Author: Boaz Mui
Mui, Boaz, 2025 Teleaudiology as an Avenue for Transforming the Future of Hearing Care in Australia, Flinders University, College of Education, Psychology and Social Work
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Teleaudiology refers to the remote delivery of audiological services by leveraging telecommunications and digital technology. This mode of service delivery surpasses geographical and time constraints, as the client and clinician can be in different locations and some services do not necessarily need to be delivered in real time. Teleaudiology can be applied to almost all service types, ranging from hearing assessment to intervention and rehabilitation. Despite the benefits of teleaudiology being well recognised, many clients and clinicians showed hesitation about its use and considered it applicable to a limited variety of services. Infrastructural and legislative constraints further restricted teleaudiology implementation on a larger scale. It was not until the COVID-19 pandemic when hearing healthcare stakeholders were faced with substantial challenges in continuing in-person care and more attention was brought upon the feasibility of utilising teleaudiology to match service demand. Clinical guidelines on teleaudiology use were developed by the professional organisations in some countries (e.g., Australia) to inform safe and effective practice during and beyond the pandemic. Nevertheless, teleaudiology uptake in Australia has been generally slow in spite of the presence of a growing body of evidence on the clinical applications of teleaudiology. A more thorough understanding of stakeholders’ perceptions is crucial to further teleaudiology implementation in the post-pandemic landscape.
To address the aim of enhancing teleaudiology service delivery through evaluation of web-based and smartphone-based interventions with the incorporation of hearing healthcare stakeholders’ opinions, this thesis presents a series of five studies using mixed methods encompassing three distinct components of teleaudiology service delivery.
Study 1 and Study 3 explored the experiences and perceptions of hearing healthcare stakeholders in Australia towards teleaudiology uptake through the use of online surveys and semi-structured interviews. Findings suggested that certain barriers to teleaudiology uptake still existed, rendering its widespread implementation restricted. That said, recent endeavours in improving teleaudiology uptake were seen and stakeholders generally held positive attitudes towards post-pandemic teleaudiology use.
Study 2 and Study 5 revolved around Oto, a smartphone application (app) developed for tinnitus management. These studies employed a longitudinal feasibility trial and randomised controlled trial design to evaluate Oto’s effectiveness and usability. Results indicated that Oto was effective in reducing tinnitus severity and distress and the effects were relatively long-lasting (up to 9 months). Its usability was also rated high among app users.
Study 4 focussed on remote hearing assessment and examined the performance, ecological validity, and usability of two smartphone-based hearing assessment apps – Hearing Test (Android version) and Mimi Hearing Test (iOS version) – alongside a web-based app, MDHearing Aid in screening for mild and moderate hearing loss. This study revealed generally reasonable performance, ecological validity, and usability of all examined apps, with the Hearing Test app demonstrating most potential for hearing screening purposes in adults.
Overall, this thesis adds to the evidence base and generates significant knowledge to support the viable and effective use of teleaudiology for remote service delivery during and beyond the pandemic. For the potential of teleaudiology to be fully realised, ongoing research and collaborative effort from all stakeholders is needed to tackle current challenges and barriers.
Keywords: teleaudiology, telehealth, mobile health (mHealth), Australia, stakeholder perceptions, tinnitus, hearing assessment
Subject: Primary Health Care thesis
Thesis type: Doctor of Philosophy
Completed: 2025
School: College of Education, Psychology and Social Work
Supervisor: Professor Raj Shekhawat