Otolaryngologists Concerned about Online Consumer Hearing Test

A subsidiary of UnitedHealth Group has launched an online hearing test and a line of lower-cost hearing devices that are generating alarm about patient safety among otolaryngologists.

In an Oct. 2011 release announcing its products, hi HealthInnovations said its goal is to reduce the cost of hearing aids so that more people have access to them. About 36 million American adults have hearing loss, but only one of five people who could benefit from hearing aids wears one, according to the National Institute on Deafness and Other Communication Disorders.

Anyone can take the hearing test at hi HealthInnovations’ website, using earphones and most computers, tablets or smartphones. After completing the test, users are shown a summary of their “hearing health” and, if applicable, hearing devices that may work well for them. People who have had a hearing test within the past year can enter their audiogram results into the computer to see device recommendations. The website states that if consumers decide to purchase any of hi HealthInnovations’ four hearing devices, their test results will allow the company to custom program the devices to their specific hearing levels.

Hi HealthInnovations has contracted with several UnitedHealthcare Medicare Advantage and Medicare Part D plans to make the devices available to plan members. Some Medicare Advantage plan members would have no out-of-pocket costs. Retail consumers would pay between $749 and $949 for the hearing aids, much less than the usual cost.

Poor Results

Otolaryngologists worry about the accuracy and safety of the direct-to-consumer approach.

“There’s a reason that we have an audio booth that costs anywhere from $30,000 to $40,000 to do hearing tests, and that’s to maintain the accuracy of the hearing tests,” said Todd Hillman, MD, an otolaryngologist at Pittsburgh Ear Associates. “There is not a viable way to do an online hearing test that is accurate or consistent at this point in time.”

The hi HealthInnovations website tells consumers to take the test in a quiet place where there is no noise from the TV, fans or appliances. But these precautions are insufficient, otolaryngologists said. Everyone’s home has some background noise, which will affect the test results, Dr. Hillman said. That’s why a soundproof booth is necessary.

Audiometers are calibrated to meet federal guidelines, noted Mark Pyle, MD, academic vice chairman of otolaryngology and residency program director at the University of Wisconsin in Madison. This ensures test accuracy nationwide. With an online test, “there is no calibration, there is no soundproof room, there is no masking, there is no control,” Dr. Pyle said. “So we really don’t know what degree of hearing loss they have. Some people may receive devices that are too powerful. They may receive devices that aren’t appropriate.”