1. Health and Wellness for all Arizonans azdhs.gov Dr Bradley Golner, MD Phoenix Pediatrics Az EHDI Chapter Champion

2. Health and Wellness for all Arizonans azdhs.gov EHDI Goals Understand the role of the Medical Home Improve Communication with parents Help PCPs to understand the screening status of their infants Help PCPs to understand their patients diagnosis Reduce Loss to Follow-up

3. Health and Wellness for all Arizonans azdhs.gov EHDI Goals Remember 1-3-6 – Hearing screening testing for all babies should be complete by 1 month of age – Diagnostic evaluation by audiology completed by three months of age – Early Intervention no later than 6 months of age if hearing loss present

4. Health and Wellness for all Arizonans azdhs.gov Developmental Emergency Critical developmental window EHDI goals are in place to avoid developmental delays Not diagnosed/late diagnosis: $500,000/life

5. Health and Wellness for all Arizonans azdhs.gov Empower EHDI Chapter Champions to work with stakeholders and their respective AAP chapter to conduct education and training in an effort particularly focused on reducing the rate of loss to follow-up/documentation. Increase knowledge regarding newborn hearing screening and the EHDI system Provide practical strategies for improving systems regarding newborn screening/surveillance and link systems within the state.

6. Health and Wellness for all Arizonans azdhs.gov "The primary care physician must assume responsibility to ensure that audiological assessment is conducted on infants who do not pass screening and must initiate referrals for medical specialty evaluations necessary to determine the etiology of the hearing loss." Joint Committee on Infant Hearing, 2007 http://www.jcih.org/

7. Health and Wellness for all Arizonans azdhs.gov Newborn Screening Diagnosis Intervention Babies identified with a hearing loss should be referred to ENT/Otology and Early Intervention (AzEIP) Coordinate referrals to specialty providers based on etiology of hearing loss Ongoing Monitoringresults, treatment, education and family support

8. Health and Wellness for all Arizonans azdhs.gov At 1st well baby visitCheck hearing screening results on back of immunization card or hospital discharge summary for referred or missed/incomplete screens Refer well babies failing inpatient screen for outpatient screen Refer those failing inpatient NICU, and those failing both inpatient and outpatient (as well babies) for an Auditory Brainstem Response test by an audiologist specializing in pediatrics (may require sedation/anesthesia if approaching six months of age or older.)

9. Health and Wellness for all Arizonans azdhs.gov Parent Communication Every newborn baby is PERFECT!!! Tommy3.5 years old, failed newborn screen What not to say Educate and Empower the parents

10. Health and Wellness for all Arizonans azdhs.gov Communicating with PCPs Blue Vaccine cardswhy they are important Reporting results-hospital charts and EHDI Notifying the PCP for babies who refer Educating the PCP

11. Health and Wellness for all Arizonans azdhs.gov Reducing Loss to Follow-up Loss to Follow-up… #1 problem we all face We all can improve: – Screeners- communicating with parents, PCP – EHDI team-notify and educate – Audiology-NICU babies, empower parents, PCP – EHDI-ensure appt are not missed

12. Health and Wellness for all Arizonans azdhs.gov o Between the newborn period and school age the incidence of hearing loss doubles o Most common risk factors for late onset or progressive loss are: CMV, Meningitis, o Illness, Head Injury, and Family History o Consult audiologist on ongoing audiological monitoring beyond the newborn period