Sound returned to Alan Holt’s world in late 2017 when surgeons at St. Paul’s Hospital inserted a cochlear implant (CI) into his right ear. Music, bird song and the laughter of his grandchildren returned to his life after years of diminished hearing, caused by a career in a noisy Sunshine Coast pulp and paper mill. Things eventually deteriorated to the point where hearing aids he used were no longer effective.
Cochlear implant recipient Alan Holt waits in a Victoria hospital for St. Paul's CI audiologists to start his first remote mapping session. Photo: Lauren Noel, Island Health
自从收到植入物以来，这位68岁的退休人员每年都回到圣保罗大教堂（St. Paul's）进行后续行动，其中涉及重新编程该设备，这是一个称为映射的过程。在那里，CI听力学家计划并根据其特定的听力需求调整外部声音处理器。
霍尔特（Holt）是温哥华岛邓肯（Duncan）的居民，他感谢他重新获得听证会，尤其是在两次近乎事故发生的车辆驶向乡村道路（没有人行道）时，车辆驶向他后面。他听不到他们的声音。
“It was a life-changing surgery,” he says.
As thankful as he is, Holt must carve out a full day for his follow-ups, because St. Paul’s is the sole provider of cochlear implant services for adult residents of British Columbia and Yukon through itsBC Adult Cochlear Implant Program.
两年来，后续日一直进行：霍尔特（Holt）上午4.30升至纳奈莫（Nanaimo）上午8.15渡轮，然后一次在大陆上，开车去医院进行90分钟的约会。他拿起一顿饭，然后开车去渡轮上5.30 pm的航行，在晚上9点返回家中，精疲力尽。
Travelling to and from the clinic “a real hassle”
“It’s a long day,” says Holt. “The whole experience of driving in the city, trying to find parking – it adds a whole bunch of stress. It’s a real hassle and it takes a lot of time.”
由于渡轮旅行周围有19年的风险，他特别害怕今年的约会。
A first for BC adults
As it turns out, the 2020 visit to the clinic has been dramatically different. And Holt is thrilled about it.
圣保罗已与岛健康和省级卫生服务局（PHSA）合作，在卑诗省建beplay全站App立了第一个远程成人映射计划。它于12月4日启动。该计划是为了让患者通过远程医疗进行年度随访，尽管每三年都会看到他们进行身体检查。
Holt is one of the first virtual mapping patients. On this December day, St. Paul’s CI audiologist Myron Huen uses a sophisticated video platform to remotely test Holt’s processor, far from where he sits in a clinic at Victoria’s Royal Jubilee Hospital.
“听证会怎么样？”休恩问霍尔特，她的显示器上的图像笼罩在她的显示器上。“您的电池很好吗？我们将重新拍摄，以确保您的听力尽可能最佳。”
The two communicate with each other via computer screens, and Huen spends the next 90 minutes painstakingly fine-tuning Holt’s device. When she has to deactivate the implant, she types what she’s doing on a screen Holt can see on his screen. She will test an array of 22 electrodes implanted inside Holt’s cochlea, the snail-shaped part of the inner ear that lets people hear. (Cochlear implants work通过绕过内耳的受损部分，然后直接刺激导致大脑的听觉神经。它们涉及内部和外部组件）。
COVID-19 expedited the virtual program
Virtual health has become a hallmark of many aspects of patient care since the pandemic, and this clinic is no exception. “This program has been years in the making, but COVID gave it a real push,” says Huen. “With COVID, telehealth has been a central part of health-care delivery.”
CI audiologist Jowan Lee, who treats CI patients virtually and in person too, gives the program high praise. “It’s so seamless, it’s like the patient is right in the room,” he says. “This remote mapping service was made possible because of the collaboration with virtual-care services at Island Health and Providence, and the IT wunderkinds at PHSA and Island Health. They did the meat of the work and I’m the one who benefits, along with the patients.”
Island Health的首席医疗信beplay全站App息官Mary Lyn Fyfe博士说：“我们的跨学科团队成员之间在创建这项虚拟健康范围内授权服务方面的合作给我们留下了深刻的印象。每个人都了解该计划的重要性，尤其是在大流行期间，使其成为优先事项，因此是我们岛上居民的现实。”
Goal is to expand remote mapping clinics
Vancouver Island was chosen because of the high number of people with cochlear implants, about 180 patients. Lee says the goal is to possibly expand the virtual clinics up the island then, if things go smoothly, to Interior and Northern Health. “People there have insanely long days to get to the clinic – often a 10-hour drive, depending on where they live.”
虚拟诊所可能会减轻空间高级诊所的负担，并因此允许听力学家亲自见到更多的患者。
艾伦·霍尔特（Alan Holt）对他的第一个虚拟任命感到非常满意。“这是一个非常好的过程。在渡轮航站楼没有等待，没有试图在温哥华市中心找到停车场或提早起床。”他在下午1.15时在家 - 比平常早八个小时。“时间，成本和减轻压力是巨大的节省。”
背景者：关于Providence Health Care/Island Hbeplay全站Appealth远程人工耳蜗计划