How to be a Hear-O:
Leveraging interdisciplinary partnerships to improve hearing healthcare
by Sarah A. Sydlowski, AuD, PhD, MBA, FNAP
Cleveland Clinic
If you live long enough, there is a nearly 100% chance that you will live with some degree of hearing loss. You probably already know and interact on a regular basis with someone who has hearing loss. Hearing loss is the third most common chronic health condition among older adults, currently affecting nearly 40 million people1. Even more concerning, approximately 29 million are untreated – living with a condition they believe is just a “normal” consequence of aging. Yes, hearing loss in older adults is common. But that fact doesn’t mean that it should not be managed.
Untreated (or undertreated) hearing loss is associated with other medical comorbidities. It is the third most common reason for years lived with disability2 and has a noticeable impact on quality of life. Hearing is how we stay connected in our communities, engaged with loved ones, and active in the workplace. As hearing diminishes, the cognitive energy required to participate in common activities increases, often leading individuals to withdraw from engagements that prove too taxing to be enjoyable. This social isolation is one of the most cited associations with cognitive decline.3 While hearing may not capture the attention it deserves, brain health certainly does.
Hearing loss also has the potential to impact other aspects of health. It has been cited with relationship to higher healthcare costs and poorer healthcare utilization,4 decreased compliance with provider recommendations, 5 lower ratings of physician-patient communication, 6 and falls. 7
As the population ages, the number of people living with hearing loss is expected to grow exponentially, ballooning to 700 million people worldwide by 2050. 8 While audiologists take particular interest in addressing this important healthcare issue, successfully connecting people to care will only be accomplished through effective interdisciplinary partnerships. Some of the early work is already underway. In 2021, the Hearing Health Collaborative (HHC) was formed and is comprised of audiologists, neurotologists, family and geriatric medicine physicians, professional association directors, patients, and hearing instrument specialists, including several NAP Fellows from the Audiology and Allopathic and Osteopathic Medicine Academies. The vision of the HHC is to Create a world where every adult has awareness of and access to timely and comprehensive hearing health. The mission of the HHC is Using an inter-disciplinary approach, the HHC will optimize adult hearing health by identifying access barriers, implementing innovative solutions, and improving policies and care delivery in the US. In order to accomplish this mission, the HHC has used an A3-Thinking approach* to understand the current conditions, recognize the root causes of the problem, and identify impactful countermeasures that will spur the desired change.
Through this structured, systematic process, three major countermeasures were identified and early implementation efforts are underway:
Countermeasure 1: Develop and embed a simple metric as a vital sign for hearing health to increase the number of adults who can identify their hearing loss;
Countermeasure 2: Develop and embed a simple and consistent staging system for sensorineural hearing loss that defines appropriate treatment pathways as standard of care; and
Countermeasure 3: Secure evidence-based procedural change for timely referral for clinical evaluation and treatment of hearing loss as standard of care to enhance access to effective management options.
The greatest opportunity for inter-disciplinary collaboration relates to the work associated with Countermeasure 3 (referral for clinical evaluation and treatment of hearing loss). By the time an individual sees an audiologist, they most likely already recognize a concern for their hearing and are ready to take action. In order to move the needle for the 75% of adults with hearing loss who aren’t taking action, intervention must begin long before they see an audiologist, in the care of our inter-disciplinary colleagues.
One key opportunity is the partnership between audiologists and primary care providers. In a recent survey of 400 primary care providers, 9 it was noted that 95% of respondents thought it’s important for patients to know what “normal” hearing is; but only 57% of respondents were confident they knew what “normal” hearing is, only 40% think hearing loss is treatable, and only 17% believe hearing loss is preventable, which is fairly similar to the perceptions of the general population. 10
Primary care providers are tremendously influential on their patients, particularly when they encourage change and provide concrete instruction for management. 11 Looking to the future of hearing healthcare, these partnerships will be essential to identifying hearing loss earlier and inspiring patients to take action to manage their hearing loss sooner. The key question to answer is how to make it simple for busy providers to incorporate hearing health as a priority in their appointments.
One option is to incorporate simple hearing screening tools. As an example, as part of a pilot program at Cleveland Clinic, hearing screening tablets were embedded in family medicine and geriatric medicine practices. Taking approximately two minutes to administer, the tablets quickly offered data regarding the patient’s hearing ability, making it easier for their provider to point to concrete data rather than suggesting a hearing test without evidence a change has occurred. Steps were also taken to simplify scheduling comprehensive audiologic evaluations so patients could easily take action.
Programs like these are limited today, but the future of hearing healthcare depends on building effective interdisciplinary partnerships and programs. What can you do today?
- Integrate conversation regarding the importance of hearing health
- Follow the work of the Hearing Health Collaborative to identify and endorse a standard method for adult hearing screening (https://adulthearing.com/hearing-health-collaborative/)
- Recommend that patients have their hearing evaluated early and that they take action to manage their hearing loss as soon as its identified
- Normalize the idea that hearing loss isn’t “normal” and deserves management just like vision, blood pressure, and other common conditions of aging
By working together, we can improve the quality of life for aging adults and ensure that they can stay connected and vital for as long as they desire.
Footnote:
*A3 Thinking is a structured problem-solving and continuous improvement approach that to organize problem-solving process, facilitate collaboration, and drive organizational learning. It's a tool and a mindset focused on understanding the current state, identifying root causes, developing solutions, and tracking progress.
1Blackwell, DL; Lucas, JW; Clarke, TC (2014). Summary health statistics for U.S. adults: National Health Interview Survey, 2012 . National Center for Health Statistics. Vital Health Stat Feb:(260):1-161.
2GBD 2019 Hearing Loss Collaborators. (2021). Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019. Lancet. 397(10278): P996-1007. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00516-X/fulltext
3Lampraki C, Zuber S, Turoman N, Joly-Burra E, Mack M, Laera G et al. (2025). Profiles of social isolation and loneliness as moderators of the longitudinal association between uncorrected hearing impairment and cognitive aging. Communications Psychology. 3(101).
4Reed NS, Altan A, Deal JA, et al. Trends in Health Care Costs and Utilization Associated With Untreated Hearing Loss Over 10 Years. JAMA Otolaryngol Head Neck Surg. 2019;145(1):27–34.
5McKee M, James TG, Helm KVT, Marzolf B, Chung DH, Williams J, Zazove P. (2022). Reframing Our Health Care System for Patients With Hearing Loss. J Speech Lang Hear Res, 65(10):3633-3645.
6Mick P, Foley DM, Lin FR. (2014). Hearing Loss is Associated with Poorer Ratings of Patient–Physician Communication and Healthcare Quality. J Am Geriatrics Soc, 62(11): 2207-2209.
7Yeo BSY, Tan VYJ, Ng JH, Tang JZ, Sim BLH, Tay YL, et al. (2025). Hearing Loss and Falls: A Systematic Review and Meta-Analysis. JAMA Otolaryngol Head Neck Surg.151(5):485-494.
8World Health Organization. https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss
9Sydlowski SA, Marinelli JP, Lohse CM, Carlson ML, Hearing Health Collaborative. (2022). Hearing Health Perceptions and Literacy Among Primary Healthcare Providers in the United States: A National Cross-Sectional Survey. Otol Neurotol
10Carlson ML, Nassiri AM, Marinelli JP, Lohse CM, Sydlowski SA, Hearing Health Collaborative. (2022). Awareness, Perceptions, and Literacy Surrounding Hearing Loss and Hearing Rehabilitation Among the Adult Population in the United States. Otol Neurotol
11Bardach SH, Schoenberg NE. (2018). The role of primary care providers in encouraging older patients to change their lifestyle behaviors. Clin Gerontol, 41(4): 326–334.
