Health care delivery models—including hearing health care—are changing quickly, driven by many economic, technological, and accessibility factors. For hearing health care, one of the most forceful drivers of change in professional service delivery is the digital revolution.
This digital infrastructure has been in place for some time, but has been growing exponentially as the world becomes infused with mobile technology, wireless (Bluetooth) technology, and broadband connectivity combined with the popular use of social media. Today's consumers embrace technology and use it to approach health care concerns.
Increasingly, consumers are seeking health information on the Internet. More than 70,000 websites disseminate health information and more than 50 million consumers are looking to the web for online health information (Toms and Latter, 2007). The advantages of seeking information online include its ease of accessibility, interactive features, and anonymity.
Many hearing health care providers realize these advantages, and are finding ever-increasing ways to deliver services online. Manufacturers are developing consumer-oriented technology, insurance companies are entering the market, and consumers are demanding more transparency when receiving hearing health services and purchasing hearing aids. The federal government, in turn, has taken a keen interest in consumer access to hearing aids.
Two federal agencies play an important role in the evolving nature of hearing aid technology and use. The Food and Drug Administration (FDA) is charged with protecting the public health by ensuring the safety and efficacy of hearing aids and hearing assessment devices. The FDA also regulates the manufacturing and marketing of hearing-related products.
The National Institute on Deafness and Other Communication Disorders (NIDCD) plays a very different role, encouraging innovative research to improve consumer accessibility and affordability of hearing health care services. Research and changing technology have created new opportunities to make automated hearing screenings and full-scale audiometry a possibility. Hearing aid programming may be possible through these emerging technologies in the near future.
To facilitate innovative ideas, NIDCD issues requests for proposals for grants to develop low-cost technologies (e.g., hearing aids and hearing screeners), and to develop new delivery systems (e.g., hearing aid fitting and management via telepractice and the Internet).
Manufacturers, Insurance, Consumers
Hearing aid manufacturers, health insurance companies, and consumers also have a stake in the hearing aid accessibility debate. Each manufacturer offers a line of products at a variety of price points, and each is producing lower-cost hearing aids. Manufacturers also are developing computer software and cell phone and tablet apps that allow consumers to program their own hearing aids. Some manufacturers are creating direct-to-consumer models that bypass consumer interaction with hearing health professionals.
Health insurance companies are a relatively new player in the delivery of hearing health services. Traditionally, insurance companies have excluded hearing aid coverage and limited coverage for hearing health services. Now they are starting to revamp their business models, including direct-to-consumer plans—rather than improve coverage—in attempts to increase accessibility and affordability while boosting enrollment in their plans. The entrance of insurance companies into the market alters the dynamic—they have the financial resources and volume to negotiate lower rates on hearing aids, an interest in developing direct-to-consumer and discounted rate models, and the financial resources to research and develop new service delivery models that may or may not include hearing health professionals.
Consumers, with increased access to information, are beginning to play a larger role in their own hearing health care and hearing aid purchases. They are demanding clear information from service providers to help them make better and more informed decisions on their purchases. They are looking for transparency of costs and differentiation between the cost of services and devices. However, many do not look beyond researching and purchasing devices, and may not realize the benefits of audiologic rehabilitation and its value in achieving optimal hearing aid outcomes.
What's missing from manufacturers, insurance companies, and many Internet sites is information on the essential value of professional audiologic services. As hearing health care providers, audiologists need to communicate that for safety and best outcomes with hearing aids, consumers should seek audiologic services prior to purchasing hearing devices—and that post-fitting services, such as audiologic rehabilitation, are an integral part of overall hearing health care.
This consumer education on the essential value of professional audiologic services should be used in all forms of marketing:
- General information (e.g., a practice's website).
- Patient communication: newsletters and open-house events.
- Consumer marketing: free seminars, free hearing screenings at community health fairs, and advertising.
- Referral sources: contact with primary care practitioners (including physicians, nurse practitioners, physician assistants, and even medical office staff), who have significant influence on their patients.
ASHA offers a number of resources to support audiology practices and webpages:
- Consumer resources. The ASHA website has accurate and reliable information for consumers.
- Newsletters. Audiology Information Services patient newsletters are available at no charge.
- ProSearch. Include yourself in the ProSearch Directory. The thousands of annual callers to ASHA who want help locating appropriate services are referred to this online directory.
Technology and innovation may be changing the health care environment, but it is up to audiologists to communicate one steadfast message: hearing health care requires the expertise and skills of audiologists to ensure patients' safety, satisfaction, and best possible outcomes from hearing aid use.