technology to work, which benefited me and my patients when access was a barrier.

AudiologyOnline: Have there been any advancements that you adopted and abandoned?

Joe Dansie, AuD: There haven’t been a lot of advancements that I have adopted and abandoned, but I would say that once I adopt them, there are always a few modifications to the way they get implemented and used in my daily practice. The nice thing about that is that small changes are easier to learn than big, sweeping changes.

AudiologyOnline: What is a piece of advice you would give to other audiologists if they want to try something new?

Joe Dansie, AuD: I would say embrace the “NEW.” Our profession is evolving, and we should and must evolve with it so we don’t become the “Blockbuster Video” of the hearing industry. Keep learning, keep improving, don’t have a “failure to evolve,” or an “overconfidence in legacy models.” Technology is improving, and if we embrace it, it will make our jobs easier, more efficient, and more productive with our valuable time as “doctors of audiology.”

AudiologyOnline: What diagnostic technology do you wish would come out that you think would be helpful for you and other audiologists?

Joe Dansie, AuD: I would love to see more integration of technology for seamless workflow. Some of this is coming to fruition now, such as video otoscopy being displayed on the same piece of equipment as the Tympanometer. Other integrations I would like to see are continued improvements in diagnostic equipment and the integration of telehealth capabilities. These types of advancements will improve access to better hearing healthcare for our patients, improve our workflows, ultimately elevate our profession, and demonstrate the benefits of audiology within our communities.