LM311 - Improving Adult Hearing Care in the United States Through Multidisciplinary Collaboration

Abstract:
The Hearing Health Collaborative (HHC) is a multidisciplinary alliance between audiologists, physicians, professional organizations, and patient advocates. The HHC took a scientific approach to understanding the primary causes preventing early identification of hearing loss and subsequent utilization of hearing devices by adults in the United States. This group has identified three primary factors: (1) the need for a vital sign for hearing loss, (2) a necessary hearing loss staging system, and (3) clearly defined best practices for screening and referrals. Both the process and subsequent actions will be described, as well as the potential impact on audiologic practices.

Summary:
Although available evidence is compelling that early and effective management is essential to the successful treatment of hearing loss, utilization of both hearing aids and cochlear implants remain low and the time to treat too long. Despite current thinking among hearing health professionals, there remains insufficient evidence to compel agencies such as the United States Preventive Services Task Force (USPSTF) to develop policies that address these concerns. Thus, as the population ages, the impact of unmanaged hearing loss will continue to compound.

Recognizing the importance and complexity of this problem, the Hearing Health Collaborative (HHC) was formed in May 2021 to identify and overcome challenges impacting good healthcare practices and public policy on hearing care in connection with healthy aging. Comprised of audiologists, otologists, consumer organizations, professional associations (including AAA), public health experts, and primary care providers, the HHC has applied scientific thinking to this problem, with an aim of ensuring that every adult with hearing loss in the United States has timely and accurate diagnostic and treatment information required to make an informed decision to optimize their hearing health. The goal is to double the adoption rate for CI and HA, and reduce the delay in time to treatment in half, by 2032.

Using a scientific approach the Collaborative concluded there are three primary root causes affecting early identification of hearing loss and ultimately utilization of hearing devices in the United States: 1) variable and confusing language used to identify, quantify and discuss hearing loss across and between health care disciplines; 2) disparate interpretation of medical terms and vernacular among hearing health care providers, including otolaryngologists and audiologists; and 3) ambiguity in how and when to refer or treat people, particularly among primary care physicians, given the numerous care pathways available.

Three initiatives were developed to address these primary root causes impacting hearing healthcare awareness, reliable access, and timely delivery. First, develop a simple metric as a vital sign for hearing health and seek to embed this metric across health professions. Second, develop simple and consistent reporting for sensorineural hearing loss that defines appropriate treatment pathways as standards of care utilizing a severity staging process much like other diseases are staged. And third, create evidenced-based procedural changes to support timely referrals for clinical evaluation of hearing loss regardless of patient entry point in the healthcare network.

We will describe the HHC, the methodology utilized to address this complex problem and the action plans being developed to apply the initiatives of a vital sign, staging system, and screening guidelines to close the gap for hearing loss identification and treatment utilization in the United States. We will also describe the potential impact of these changes on clinical practice and public policy.

Brief Summary of Clinical Takeaways:
The clinical takeaways for this session include understanding the factors that contribute to the low number of persons who seek amplification or implant devices, the implications for a consistent language for hearing loss across health professions, and development of a system that motivates patients to engage the hearing healthcare system.