Download cochlear implant scheme

COCHLEAR IMPLANT SCHEME
Background:
The Department of Health and Family Welfare, Karnataka decided to initiate the Cochlear
Implant Scheme in the state to provide free treatment to children with severe deafness.
According to 9th Trust Board meeting, implantation of this RBSK scheme was allocated to
SAST.
Deafness:
According to the census 2011, the number of children age group 0-6 years in the category
of disability due to hearing impairment is 19392 in Karnataka. Main causes leading to
severe deafness are congenital; from mother to fetus due to intra-uterine infections, HIV,
drugs and toxins; prematurity and conditions after birth like severe jaundice, sepsis; and
childhood infections like meningitis, encephalitis and trauma. Infections as Rubella and
co-sanguineous marriages increase the chances of this condition.
The specialists suggest that the best result of cochlear implantation surgeries are seen
patients aged 8 months to 2 years. Good results are also seen till 6 to 8 years.
About Cochlear Implant:
A cochlear implant is a small, complex electronic device to provide a sense of hearing to a
person who has severe or profound deafness, not responding to hearing aids. The implant
consists of an external part placed behind the ear and a second part that is placed under the
skin by surgery. Cochlear implant bypasses the damaged portions of the ear and send
signals through the auditory nerve to the brain.
The entire process of Cochlear Implantation is in three phases:1. Testing and Pre-operative counselling
2. Surgery/ Implantation
3. Follow up and auditory verbal therapy – for a minimum of one year
To provide the three modalities of treatment, three types of hospital facilities are required:
1. Assessment centre – Centres which can conduct the specific tests.
2. Surgical centre – Hospitals to perform surgery
3. AV therapy centre – Centres which can provide complete rehabilitation and AV
therapy.
Cochlear Implant Scheme:
Cochlear Implant Scheme of National Health Mission, Health and Family Welfare
Department, Karnataka will be implemented through the Rashtriya Bal Swasthya
Karyakram (RBSK) and Suvarna Arogya Suraksha Trust (SAST). The scheme provides
free treatment to children with severe deafness. The treatment consists of surgery or
Cochlear Implantation and 1 year of rehabilitation therapy post surgery. The full package
has been fixed as Rs 6.5 lakhs including Surgical cost and Rehabilitation costs.
Beneficiaries
Beneficiaries are children between 8 months to 6 years having severe to profound sensorineural deafness, not responding to hearing aids trial.
Identification of beneficiaries
Identification of beneficiaries will be carried out by RBSK team. This team will
screen children enrolled in Anganwadis, Government, Government aided and Government
residential schools. Any children identified with deafness/hearing impairment will be
referred to the district hospital for further evaluation and management.
Investigations for severe deafness will be done at the level of district hospitals. The
beneficiaries will be selected by the District Cochlear Committee headed by District ENT
Surgeon, based on investigations results and hearing aid trial. The Beneficiaries will be
sent to Network Hospitals for treatment.
Network Hospitals:
Network hospitals have been selected for surgery and Auditory Visual Therapy (AV
Therapy) and training, across the state and these will be empanelled under SAST. They
are:
Surgical Hospitals:
1.
2.
3.
4.
5.
Indira Gandhi Institute and Child Health, Bangalore
Wenlock Hospital, Mangalore
Karnataka Institute of Medical Science, Dharwad
KC General Hospital, Bangalore
Raichur Insitute of Medical Sciences, Raichur
AV Therapy Centres:
6. JSS, Dharwad
7. KMC, Mangalore
8. Institute of Hearing and speech, Mysore
9. Dr. SR Chandrashekar Institute of speech and Hearing, Bangalore
10. Manasa Cochlear Implant and ENT Center, Bangalore
11. Raichur Insitute of Medical Sciences, Raichur
State Cochlear Implant Committee:
The State Cochlear Implant Committee has been formed under the chairmanship of
MD NHM, will approve cases for cochlear implant scheme and provide technical guidance
for the scheme.
Roll-out of the scheme:
Presently the screening of beneficiaries is ongoing at the districts by the RBSK
team. As of now hospitals empanelled are:- Indira Gandhi Institute and Child Health,
Bangalore, Wenlock Hospital, Mangalore and Karnataka Institute of Medical Sciences,
Dharwad, for implementation of the Scheme.
Benefit package:
Benefit package list for Cochlear Implant Scheme
Sl.
No.
1
2
3
Procedure
code
2001
2002
2003
Procedure Name
Cochlear Implant Surgery
* Surgery (53000)+Implant
cost (5.2 lakhs) * Pre-op
evaluation (including
vaccine for
meningitis) 10000/* Initial mapping and switch
on - 5000/-
Rehabilitation Therapy (Part
- 1 for first 6 months)
*Auditory Verbal Therapy +
*Post Switch on
mapping/initiation of AV
Therapy and training of
Child and Guardian - 12600
* Food, Travel and Wage
loss - 9100
Rehabilitation Therapy (Part
- 2 for second 6 months)
*Auditory Verbal Therapy +
*Post Switch on
mapping/initiating of AV
Therapy and training of
Child and Guardian - 23400
* Food, Travel and Wage
loss - 16900
Total
Package
rates
588000
Preauthorization
documents
Photo with AM,clinical
notes for pre-op
evaluation and
vaccination, all
investigations and
reports, Cochlear board
form, treatment
schedule, name of
referral hospital, parents
declaration, preauth form
manual and online
Preauth form, session
plan and schedule
21700
Preauth form, session
plan and schedule
40300
650000
Claim documents
Discharge photo with AM,
claim form manual and
online, operative notes, case
sheet, carton label of
implant, post op scar, AM
daily visit form/ feedback
form including travel and
food , Switch on details
along with Video of
evaluation with date and
time stamp - in ftp server,
discharge summary and
referral form
Videos of evaluation with
date and time stamp for Post
op evaluation and End of
Quarter- 1 in ftp server,
food, travel and wage
allowance vouchers,
Monthly report Forms,
Quarterly update forms,
claim form , feedback form
Videos of evaluation with
date and time stamp for end
of Quarter 2 , 3 and 4 -in ftp
server, food, travel and wage
allowance vouchers,
Monthly report forms,
Quarterly update forms,
claim form , feedback form
Hospital letter head or Hospital seal
Cochlear Implant Scheme, Karnataka
Monthly report submission form
PATIENT PROFILE
Patient Name:
Patient ID no :
Parent/ Guardian’s Name:
Age: _____ months________ years
Gender: M
F
Address: Village,Taluka,District
Surgical Hospital: Name, district
Rehabilitation Centre: Name, district
Type of surgery:
TICK ONE ONLY: Quarter I - Month 1 to 3
Sl.
No.
1.
2.
3.
4.
5.
6.
7.
8.
Week
Session
Date
Present/
absent
Quarter II – Month 4 to 6
Quarter III – Month 7 to 9
REPORT OF AUDITORY VERBAL THERAPY AND MAPPING
Session
Session activities - Tick if Completed,
number of
Write NA if not required
AV
Audition
Speech
Language
Cognition
Therapy*
Week – 1
Week – 1
Week – 2
Week – 2
Week – 3
Week – 3
Week – 4
Week – 4
Total number of therapy sessions attended =
All sessions: completed / not completed
Mapping session**: Date
Issues in mapping
None
Use of processor etc
Status of sutures
Status of skin under
coil
Others/
Sound field test done:
ECAP done: Yes/No
Yes/No
Comfort with respect to magnet of coil: Yes/No
Referral to ENT surgeon required: Yes/No
NOTE:
* Session numbers 1 to 104 over the duration of 12 months
**Mapping- 10 sessions
Signature of Scheme coordinator:
Quarter IV – Month 10 to 12
Sign of
Therapist
Parent
guidance
Sign of parent/
guardian
Hospital letter head or Hospital seal
Rehabilitation Quarterly update form
Karnataka Cochlear Implant Scheme
Patient Name: ___________________
Age: _____ months/yrs Gender: M
F
Parent/ Guardian’s Name: _________________________Patient ID no. : ________________________
Surgical Hospital: _______________________Rehabilitation Centre: ___________________________
IMPLANT DATE
HEARING AGE
MODEL/COMPANY OF IMPLANT:
DATE OF AUDITORY VERBAL THERAPY STARTED
SWITCH ON -
VIDEO
PARENTS GUIDANCE
DATE OF MAPPING
STARTED:
DAILY ATTENDANCE
TAKEN:
WEEKLY AND MONTHLY
REPORTS SUBMITTED:
EVALUATIONS
DATE TO
BE SENT
FOR
EVALUATI
ON
EVALUATIONS
INITITAL STATUS
SIGNATURE OF
THERAPIST
PROGRESS IN 1ST
QUARTER
SIGNATURE OF
THERAPIST
AIDED
AUDIOGRAM
POST-OP / INITIAL
EVALUATION
On the day of therapy
commencement/within
the first week
DATE ON
WHICH
REPORTS
RECEIVED
AUDIOLOGICAL
EVALUATION
SPEECH
PERCPTION TESTS
MAIS
SPEECH
LANGUAGE
BASELINE
EVALUATION
VIDEO (to analyze the
parent child
interaction- before
exposure to AVT
sessions)
AIDED
AUDIOGRAM
EVALUATION IN IST
QRT
3months \
AUDIOLOGICAL
EVALUATION
SPEECH
PERCPTION TESTS
MAIS
EVALUATION OF
PROGRESS
SPEECH &
LANGUAGE
EVALUATION IN IIND
QRT
AIDED
AUDIOGRAM
Hospital letter head or Hospital seal
6 months
AUDIOLOGICAL
EVALUATION
SPEECH
PERCPTION TESTS
MAIS
EVALUATION OF
PROGRESS
SPEECH &
LANGUAGE
PARENT CHILD
INTERACTION
ANALYSIS
VIDEO
AIDED
AUDIOGRAM
EVALUATION IN III
QRT
9 months
AUDIOLOGICAL
EVALUATION
SPEECH
PERCPTION TESTS
MAIS
EVALUATION OF
PROGRESS
SPEECH
LANGUAGE
AIDED
AUDIOGRAM
EVALUATION IN
IVTH QRT
12 months
&
AUDIOLOGICAL
EVALUATION
SPEECH
PERCPTION TESTS
MAIS
EVALUATION OF
PROGRESS
SPEECH &
LANGUAGE
VIDEO