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IOM Consensus Study Met with Cautious Optimism

Katz, Alissa

doi: 10.1097/01.HJ.0000471629.60865.f0
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Leaders in hearing healthcare expressed hope that the IOM consensus study will focus on the services and care audiologists provide. © iStock/Courtney Keating

The mission of a current consensus study from the Institute of Medicine (IOM)’s Board on Health Sciences Policy is pretty uncontroversial: better access and affordability in hearing healthcare.

The study has a fourfold purpose: to provide a contextual background, address federal regulations for hearing aid dispensing, address hearing healthcare access and affordability, and make recommendations, according to the IOM statement of task.

The idea for the study dates back to 2009, when the National Institute on Deafness and Other Communication Disorders (NIDCD) of the National Institutes of Health (NIH) held a workshop on affordability and accessibility issues and on research priorities. Then in January 2014, IOM had a similar workshop.

“[It's] definitely a progression from the NIH workshop to the IOM workshop and now to a study,” said Cathy Liverman, codirector of the current study. “The difference for us is that a study can provide recommendations.”


The Committee on Accessible and Affordable Hearing Healthcare for Adults also will analyze the importance of hearing to individual and societal health, looking at issues like isolation, social connectivity, well-being, and economic productivity.

Academy of Doctors of Audiology (ADA) President Kim Cavitt, AuD, said she's hoping the committee goes beyond a concentration on products.

“We want to see more focus on the role of the audiologist and the provision of evidence-based hearing and balance care. We can't lose sight of the service and the rehabilitation that are needed for people to be successful with amplification.”

American Academy of Audiology (AAA) Past President Erin Miller, AuD, expressed a similar sentiment in an email to The Hearing Journal (HJ).

“The fact that we have multiple government agencies participating in the consensus study and discussing hearing loss as a population health issue is very positive,” she said.

“We are hopeful these discussions will lead to a meaningful change in the current federal regulations. We do, however, have some concern that the focus of the study turns to a discussion solely about technology, and this is only one facet to ensuring positive outcomes for patients with hearing loss.”

Amanda O'Donnell, AuD, a clinical audiologist and clinical assistant professor at the University of North Carolina at Chapel Hill, attended the first committee meeting. She sees the study as a largely positive development, she said in an email to HJ.

“Unfortunately, as a result of poor hearing healthcare coverage, many audiologists are not accessible for treatment services through the normal pathway of the insurance plan. In addition, coverage of hearing aids and hearing aid-related services is not provided by Medicare in spite of the prevalence of hearing loss in the aging population.”


The committee, which has convened in a series of open meetings, is chaired by Dan G. Blazer, MD, J.P. Gibbons Professor of Psychiatry Emeritus at Duke University, and includes audiologists Nicole Marrone, PhD; Judy R. Dubno, PhD; and David A. Zapala, PhD; retired Hearing Loss Association of America (HLAA) Executive Director Brenda Battat, MS; otolaryngologists Frank R. Lin, MD, PhD, and Debara L. Tucci, MD, MBA, MS; retired hearing instrument specialist Thomas Pippin; and epidemiologist Karen J. Cruickshanks, PhD, among other members.

“It is important that there is input from all parties who might be impacted by policy changes relative to identification and treatment of adults with hearing loss,” Dr. Miller said. “We were, however, pleased to see that two of our members sit on the committee and can provide the audiologist's perspective.”

What Dr. Cavitt said is missing, however, is the practitioner perspective.

“You have some amazing people who have done a lot of work in hearing aids, epidemiology and public health, and the legalities of this,” she said. “You want to really see the whole picture. I think real practitioners who are doing this work should at least be reached out to to present.”

The committee's final report is due in May 2016.

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