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Hearing Testing in Ophthalmology Clinics: An ROI Case Study

Houston Eye Associates employed rapid hearing assessments in their ophthalmology clinic to generate referrals to their affiliated hearing clinic. The result? Better access to hearing care for their patients and increased revenue for the hearing center.

Hearing loss is a serious problem worldwide. The World Health Organization estimates that there are almost half of a billion people suffering from disabling hearing loss.  That number is expected to virtually double by 2050.[1] The National Institute of Deafness and Other Communication Diseases (NIDCD) estimates that there are approximately 37.5 million Americans over the age of 18 that suffer from hearing loss.[2]

Part of the issue is identifying and providing proper interventions for those with, or at risk for, hearing loss. The NIDCD suggests that almost thirty million Americans could benefit from using hearing aids.[3] However, it is estimated that it takes the average person seven years of living with hearing loss before they seek medical assistance.[4]

Increasingly, it is becoming clear that the totality of hearing loss cannot be addressed by hearing professionals alone. Partnerships with additional healthcare providers can help play a pivotal role. For example, partnerships with affiliated or third-party health clinics can help identify and triage individuals suffering from hearing loss into hearing care workflows, leading to individuals, who wouldn’t otherwise seek assistance, getting the hearing care attention that they need. And, as you will see, it can make economic sense to do so.

Houston Eye Associates (HEA) is the largest ophthalmology practice in the United States with approximately sixty clinics in twenty-eight locations around Houston. HEA’s headquarter alone sees well over one thousand clients every day, of which the majority are over the age of sixty. This is a major demographic for possible hearing loss.

HEA has an onsite hearing center led by Dr. Carrie Raz (Doctor of Audiology). Her objectives for the hearing center are twofold: to improve access to hearing healthcare for HEA clients and to improve the success of her hearing center. The two objectives are not mutually exclusive.

In late 2017, Dr. Raz sought out SHOEBOX QuickTest, a simple, self-administered hearing screening test used for new customer acquisition. The QuickTest technology promised to provide an accurate assessment in only a few minutes: one minute for the test and a couple minutes for follow-up questions, all on an iPad. The speed of the system was a major factor because it was important that the test did not slow down clinical operations. The QuickTest also promised to be simple to use, which was critical because ophthalmology technicians — not hearing health professionals — were tasked with administering the test.

Dr. Raz ran the pilot from December of 2017 to March of 2018 (approximately three full months) where she evaluated incorporating a QuickTest into an HEA-affiliated ophthalmology clinic workflow. Here is how the hearing test was administered during the eye exam:

Pre-appointment: Patients were notified via a personalized letter from the Ophthalmologist that an optional QuickTest would be available during their scheduled eye exam.

In-appointment: In the preliminary consultation with the technician, a QuickTest was offered to the patients (voluntary). Those who agreed were given the QuickTest and shown results. Patients who presented with potential hearing loss were given the option for a referral to the hearing center for a follow-up hearing appointment where a more detailed assessment could be performed.

Post-appointment: Dr. Raz reached out to those who expressed interest, and who presented with some possible hearing loss (qualified contacts), to schedule a hearing appointment. She tracked appointments and hearing aid sales.

Here are the results for three months in a single clinic:

Number of QuickTest Assessments Performed: 102
Appointments Scheduled: 23
Appointments Executed: 13*
Hearing Aid Revenue Generated: $9,600 (4 units sold)
SHOEBOX Subscription Cost: $750 ($250 / month)
Gross Profit: $7,200

*Note that the drop off in executed appointments can be attributed to a couple factors: appointments scheduled outside of data collection range, and some loss of interest/appointment cancellations

These results demonstrate that using SHOEBOX QuickTest in an ophthalmology clinic workflow was effective for referring non-hearing clinic patients into a hearing clinic workflow (23/102 potential appointments scheduled and 13/23 scheduled appointments executed). Of the thirteen appointments completed, an appreciable number of hearing aids were sold (4) generating $9,600 in sales. These results also indicate that Dr. Raz was successful in improving access to hearing healthcare to HEA’s client base.

After operational costs and product margins, which includes the $750 ($250/month) spent on the QuickTest system, Dr. Raz’s hearing clinic yielded an almost tenfold return on investment. This result proved to Dr. Raz that this methodology for lead generation could play a substantial role in the ongoing success of her hearing clinic.

“Our main goal was to employ a technology that was going to be easy to implement in our affiliated clinics. If the technicians don’t buy in, or can’t run the tests, or it slowed the clinic’s workflow, the system wasn’t going to work. Thankfully, SHOEBOX QuickTest was easy to operate and helped facilitate hearing appointments for my clinic. I would not have sold those four hearing aids otherwise. In only a few months, QuickTest has more than paid for itself,” said Dr. Raz after the pilot.

Dr. Raz has since expanded QuickTest into more clinics and hopes to make it a staple in the standard of care at HEA.

[1] http://www.who.int/mediacentre/factsheets/fs300/en/

[2] https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing

[3] https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing

[4] Kochkin, S. (2007). MarkeTrak VII: Obstacles to adult non-user adoption of hearing aids. The Hearing Journal, 60 (4), 24-51