Telehealth Best Practices: Dr. Hope Lanter On How To Best Care For Your Patients When They Are Not Physically In Front Of You

Dave Philistin, CEO of Candor
Authority Magazine
Published in
13 min readMay 7, 2021

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Technical set-up is critical. We have created a team that helps prepare patients for their appointment and ensures that they have the proper technical requirements to prevent delays during their appointment. Technical delays can get in the way of making the best use of the provider’s time. In cases where there are technical issues, it can make the remainder of the appointment feel rushed and often times, the patient feels additional stress when things do not go smoothly.

One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?

In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Hope Lanter, Au.D.

Dr. Hope Lanter is a lead audiologist at hear.com, a global leader in hearing care and the largest online retailer of medical-grade hearing aids. Dr. Lanter has more than fifteen years of experience as an audiologist working directly with patients and helping them find the best hearing loss treatments that fit their individual needs. She received her M.A. in audiology from the University of Iowa and her Au.D. in audiology from A.T. Still University of Health Sciences.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?

I grew up in a rural area just outside Winston Salem, North Carolina. Growing up, I spent a lot of time with my grandparents and even opened a roadside vegetable stand with my grandpa when I was 12 years old. I quickly learned that I had a passion for working with the adult and geriatric populations. This was also the beginning of invaluable lessons of customer service and relationship building that taught me communication skills that I still use today.

I was fortunate to go with my grandmother to get her first hearing aid and she remarked that she had forgotten that clocks tick when she came home that day. I was hooked! I knew that my passion for geriatrics and care for others was a perfect match for audiology.

Can you share the most interesting story that happened to you since you began your career?

I once had a patient ask me if I could help her sister after she had successfully been fit with hearing aids. She described her sister as someone who was legally blind and hard of hearing and had been told there was nothing that could be done for her. I told her that I would need to evaluate her sister before I could really answer her initial question.

Her sister came in for her evaluation and I immediately knew after completing her audiogram that she had very severe hearing loss, but one ear was a candidate for a hearing aid. At her fitting appointment, I put her hearing aid on, her husband spoke and because she was able to hear him, she responded. We all started crying and he knelt in front of her, looked at me and said, “You gave me my wife back!”

This story is a reminder of how much our work in audiology can impact people’s quality of life and drives me every day to deliver the gift of better hearing to as many people as possible.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Enthusiasm is contagious — and so is the lack of it” is a quote from Dale Carnegie. I believe that you have to be passionate and enthusiastic about what you believe in to inspire others. In hearing care, about 75–80% of the people who could benefit from hearing aids do not wear them. Patients need to see your passion to be inspired to take the steps needed to improve their hearing.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

One of the most influential people in my life was my mentor, Dr. Ruth Bentler at the University of Iowa. I moved 1,000 miles from home for the opportunity to be a part of their audiology program.

I recall that during our orientation, she told us, “Nobody made a mistake in choosing for you to be here. Your fraud complexes may be checking in hard right now, but you all deserve to be sitting here today.” It was as though she read my mind. Being a top researcher in the nation, she never lost sight of being authentic and dedicated to promoting our field. She also said to us that day, “You can learn everything that there is to know about audiology, but if you can’t explain it to every single person you encounter, then you’ve learned nothing.”

This message meant so much to me and has always been a cornerstone to how I have approached each and every patient and audiological discussion both professionally and personally.

Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?

In-office appointments can provide many advantages and benefits for both patients and providers. Some patients feel more comfortable in a face-to-face interaction and can perceive that they are getting better care which may lead to more trust.

As a provider, being able to read the body language of a patient is important but can be reduced by the video component of a telehealth appointment. For example, if someone is anxiously tapping their foot on the floor, I can easily see this if they are in person and in front of me and better gauge how to communicate with them. In addition, in-office appointments allow for an additional layer of control over the environment and limit distractions, noise and technical issues.

On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?

When patients are not in the same space as their doctor, this can create some difficulties. There are often distractions from other family members, children, pets, etc., during the appointment, which can make it difficult to create a safe space for private conversations as well as a quiet environment for testing hearing. This can also be a challenge as a provider when a patient is not fully engaged during an appointment.

Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You ? (Please share a story or example for each.)

  1. Technical set-up is critical. We have created a team that helps prepare patients for their appointment and ensures that they have the proper technical requirements to prevent delays during their appointment. Technical delays can get in the way of making the best use of the provider’s time. In cases where there are technical issues, it can make the remainder of the appointment feel rushed and often times, the patient feels additional stress when things do not go smoothly.
  2. Introductions pave the way for success. I have long said to any staff that I have worked with that we cannot become complacent and forget that medical appointments are the most important event to the people we see each day. Many patients have not experienced video calls and connecting with others through a digital platform and that can add an additional layer of stress. Allowing for a few moments of introduction and connection will reap tremendous benefits in not only creating a positive experience, but also in delivering the best care. Be sure to look into the camera to best connect with the patient.
  3. Develop a protocol/agenda to manage time efficiently. Set up expectations for how the appointment will flow. Each person you treat via telehealth should have a similar and consistently positive experience. It is important to determine what the minimum criteria should be and deliver it every time. Due to the unpredictable nature of telehealth appointments, it can sometimes be difficult to follow the same steps that are easier to direct in-office. For example, I had a patient that wanted to introduce me to his dogs during a call and while this helps build rapport, we have to remember to keep those moments brief and keep the appointment professional. These moments can also take the appointment off course, so it is best to have a structure that allows you to quickly get back to helping your patient.
  4. Ensure that the patient is in a distraction free environment. When you are in the office, you can control noise levels, interruptions, etc. As soon as you begin a virtual visit, this level of control is no longer possible. You must start each appointment with a very clear discussion that they will receive the best care if they are in a distraction-free and quiet environment. Asking for their commitment to work together to ensure the best outcome is always worth establishing.
  5. Adjust your style. Many providers want to believe that the virtual visit will be exactly like an in-office visit. Accept that it is different and adjust your style accordingly. For example, in teleaudiology, we ask the patient to guide an otoscope into their ear for examination. Giving them tips on how to position the otoscope in their hand or how to properly position it into the ear is a necessary step that wouldn’t be necessary in the office. Consider significant others or family members as a potential asset to telehealth appointments when the patient may have limitations. They may be able to help with positioning the otoscope or helping the patient understand when they aren’t hearing well.

Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?

We have learned a lot over the last year living through a pandemic, especially that anything, even health appointments and consultations, can be moved to a virtual format. Additionally, teleaudiology is rapidly gaining popularity, with a 500% increase of online hearing tests scheduled over the course of pandemic. Teleaudiology is opening the door for many patients to get the hearing loss treatment they deserve, and fast.

I often find with patients that the stigma behind hearing loss and wearing hearing aids is a main reason they do not seek the help and treatment they need as soon as they are showing symptoms. Hearing loss affects individuals at any age, not just older generations. About 40 million US adults aged 20–69 years have noise-induced hearing loss.

However, for those who struggle with the idea of having hearing loss or hearing difficulty, a virtual appointment with a hearing aid expert or audiologist removes a lot of the pressure. They can receive advice from an expert in the comfort of their own home and not having to research audiologists in the area, schedule and drive to an appointment is just one less barrier a patient has to overcome when seeking treatment. In addition, those with physical limitations, compromised immunity or those living in remote areas now have access to care that was limited to them before.

Telehealth can also shorten the lifecycle of treatment for patients. They are able to schedule appointments faster, spend less time in a waiting room and get the health answers they need as quickly and efficiently as possible. Patients are starting to notice this great benefit, especially as it relates to hearing health.

Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?

At hear.com, we have developed the Clinic-in-a-box. We provide a phone consultation prior to sending out the box so we are even more prepared for the appointment to go smoothly. The Clinic-in-a-box gives each patient everything they need to have a complete hearing evaluation with state-of-the-art testing and hearing aid fitting in one box. We even include a bigger screen tablet with high quality video connection so that every patient has the same exceptional experience. Each person receives a tech set-up call the day before their appointment to ensure they are comfortable and ready to use the equipment sent to them. The kit is set-up with user-friendly steps and allows for less stress related to the set-up so that the focus can remain on care.

If you could design the perfect Telehealth feature or system to help your patients, what would it be?

Remove the barrier of internet accessibility by having a tablet that can instantly connect anywhere on the planet immediately out of the box.

Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?

Be sure to have a video camera, good lighting and a quiet space for the appointment. It’s important for patients to remember that although they are not actually in the office, this is still their time to have important conversations with their doctor. We all have video call fatigue after this past year, so patients may have the instinct to speed through the call as quickly as possible and move on to the next thing.

My best advice for patients is to slow down, ask questions, take notes and make sure you are on the same page as your doctor. In addition, they should recognize that this is a medical appointment and their preparation with time and a quiet environment will yield the best results. It can also be helpful for patients to come to the appointment with a list of questions written down to ensure all of their concerns are addressed during the appointment. Also, make sure your doctor knows how to reach you and your pharmacy if needed after the appointment, and where you can reach out if you have any additional questions.

The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?

A few years ago, a hearing aid manufacturer had a VR experience to showcase what it is like to navigate hearing at a large, group dinner table with hearing loss and then with wearing their new hearing aid. In the hearing loss demonstration portion, I was able to look around the table and experience what it was like to have multiple people talking to me but not feel like I was able to follow along.

In the hearing aid simulation, I could directly see the features of the device and how it could overcome the difficulties that hearing loss presents. I think this is an exciting application of VR that would allow patients to experience what wearing hearing aids in realistic environments would be like and this may help bridge the gap to getting their hearing loss treated much sooner. Also, this can allow their family members to have a better understanding of what it is like to actually live with hearing loss.

Is there a part of this future vision that concerns you? Can you explain?

As with any VR experience, we can never create something that will replace the real-life experience, so the patient always has to take an additional leap beyond this. However, if this helps bridge another person to addressing their hearing loss and takes some of the fear and stigma away, then we never want to underestimate the value.

Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

Create a progressive movement to remove the stigma of wearing hearing aids. About 75–80% (about 29 million in the US alone) of those that need hearing aids do not wear them. We have to do more to promote people taking control of their hearing health.

We have seen that even when the barrier of cost is removed, the adoption of hearing aids still remains low. Many people attach hearing aids with being old and as a disability. Hearing loss impacts overall quality of life as well as health. If we change the stigma around hearing loss and hearing aids, there could be a dramatic positive impact on a tremendous number of people suffering.

How can our readers further follow your work online?

Readers can visit https://www.hear.com/ for more information on hearing loss signs and treatments, hearing aids and to schedule a telehealth appointment. Our resource center also provides a lot of useful tips and information regarding hearing health at https://www.hear.com/resources/. In addition, you may publications that I am featured in at https://www.hear.com/news/.

Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.

Thank you for your time. It was great chatting with you!

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Dave Philistin, CEO of Candor
Authority Magazine

Dave Philistin Played Professional Football in the NFL for 3 years. Dave is currently the CEO of the cloud solutions provider Candor