Breaking the barriers for hearing implants: the need to re-think, re-model and rejuvenate hearing implant healthcare in the brave new world.

Over the last decade there have been a number of seismic shifts in the hearing implant landscape. This has been led by marked advances in hearing implant technology, surgery and rehabilitation. The criteria for cochlear implantation has broadened dramatically for all ages. At the same time, there has been heightened clinical expertise in hearing implants demonstrated by clinicians across the industry. People are now more knowledgeable and demanding of independent decision-making so they can actively control their own hearing implant care. Australia has excellent access to cochlear implant innovation, technology and clinical care, with well qualified medical and allied health professionals. When indicated, hearing implants are available for unilateral and bilateral hearing losses, in children and adults and across all socioeconomic strata. Despite this rich and ripe environment, we have in Australia the embarrassing statistic that only one in ten adults who could benefit from a cochlear implant eventually accesses the benefit of such technology. Furthermore, those people who eventually do receive a cochlear implant often do so after years of unnecessary and unacceptable delay. This inadequacy is a reflection of a wanting healthcare delivery model for implantable hearing solutions in Australia, particularly in its regional areas. Presently there are the technological tools to address this, including e-consultation, remote programming and the utilisation of cloud--based technology. This paper will review an innovative new hearing health service established in Australia and take a detailed look at the barriers experienced by people considering hearing implants and how each are being address to improve access to implantable hearing devices. this includes challenging all medical and hearing clinicians to rethink, revisit and re-shape the means of referring people for the hearing implant care they need and deserve. [ABSTRACT FROM AUTHOR]