2026 Early Hearing Detection & Intervention Conference
March 15-17, 2026 • Jacksonville, FL
3/16/2026 | 10:05 AM - 10:35 AM | Facilitating Collaborative Dialogue with Primary Care Offices to Address Newborn Hearing Screening Lost to Follow-Up/Lost to Documentation | City Terrace 12
Facilitating Collaborative Dialogue with Primary Care Offices to Address Newborn Hearing Screening Lost to Follow-Up/Lost to Documentation
Introduction: One-third of Tennessee infants who fail newborn hearing screening do not have final evaluation outcomes documented in Tennessee’s Newborn Screening Program (NBS) database, i.e., they are lost to follow-up (LTFU). Some infants have received rescreen or diagnostic evaluation, but the results were not reported to the NBS, i.e., lost to documentation (LTD). Since July 2023, the TN NBS has received funding from the CDC to assess the extent of LTD, and the pilot study in 2024 found that ~90% of the LTFU cases were lost at the rescreen stage, an LTD rate of 44%, which was much higher than the rate of 14% among those lost during the diagnostic evaluation stage. Continuing from the previous study, this project focused on understanding the processes and identifying barriers among primary care providers (PCP) related to newborn hearing screening and follow-up (NHFU).
Method: The LTFU cases for 2022-2024 births were summarized by PCP. Seven practices with high rates and volumes of LTFU were identified, and four participated in this study. The part-time Audiology Consultant scheduled virtual meetings or calls with key providers and/or staff at PCP offices to discuss topics on NHFU, challenges faced by families seeking follow-up, and internal processes for documentation, reporting, and referrals. The facility-specific lists of LTFU cases were shared with the PCPs, and when available, the updated information on re-screening was recorded and entered in the NBS data system.
Results: The presentation summarizes how to facilitate productive consultative meetings with PCP staff, identify PCP protocols that facilitate or counterproductively affect NHFU efficiency, and review updated data gathered on babies during the project period.
Conclusions: The collaboration revealed ways the NBS team could support the PCP offices and yielded new information about the efficiency of internal PCP protocols for babies needing hearing follow-up.
- The participant will be able to identify ways to facilitate productive consultative meetings with primary care providers' staff, addressing practice-specific ways to increase newborn hearing screening and follow-up efficiency.
- The participant will be able to apply Tennessee experiences to their own programs to reduce loss to follow-up/documentation.
- The participant will be able to identify at least two barriers for PCPs to report hearing results to the state’s EHDI program.
Presentation:
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Handouts:
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Transcripts:
CART transcripts are NOT YET available, but will be posted shortly after the conference
Presenters/Authors
Julie Beeler
(Primary Presenter,Co-Author), University of Tennessee Health Science Center Audiology and Speech Pathology, jbeeler8@uthsc.edu;
Julie Beeler is an audiologist and speech-language pathologist with the University of Tennessee Health Science Center Department of Audiology and Speech Pathology (UTHSC ASP) in Knoxville, where she serves as a program liaison. Julie is also an instructor for undergraduate courses in aural rehabilitation. Julie also collaborates with Tennessee's Newborn Hearing Follow-Up Program on various efforts, including providing audiology consultation and supervising an EHDI practicum for UTHSC AuD students. She is a board member of Tennessee Hands & Voices.
ASHA DISCLOSURE:
Financial -
• Receives Consulting fee for Consulting from Tennessee Department of Health Newborn Hearing Follow-Up Program.
Nonfinancial -
No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
Financial -
Financial relationship with Tennessee Department of Health Newborn Hearing Follow-Up Program.
Nature: Audiology Consulting.
Nonfinancial -
No relevant nonfinancial relationship exists.
Yinmei Li
(Co-Presenter,Co-Author), Tennessee Department of Health, yinmei.li@tn.gov;
Dr. Yinmei Li is the lead epidemiologist in the Perinatal, Infant and Pediatric Care section of the Family Health and Wellness division of the Tennessee Department of Health and has been in this role since 2014. Before joining the FHW division, she worked for three years as the chronic disease epidemiologist and then expanded her scope of work to include maternal and child health and injuries as the director of the Surveillance, Epidemiology and Evaluation section for 8 years with the TDH. She received an MD equivalent degree from Shanghai Medical College, Fudan University in China, and a Master’s degree in Experimental Statistics, a Master’s degree in Epidemiology, and a PhD in Veterinary Medical Sciences from Louisiana State University.
ASHA DISCLOSURE:
Financial -
• Receives Grants for Management position from The CDC.
Nonfinancial -
No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
Financial -
Financial relationship with The Centers for Disease Control and Prevention.
Nature: The project is partially supported by the CDC through the EHDI surveillance grant. .
Nonfinancial -
No relevant nonfinancial relationship exists.
Charles Lechner
(Co-Author), Tennessee Department of Health, charles.r.lechner@tn.gov;
Charles Lechner joined the Newborn Screening Follow-up Program within the TN Department of Health in February 2023 as an epidemiologist. Prior to this, he was an Association of Public Health Laboratories Data Analytics Fellow stationed within the TN Newborn Screening
Laboratory. His background is in bioinformatics and he is passionate about using technology and data to better the lives of others, especially within the fields of neonatology and pediatrics.
ASHA DISCLOSURE:
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Nonfinancial -
AAA DISCLOSURE:
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Holli Allen
(Co-Presenter,Co-Author), Department of Health, Holli.N.Allen@tn.gov;
Holli Allen, B.A. is the Program Director for the Tennessee Early Hearing Detection and Intervention Program. Her professional experience includes care coordination for families with special health care needs and federal grant management. Holli holds a Bachelor of Arts in Political Science from the University of Tennessee at Martin and a graduate certification in Health Care Management from East Tennessee State University.
ASHA DISCLOSURE:
Financial -
• Receives Salary for Employment from Tennessee Department of Health.
Nonfinancial -
No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
Financial -
Financial relationship with Tennessee Department of Health.
Nature: .
Nonfinancial -
No relevant nonfinancial relationship exists.
Angela Keyton
(Co-Author), Tennessee Department of Health, angela.keyton@tn.gov;
Angela Keyton, RN, Public Health Nurse Consultant Manager - RN Coordinator for Pediatric Case Management at the Tennessee Department of Health. With 16 years of experience as a Registered Nurse, including 10 years in Pulmonary Step-Down Care, Angela has been dedicated to public health for the past seven years. In her current role, she oversees pediatric nurse case managers' activities in newborn screening, newborn hearing screening, newborn CCHD screening, and the childhood lead poisoning prevention program.
ASHA DISCLOSURE:
Financial -
Nonfinancial -
AAA DISCLOSURE:
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Nonfinancial -
Hilary Fryman
(Co-Author), Tennessee Department of Health, hilary.fryman@tn.gov;
Hilary Fryman, RN BSN is the Education and Quality Improvement Nurse for the Pediatric Case Management and Newborn Screening Follow-up Program. She has been a Registered Nurse for 17 years and has been in with the Tennessee Department of Health for 8 years. In her current role, she works closely with the Director of Pediatric Case Management and Tennessee Newborn Hearing Screening Program Director to create and update processes and procedures for daily nurse case management task rotations and education for hospitals, midwives, pediatricians, and audiologists. Hilary provides ongoing hospital education and completes visits to hospitals that are need of technical assistance in meeting state benchmarks, such as the initial hearing screening rate and initial fail rates. Hilary has played a key role in several implementations for the newborn screening program such as, Remote Diagnostics Entry Portal for Audiologists. Hilary helps bring awareness to newborn screening by organizing events for Rare Disease Day and CCHD Awareness in February, Speech and Hearing in May, and Newborn Screening Awareness Month in September. Hilary serves as the Co-Chair for the APHL National Continuous Quality Improvement Sub-Committee.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exists.
Nonfinancial -
No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
Financial -
No relevant financial relationship exists.
Nonfinancial -
No relevant nonfinancial relationship exists.
Amanda Ingram
(Co-Author), Tennessee Department of Health, amanda.d.ingram@tn.gov;
Amanda Ingram, RN is the Director of the Pediatric Case Management and Follow-up Program for the Tennessee Department of Health. She has been a Registered Nurse for 24 years with 13 years of Neonatal Intensive Care experience and has been with the State of TN Department of Health for 8 years. She has served as Director for Newborn Screening Follow-up for the past 6 years. Prior to this role she served as the Case Management Coordinator and prior to that she was a case manager for the program. She oversees all follow-up and case management activities for Newborn Screening, Newborn Hearing Screening, Newborn CCHD Screening, and the Childhood Lead Poisoning Prevention Program.
ASHA DISCLOSURE:
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Nonfinancial -
AAA DISCLOSURE:
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