By Brian Taylor, AuD, Editor-at-Large
It should concern every hearing care professional (HCP) that anywhere from 5 percent to one-quarter of patients never use their hearing aids. Or that by some accounts, an astounding 98 percent of hearing aid owners say they had at least one problem with their hearing aids in the first year. Or that 54 percent of problems go unreported to HCPs, and 46 percent remain unresolved even after seeing an HCP.
I think we can all agree, such findings indicate that the hearing patient journey, at least for some, can be complex, and has room for improvement.
All this is happening at a time when more people are seeking the services of an HCP. Not only do 20 percent of people aged 60 or older suffer disabling hearing loss, but up to 18 percent of U.S. adults self-report communication difficulties despite normal audiograms.
And many of the latter are apparently looking for help. In a recent survey of more than 200 audiologists, 68 percent reported seeing individuals with self-reported communication difficulties but normal hearing. We know that people with mild hearing loss don’t usually acquire hearing aids, so it’s fair to assume those with subclinical hearing loss rarely seek assistance, even though today’s advanced hearing aids could enhance their ability to communicate in a variety of situations.
Whatever we’re doing—and however we’re doing it—there continue to be unaddressed gaps in hearing aid usage and overall adoption. If people are going to get the hearing care they need, we have to make it easier for them to adopt hearing aids. The profession (HCPs) and industry (hearing aid manufacturers) must work in partnership to find ways to solve both wear-time and uptake problems.
High-quality, regulated devices in a range of price points and form factors are, of course, part of the solution. But we should employ another important strategy if we’re to expand the market and improve hearing aid wear-time: widescale embrace of telehealth services in audiology.
Growing Telehealth Adoption
In April, the Centers for Medicare & Medicaid Services acknowledged the importance of telehealth in delivering audiology services by significantly expanding the number of telehealth services that audiologists could bill directly to Medicare during the current public health emergency.
For a variety of reasons—some brought into stark relief by the Covid-19 pandemic—ongoing telehealth will prove important to delivering hearing care. It will also help address aspects of the hearing patient journey that might otherwise hinder hearing aid use and uptake. I encourage professional and industry organizations to endorse telehealth options, establish best practices, and set us on a path toward vastly improved hearing outcomes through the acceptance and promotion of telehealth services.
Telehealth has already begun to prove its value. When the Covid-19 pandemic struck, healthcare providers and their patients were urged to adopt telehealth services—care provided virtually, at a distance, via telephone or computer-based videoconferencing software. According to recent analysis by McKinsey & Company, telehealth utilization spiked in spring 2020 and has now leveled off at 38 times what it was before the pandemic. This would indicate a positive, long-term shift in healthcare delivery. Today, McKinsey & Company reports 13 to 17 percent of all office and outpatient visits, across all tracked specialties, are telehealth visits. Moreover, researchers see skyrocketing investment in virtual care.
Now consider hearing health, specifically. The patient journey toward better hearing can be time-consuming. Each of the pictured five key steps has traditionally required at least one in-person visit with an HCP, taking an average of 30 to 60 minutes of facetime, not including travel. By enabling the patient and HCP to pick and choose when and how they interact, telehealth has the potential to empower the patient to become a more effective hearing aid wearer over the long haul.
Implementing Telehealth Successfully
At Signia, like other hearing aid manufacturers, we’ve spent several years developing telehealth solutions designed to help HCPs engage remotely with their patients after the initial in-office fitting, including remote tuning, troubleshooting, and video calls.
Although some patients may not be comfortable with telehealth technology and others simply prefer face-to-face care—we’re reaching a point when a permanent, full-time telehealth option is not just viable, but also critical to the growing need for better hearing.
When given a choice in other specialties, many patients prefer a telehealth option, especially for routine appointments. Even older adults—many of whom would benefit from hearing aids—have shown they’re comfortable with the technology needed for telehealth. After becoming acquainted with online tools to connect with family and friends during a pandemic, many are willing and able to try telehealth when offered the tools.
Of course, there are elements of hearing care that are still necessary to be conducted in-person, but today, a significant portion of the patient experience can take place via telehealth – and that’s a good thing for HCPs and patients alike.
- Aazh, H., Prasher, D., Nanchahal, K., & Moore, B. C. (2015). Hearing-aid use and its determinants in the UK National Health Service: a cross-sectional study at the Royal Surrey County
- Solheim, J., & Hickson, L. (2017). Hearing aid use in the elderly as measured by datalogging and self-report. International journal of audiology, 56(7), 472–479
- Bennett, R. J., Kosovich, E. M., Stegeman, I., Ebrahimi-Madiseh, A., Tegg-Quinn, S., & Eikelboom, R. H. (2020). Investigating the prevalence and impact of device-related problems associated with hearing aid use. International journal of audiology, 59(8), 615–623.
- Bennett, R.J. (2021) Underreported hearing aid problems: No News is good news, right? Wrong! Hearing Journal Feb 16-18.
- Tremblay, K. L., Pinto, A., Fischer, M. E., Klein, B. E., Klein, R., Levy, S., Tweed, T. S., & Cruickshanks, K. J. (2015). Self-Reported Hearing Difficulties Among Adults With Normal Audiograms: The Beaver Dam Offspring Study. Ear and hearing, 36(6), e290–e299.
- Koerner, T., Papesh, M., & Gallun, F. (2020). Questionnaire survey of current rehabilitation practices for adults with normal hearing sensitivity who experience auditory difficulties. AJA. 29:738-761.
About the Author
Brian Taylor, AuD, is the senior director of audiology for Signia. He is also the editor of Audiology Practices, a quarterly journal of the Academy of Doctors of Audiology, editor-at-large for Hearing Health and Technology Matters and adjunct instructor at the University of Wisconsin.
*feature image courtesy of Cambridge in Color