Why we're betting on task shifting in audiology, and why you should too.

By Grant Slabbert on 2018.April.12
Grant Slabbert

World Hearing Day was a little over a month ago. On the day, WHO released their estimates of the numbers they predict will have disabling hearing loss by 2050.

While the numbers they predicted were startling, it didn't seem as though it garnered enough of a reaction.

They estimated that 900 million people will suffer from disabling hearing loss by 2050. That is up from the current number of 466 million.

The lack of reaction from major news outlets and the media may have been due to a lack of perspective. We often don't understand such large numbers without a little contextualization.

So let's look at it another way.

The current population of the United States is sitting at 325 million while Mexico is 127.5. If we are to combine the entire populations of both countries we reach only 453.5 million. While we can understand that this is a lot of people, we are still 13 million shy of the current global population of those with disabling hearing loss.

 USA and mexico

By the time we reach 2050, this population would grow to include the entire current population of the USA, Canada, Mexico and Western Europe. (Still a little short at only 886 million )

usa mexico canada and western europe

The combined annual loss of productivity and direct health costs of this population of unaddressed hearing disabled is over $755 billion.

But once you do, it is clear that a global  population of hearing disabled exists and it rivals the population of some of the largest and most advanced nations in the world.

Dr Etienne Krug, Director of the WHO Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, says “Past trends and future projections predict a vast increase in the number of people with hearing loss.” , “Unless appropriate action is initiated, nearly one in 10 people could have disabling hearing loss by 2050. This will considerably affect their lives and pose a significant cost to health systems. Governments must act now to prevent this rise and ensure people with hearing loss can access the services and technologies they need.”

While government and various stakeholders and industries have an important role to play in education, regulation and prevention, the burden of care will be firmly placed on the hearing health care (HCC) profession and medical profession at large.

The coming years will see a heavy leaning on the existing HHC industry to do everything necessary to alleviate what is, in global terms, a veritable crisis.  We wrote recently about why audiology isn't going anywhere soon, this is just another reason. 

The HCC is well aware of the impact of untreated hearing loss. It is devastating to the affected person and the communities that support them.

When it comes to global issues, too often we think of them as geographically distant. By that I mean that we have a natural tendency, as a way of softening the blow or, to assume that these issues pertain only to the developing world. They don't.

Or that we are somehow immune or have access to a cure just around the corner. while there is some promising research afoot, we don't.

We need to face up to these issues and we need to do it now, before the World Health Organisation’s 1 in 10 projections become a reality.

But how do we do it?

The shortage of medical professionals throughout the world only adds to the issue at hand. HHC professionals are rare and in some countries non-existent. Where they do exist, they are almost exclusively situated in urban areas.

I have always believed that when approaching any worthy project, the level of difficulty should never negate its necessity.

Over the last few years technology has offered up some solutions that should make this mammoth task a little easier.

Tele-audiology has opened the door for us to reach patients over cover greater distances. Portable audiometry technology has not only reduced cost, but free'd us from the constraints of expensive and cumbersome sound booths, without any loss of functionality or quality.

Advances in technology show us that we have the tools, but what about the people?

One thing that is certain is that this world has no shortage of people. With new technology comes automation. Automation allows trained technicians to perform the time consuming work of professionals. These professionals then spend their valuable time, more effectively on more advanced work.

This is known as task-shifting.

The WHO is backing it and have also issued guidelines for implementation and we are betting on it all the way and you should too.

What exactly is task shifting?

Task-shifting is the assignment of tasks to less qualified healthcare personnel.

More specifically, it is the identification and assignment of tasks that can be performed by a facilitator or technician rather than by the medical professional who's time and expertise can be more effectively used.

Tele-Audiology and automation enables hearing healthcare professionals to train less qualified health workers (i.e. nurses) to conduct or facilitate assessments without a hearing healthcare professional being present. While the assessment is paramount, the audiologist’s physical presence is not. In this case a technician is deployed to facilitate the assessment by placing the equipment on the patient and initiating an automated test.

This is not new, nor groundbreaking. You most likely do it every day already. Your practice manager, receptionist or office cleaner have assumed the responsibilities and tasks that you, as a HHC provider would be spending valuable time doing. They take care of the tasks for you so that you can do more of what you need to do as a professional.

Technology makes it possible to extend this already well used practice to your professional services.

3 ways tele-audiology and, by extension, task shifting works.

- Synchronous:

The facilitator sets up the patient for testing at their location.

The audiologist connects to the testing equipment via the internet and performs the testing, analysis and interpretation in real-time from their location. Video is used to consult with the patient and to give recommendations or suggest management.

While providing greater reach for the audiologist, this is still time consuming and requires the audiologists undivided attention. It is not the most effective use of time but is a good start.

- Asynchronous:

A trained facilitator visits the patient, sets them up for testing and then assesses the patient’s hearing using automated testing protocols.  The data is then sent on to the audiologist for analysis and interpretation. The audiologist can then consult with the patient over the phone or via video conferencing to make recommendations.

Here, the audiologists time spent is spent on interpretation and recommendation rather than data capture. Multiple facilitators could be in the field testing patients and gathering data for a single audiologist to process. Placing equipment in doctors rooms, clinics or hospitals for medical professionals to perform testing is also a viable option.

- Hybrid:

This is the combination of both synchronous and asynchronous methods. For example; should a screening test fail, the audiologist would then log in and take over testing manually for more granular control of the test and further diagnosis.

Task shifting is an efficient use of the medical professionals time, it makes good business sense and can go a long way to making hearing healthcare accessible to the millions who need it.

Turning one hearing healthcare professional into an efficient and effective team capable of doing so much more.

Find out more about tele-audiology implementation here.


Find Out More About KUDUwave Audiometers Thinking out the booth


Tags: Audiology, Tele-health