Surgical Hearing Implant Program Otolaryngology ANNUAL REPORT 2015 Department Name
Medical Director - Summary The Surgical Hearing Implant Program had an exciting year. By the end of the fiscal year for 2014, we were able to perform the maximum number of surgeries allowed by our program, for both cochlear implants and bone anchored hearing aids. This year concluded the first negotiated contract by our program. Together with WRHA Logistics Department, a working group was formed to participate in a new RFP for hearing devices for the next 3-5 years. New contracts have been awarded, with a strong focus on value to patients. Improvements in technology and surgical technique continue to allow us to provide patients cutting edge technology through more minimally invasive techniques. This year also marked progress in the development of our Bone Anchored Hearing Program. Through collaboration with WRHA and Central Speech and Hearing Clinic, we are planning to consolidate services to provide outpatient clinic care in a community setting. This will improve patient wait times and access, and improve our ability to service patients needs. The program continues to work towards the development of a comprehensive database to allow us to track patient outcomes. Dr. Darren Leitao, Co-Director Pediatric Otolaryngology - Head and Neck Surgery Assistant Professor, University of Manitoba Section Head - Pediatric Otolaryngology Dr. Jordan Hochman, Co-Director Otologic and Neurotologic Surgery Assistant Professor, University of Manitoba Associate Director, Surgical Modeling Simulation and Robotics Lab
1 Program Coordinator - Summary The following report was completed by Justyn Pisa, AuD and will outline the current status of the Surgical Hearing Implant Program (SHIP) of the department of Otolaryngology Head & Neck Surgery at Health Sciences Centre (HSC) as of December 31, 2015. This report will provide summary information on both cochlear and bone anchored implant programs, including the number of surgeries performed, the number of devices implanted and the surgical wait list for the 2015 calendar year. Program Personnel: Darren Leitao MD: Jordan Hochman MD: Les Garber MD: Justyn Pisa AuD: Co-Director and Pediatric Cochlear Implant Surgeon Co-Director and Adult Cochlear Implant Surgeon Pediatric and Adult Bone Anchored Implant Surgeon Program Coordinator and Audiologist for Bone Anchored Hearing Aids Program Finances: Bone Anchored Implants in 2015: 14 = $102,570 Cochlear Implants in 2015: 39 = $924,410 Annual Program Device Budget: $1,185,629 Amount Spent in 2015: $1,019,663 Program Budget Surplus/Deficit $165,966 Program Achievements: Bone Anchored Implant Program Reached implant quota (14) by December 2015. Program has reached 75 bone anchored implants total. Developed a plant to transfer audiological services to the Central Speech and Hearing Clinic. Implemented an online database for patient tracking and practice management. Invited speaker at an International bone anchored implant conference (Nov 2015). Worked with WRHA to ratify a 3-year RFP with program vendors. Cochlear Implant Program Reached implant quota (35) by December 2015. Program has reached 150 cochlear implants total. Implemented an online database for patient tracking and practice management. Maintained an average wait time of 15.5 months. Worked with WRHA to ratify a 3-year RFP with program vendors. Program Goals: Submit briefing note for increased in device quota (+5 CI / +10 BAHA) to WRHA. Secure funding for the development of a baha processor upgrade program to help parents purchase replacement processors for children 18 years and under. Secure funding for the cochlear implant program to establish an adult bilateral cochlear implant program in Manitoba. Successfully transition bone anchored hearing aid services to Central Speech and Hearing.
2 Bone Anchored Implant Program Summary The Bone Anchored Implant Program achieved 100% (14/14) of its annual implant quota for the 2014 calendar year. 10 adult patients (average age: 51.9 years) and 4 pediatric patients were implanted unilaterally and fit with an external processor. There are currently 31 patients awaiting implant surgery (an increase of 11 from the previous calendar year) and 20 patients awaiting trial for candidacy. The baha program continues to receive an average of 4.3 new referrals per month and generates 1-2 new surgical candidates per month. The current surgical wait time is 18.5 months for bone anchored implant procedures (an increase of 7.1 months from the previous calendar year). The bone anchored implant program has a current caseload of approximately 145 active participants. Approximately 35% of these patients were implanted out-of-province prior to program initiation while 65% were implanted in-province since 2010 or are awaiting consultation for surgery. The program has seen an increase in patients from other provinces seeking services in Manitoba. Average wait times are expected to rise to 24 months in 2016. Bone Anchored Implant Program Summary: Jan. 1, 2015 Dec. 31, 2015 Number of bone anchored implant surgeries 14 Number of bone anchored implants 14 Number of adult baha patients 10 Number of pediatric baha patients 4 (+4) Number of patient referrals for audiological candidacy assessment 52 (-24) Average Number of patients referrals for audiological assessment (per month) 4.3 (-2.0) Number of patients seen for audiological candidacy assessment 31 (-36) Number of patients on the waiting list for audiological candidacy assessment 20 (+3) Number of patients on the waiting list for baha surgery 34 (+13) Average wait time for baha surgery (months) 18.5 (+6.9) Percentage of intraoperative complications 0% Percentage of post-operative complications (infection, excessive skin growth) 12% Total spent on bone anchored implants and sound processors $102,570 Table 1. Summary of the bone anchored implant program for 2015.
3 Cochlear Implant Program Summary The Cochlear Implant Program achieved 111% (39/35) of its annual implant quota for the 2015 calendar year. The program completed 36 surgical procedures on 31 adult and 8 pediatric patients. There are currently 40 patients who have passed audiological candidacy criteria for surgery and are awaiting consultation with physicians, consistent with the previous year. The average waiting time for adult patients is now 15.5 months, which is a decrease of almost 5 months from the previous year. The Cochlear Implant program has a caseload of approximately 140 active participants currently implanted and approximately 40 patients awaiting surgery. The program has a ~40% binaural implant rate for pediatric patients while adults continue to be implanted unilaterally. The adult waiting list was reduced by approximately 20 adults from the previous year. There is no pediatric waiting list. Cochlear Implant Program Summary: Jan. 1, 2015 Dec. 31, 2015 Number of cochlear implant surgeries 36 Number of cochlear implants 39 Number of adult cochlear implant patients 31 Number of pediatric cochlear implant patients 8 (+2) Percentage binaural (pediatric cochlear implant patients only) 40% (3/8) Number of patient referrals for audiological candidacy assessment 30 (-6) Average Number of patients referrals for audiological assessment (per month) 1.4 (-1) Number of patients seen for audiological candidacy assessment 36 (-31) Number of patients on the waiting list for audiological candidacy assessment 10 (-7) Number of patients on the waiting list for cochlear implant surgery 40 (+5) Average wait time for cochlear implant surgery (months) 15.5 (-4.5) Percentage of intraoperative complications 0% Percentage of post-operative complications <1% Total spent on cochlear implants and sound processors $924,410 Table 2. Summary of the cochlear implant program for 2015.