Last updated
Boothless Audiometry
Share PrintWe envision a future where every Veteran has seamless access to the hearing care they deserve. Using boothless audiometry, we bring state-of-the-art technology and expert care directly to local clinics. This approach reduces travel, shortens wait times, and expands access - so every Veteran can hear life to the fullest.
Origin:
February 2020, Alexandria VA Medical Center (Alexandria, Louisiana)
Adoptions:
2 successful, 1 in-progress
Awards and Recognition:
Diffusion of Excellence Promising Practice, VHA Shark Tank Winner
Partners:
Audiology and Speech, Diffusion of Excellence, Veterans Experience Office
Recent Updates
Overview
Problem
Audiology services are not available at many VA clinics, creating barriers for Veterans seeking timely and convenient hearing care. In some locations, space and building limitations, such as modular structures that cannot accommodate heavy sound booths have prevented on-site services. In these cases, tele-audiology or community care are often the only option
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Audiology services are not available at many VA clinics, creating barriers for Veterans seeking timely and convenient hearing care. In some locations, space and building limitations, such as modular structures that cannot accommodate heavy sound booths have prevented on-site services. In these cases, tele-audiology or community care are often the only options available.
Tele-audiology requires specialized equipment and personnel, and scheduling is more complex. This model depends on expensive telehealth carts, each costing over $92,000, extensive training for additional telehealth technicians, space at two VA locations, and significant investment in technology infrastructure.
When telehealth is the the only option at the nearest VA site, veterans may choose community care providers. These appointments require substantial VA personnel resources and are more costly. For example, a hearing evaluation, hearing aid fitting, and three follow up appointments through a private practice provider cost approximately $1500 per veteran, compared to $175 in salary costs for five visits within the VA.
Boothless audiometry offers a streamlined approach to delivering audiology services at VA clinics. This model improves clinic efficiency, reduces costs, and enhances the quality of care. Many veterans use the VA exclusively for hearing health care, and we believe that providing an excellent audiology experience will encourage them to consider other VA services. Our goal is to give veterans the option to receive quality, lifelong hearing care at their local VA clinic. See more
Tele-audiology requires specialized equipment and personnel, and scheduling is more complex. This model depends on expensive telehealth carts, each costing over $92,000, extensive training for additional telehealth technicians, space at two VA locations, and significant investment in technology infrastructure.
When telehealth is the the only option at the nearest VA site, veterans may choose community care providers. These appointments require substantial VA personnel resources and are more costly. For example, a hearing evaluation, hearing aid fitting, and three follow up appointments through a private practice provider cost approximately $1500 per veteran, compared to $175 in salary costs for five visits within the VA.
Boothless audiometry offers a streamlined approach to delivering audiology services at VA clinics. This model improves clinic efficiency, reduces costs, and enhances the quality of care. Many veterans use the VA exclusively for hearing health care, and we believe that providing an excellent audiology experience will encourage them to consider other VA services. Our goal is to give veterans the option to receive quality, lifelong hearing care at their local VA clinic. See more
Images
Cost of audiology community care referrals for all VISNs
Solution
After encountering the limitations of the telehealth model, we recognized that having an audiologist physically present on site would better serve Veterans. To achieve this, we relocated a full-time audiologist and transferred existing equipment from the main hospital to the outpatient clinic. Two essential components initially utilized in tele-audiology -
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After encountering the limitations of the telehealth model, we recognized that having an audiologist physically present on site would better serve Veterans. To achieve this, we relocated a full-time audiologist and transferred existing equipment from the main hospital to the outpatient clinic. Two essential components initially utilized in tele-audiology - a designated quiet room and an ambient noise measurement device - facilitate the establishment of a fully functional boothless audiology clinic.
See
more
Images
Veteran, Stacie Moore, completing audiology assessment at the Ft. Polk VA clinic. Photographer: Gary Kelly
Results
Our practice places an audiologist within outpatient clinics using the boothless audiometry protocol, providing Veterans with hearing health care closer to home. This approach reduces both travel and wait times, thereby enhancing the overall Veteran experience. The boothless audiometry protocol incorporates principles of human-centered design, accommodating
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Our practice places an audiologist within outpatient clinics using the boothless audiometry protocol, providing Veterans with hearing health care closer to home. This approach reduces both travel and wait times, thereby enhancing the overall Veteran experience. The boothless audiometry protocol incorporates principles of human-centered design, accommodating Veterans who are claustrophobic, use wheelchairs, or require transportation via stretcher, resulting in a more comfortable and pleasant experience.
Implementation is straightforward, requiring less equipment, infrastructure, and less maintenance, while also reducing administrative workload. Having an audiologist physically present in local clinics significantly increases access to quality audiology services within the VA. All aspects of boothless audiometry effectively address Veterans' needs by delivering convenient, timely, and high-quality care. See more
Implementation is straightforward, requiring less equipment, infrastructure, and less maintenance, while also reducing administrative workload. Having an audiologist physically present in local clinics significantly increases access to quality audiology services within the VA. All aspects of boothless audiometry effectively address Veterans' needs by delivering convenient, timely, and high-quality care. See more
Images
V-Signals data analysis: A-11 Customer Experience (CX) Domains November 2020 to September 2025
Voices of Our Veterans
Metrics
- Access to care - increased with Boothless Audiology
- Patient satisfaction scores - increased with Boothless Audiology
- Cost offset - reduces travel pay and community care costs
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Videos
Live Shark Tank Pitch
Implementation
Timeline
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30 to 90 Days
The timeframe for implementation will vary depending on resources available at the adopting site. The Alexandria Healthcare System was able to start two full-service audiology clinics at two separate sites within 8 months. The first discussion began at the Director's all employee town hall meeting in February 2020. If not for the COVID-19 pandemic, the boothless audiometry clinics would have been ready within four months. Our healthcare system blazed the trail by bringing veterans hearing healthcare to their local clinics, and even a pandemic did not stop us.
Departments
- Audiology and speech
- Biomed
- Administration
- Building management
- Information technology
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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PROCESSES |
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TOOLS |
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Files
- ANA Patient Setup ANApatientsetup
Risks and mitigations
| Risk | Mitigation |
|---|---|
| Funding risks | Funding risks primarily involve hiring full-time audiologists and technicians. However, these costs are offset by reducing the number of Veterans referred to community care. When Veterans choose the VA, they gain lifelong access to hearing healthcare without the need for community care renewals. In fact, it is more cost-effective for the VA to employ a full-time audiologist than to continually pay for community care services. |
Contact
Comment
Comments and replies are disabled for retired innovations and non-VA users.
Email shannon.wise@va.gov with questions about this innovation.
About
Origin story
At the start of the day, while preparing for clinic, you notice the Veteran traveled from the same small town as you did. You begin to wonder why this appointment couldn't have been handled at the local VA outpatient clinic there. According to engineering, that building can't even support a treadmill, so a large, heavy sound booth is definitely out of the qu
...
At the start of the day, while preparing for clinic, you notice the Veteran traveled from the same small town as you did. You begin to wonder why this appointment couldn't have been handled at the local VA outpatient clinic there. According to engineering, that building can't even support a treadmill, so a large, heavy sound booth is definitely out of the question. Tele-health could be an option, but it would require purchasing an expensive telehealth cart, upgrading technology infrastructure, and navigating complex scheduling. Then, a lightbulb comes on! You realize that all the equipment in your office could be used at the local facility - no sound booth, no telehealth cart required. All that's needed is a team willing to "think outside the booth."
Original team
Dr. Jessica Magro
Audiologist
Dr. Shannon Wise
Audiologist
Super idea! Have a perfect site in mind to implement this and have some interest from the Director.
This is the future of CBOC audiology, 100% on board with this approach.
Congratulations, Drs. Shannon Wise & Dr. Jessica Magro! Looking forward to seeing more adoptions of your innovation of Bootless Audiometry! Excited for our veterans and AVAHCS, Way to Go Ladies!