Dr. Raegan Bergstrom, professional practice lead in Audiology and clinical coordinator for Cochlear Implant Services at BC Children’s Hospital, has programmed countless cochlear implants for kids in person. But on June 27, this routine appointment was anything but – it was the first time Raegan completed programming virtually for two children, over video conference from BC Children’s with 14-year-old Tarron and his mom Lynnea, and 13-year-old Lily and her mom Andrea, who were located at the University Hospital of Northern British Columbia in Prince George.
“It was a really exciting day for us,” Raegan says. “We saw two patients in our first virtual health clinic for programming of their cochlear implants. We’re the first program in Canada to offer this type of service as part of routine clinical care.”
Cochlear Implant Services provides specialized care to children across the province 0 – 18 years of age and currently follows approximately 250 kids who are deaf and hard of hearing. BC Children’s is the only location in B.C. to provide cochlear implant candidacy assessment, surgery and follow-up care. While most of the patients and families live in the Greater Vancouver area, which is in line with the distribution of children in the province, around 40 per cent reside outside the Lower Mainland. The implementation of this virtual service now provides the opportunity to obtain leading edge care at home in your own community.
“The surgical procedure for placing a cochlear implant is just the beginning of a long-term relationship between the child, family and the team at BC Children’s,” Raegan explains. “On average, a child who receives a cochlear implant at a year old will participate in roughly 30 follow-up appointments that include cochlear implant programming and assessments to monitor progress and performance that can only be done at BC Children’s by a specially trained/certified audiologist.”
Initial programming of a cochlear implant occurs about four weeks after surgery and essentially turns the implant on so the child can hear sound as best as possible through the implant. Subsequent appointments are for “tune-ups” and adjusting the implant along with routine assessments to monitor progress.
“Within the first year after receiving a cochlear implant, children travel to BC Children’s for programming approximately six times, then every six months for the next two to three years,” says Raegan. “We continue to see patients annually, if not more, until they are 18 years old, when they transfer to the Adult Cochlear Implant Program at St. Paul’s Hospital.” The new virtual cochlear implant service will not completely replace all face-to-face visits at BC Children’s, but aims to cut down the overall number of trips families make to the hospital over time.
“It’s a lot less driving”
With virtual cochlear implant service now available, BC Children’s audiologists can program cochlear implants virtually through a computer and conduct the appointment via tele-health video conference. That means families like Tarron’s and Lily’s don't have to make their way to Vancouver as often for the routine procedure.
“This is a money-saver, time-saver and sanity-saver, frankly,” says Andrea, Lily’s mom. “When Lily was first implanted, when they first get the technology in, you’re expected to go down every couple of months. And that’s what we did for the first couple of years, post-implant. So in her toddler years, it was ton of travel.”
Lynnea agrees. “I think it’s wonderful,” she says of the virtual care option. “We usually set aside a few days to make the trip to Vancouver for Tarron’s appointments. It’s 12 hours of driving one way, and I like to have at least a day after his appointment in case anything needs adjusting. Being able to do this closer to home really helps.”
“It’s a lot less driving!” Tarron confirmed happily over video. "It's pretty awesome," Lily agreed. "I've never had a video chat this clear. I've Face Timed with my friends who live just a few minutes away and it's so glitchy and you guys are all the way in Vancouver and it's not glitchy at all. It's great."
Expanding care, one region at a time
The cochlear implant team is thrilled to partner with Child Health BC on this project and offer virtual cochlear implant service to families in Prince George. The team looks forward to expanding the service to other locations around B.C. in the near future. “We hope to roll out two or three more point of care sites in other areas in the next two years or so,” Raegan tells us. “Our ultimate goal is to provide more equitable care to our rural and remote families and Prince George is our first step toward that.”
Cochlear Implant Services team pictured from left to right: Samantha Gill, audiometric technician, Raegan Bergstrom – clinical coordinator, Donna Myer, audiologist, Selma Karsan, audiologist.