title: Use of telemedicine in the remote programming of cochlear implants.
abstract: CONCLUSIONS
  Remote cochlear implant (CI) programming is a viable, safe, user-friendly and cost-effective procedure, equivalent to standard programming in terms of efficacy and user's perception, which can complement the standard procedures. The potential benefits of this technique are outlined.
  
  
  OBJECTIVE
  We assessed the technical viability, risks and difficulties of remote CI programming; and evaluated the benefits for the user comparing the standard on-site CI programming versus the remote CI programming.
  
  
  METHODS
  The Remote Programming System (RPS) basically consists of completing the habitual programming protocol in a regular CI centre, assisted by local staff, although guided by a remote expert, who programs the CI device using a remote programming station that takes control of the local station through the Internet. A randomized prospective study has been designed with the appropriate controls comparing RPS to the standard on-site CI programming. Study subjects were implanted adults with a HiRes 90K(R) CI with post-lingual onset of profound deafness and 4-12 weeks of device use. Subjects underwent two daily CI programming sessions either remote or standard, on 4 programming days separated by 3 month intervals. A total of 12 remote and 12 standard sessions were completed. To compare both CI programming modes we analysed: program parameters, subjects' auditory progress, subjects' perceptions of the CI programming sessions, and technical aspects, risks and difficulties of remote CI programming.
  
  
  RESULTS
  Control of the local station from the remote station was carried out successfully and remote programming sessions were achieved completely and without incidents. Remote and standard program parameters were compared and no significant differences were found between the groups. The performance evaluated in subjects who had been using either standard or remote programs for 3 months showed no significant difference. Subjects were satisfied with both the remote and standard sessions. Safety was proven by checking emergency stops in different conditions. A very small delay was noticed that did not affect the ease of the fitting. The oral and video communication between the local and the remote equipment was established without difficulties and was of high quality.
authors.affiliation: Ear, Neck and Throat Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain. ramosorl@idecnet.com
authors.forename: Angel
authors.initials: A
authors.lastname: Ramos
authors.forename: Carina
authors.initials: C
authors.lastname: Rodriguez
authors.forename: Paz
authors.initials: P
authors.lastname: Martinez-Beneyto
authors.forename: Daniel
authors.initials: D
authors.lastname: Perez
authors.forename: Alexandre
authors.initials: A
authors.lastname: Gault
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Falcon
authors.forename: Patrick
authors.initials: P
authors.lastname: Boyle
mesh_terms: D000328:Adult; D003054:Cochlear Implants; D003638:Deafness / Q000534:rehabilitation; D004867:Equipment Design; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017755:Prosthesis Fitting; D012371:Robotics / Q000379:methods*; D012984:Software; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*