The 30-Second Test for Ear Infections That Pays for Itself: New Urgent Care Study Uses Intellivisit Data to Validate the Case for Tympanometry

Analysis of nearly 141,000 real Urgent Care visits finds an objective ear test would help about 1 in 5 patients — and earn its keep within a month

NASHVILLE, Tenn.--(BUSINESS WIRE)--Most doctors use the same tool to assess children’s ears as when their caregivers visited the pediatrician decades ago. The otoscope, the tool clinicians squint through when examining the ears, has remained essentially unchanged for more than 50 years. A new study in the Journal of Urgent Care Medicine (JUCM), built on 140,894 real-world Intellivisit encounters, examined a more accurate and less uncomfortable tool for ear exams — the tympanometer. The researchers’ data showed that not only did tympanometry make clinical sense, the technology actually pays for itself.

“Let’s be honest about otoscopy,” said Josh Russell, MD, Chief Medical Officer of UCP Merchant Medicine/Intellivisit and a co-author of the study. “A clinician looks in your ear and makes a call. However rigorous this may feel, it’s about as accurate as flipping a coin at detecting fluid behind the ear drum. We know that most kids and virtually all adults with acute ear pain don’t need antibiotics. Moreover, clinicians using an otoscope, even ENTs, aren’t great at identifying the patients who would benefit from taking antibiotics.”

Modern tympanometers are handheld devices about the size of an otoscope. They can detect movement of the tympanic membrane, or eardrum, in response to a gentle puff of air. This gives a far more objective result in seconds than can be obtained from otoscopy. Add it to the exam and the odds of correctly identifying middle ear fluid improve from around 60% to better than 90%.

“[Tympanometry] is the obvious best choice for evaluating ear complaints in adults and children. It’s cheap, it’s fast, and you don’t need to be an ENT, or even a clinician, to use it,” Dr. Russell said. “In most states a nurse, audiologist, or medical assistant can run the test. That’s the beauty of it — it standardizes an evaluation that was previously among the most subjective things that doctors did for patients.”

Dr. Russell’s perspective is more than mere opinion, the study — the first of its kind in urgent care — gives credence to his viewpoint. Dr. Jeffrey LaCour, a board-certified otolaryngologist (ENT), founder of Compassio Medical Education, and the study’s lead author agrees. Dr. LaCour and another ENT colleague vetted the Intellivisit machine-learning model with a remarkable degree of consensus when scoring cases where the tool could prove useful.

Among the more than 140,000 Intellivisit urgent care encounters, 18% of all visits could have benefitted from having tympanometry used. With in excess of 185 million annual urgent care visits across the U.S. each year, this means that 36+ million patients could benefit from wider adoption of the technology.

While the clinical case for tympanometry is convincing, the financial case is equally critical. The cost amounts to roughly $4,700 for the device with expected reimbursement around $22 per exam. For an average urgent care center, this means the device would pay for itself within a month and then generate nearly $5,000 in gross monthly revenue.

This study builds on a growing body of research from UCP Merchant Medicine applying Intellivisit data to evaluate the clinical and financial viability of diagnostic tools in UC settings, including prior published findings on point-of-care ultrasound (POCUS) and diabetes screening in urgent care settings.

According to the Health Care Cost Institute, spending on urgent care among people with employer-sponsored insurance grew by more than 50% between 2018 and 2022, driven primarily by increased use rather than rising prices. Research also shows that Gen Z and Millennials — the generations most likely to have young children presenting with ear infection symptoms — account for more than half of all urgent care visits.

As financially beneficial as implementation may be, Russell continues to return to the benefits for patients and the deeper problem with the status quo. “People come to urgent care all the time because their ears hurt. Clinicians using outdated equipment substantiate the myth that antibiotics make sense for most cases of ear pain. In actuality, the opposite is true. Most patients with acute ear pain don’t have an infection. In adults especially, a lot of concerns for ‘ear infections’ are actually misdiagnoses with referred pain coming from tension in the jaw. In the absence of a more objective test than otoscopy, patients and clinicians are set up to fail. Tympanometry offers an off ramp from this state of normalcy that we’ve accepted for too long.”

At the same time, Drs. LaCour and Russell are careful not to oversell tympanometry based on their data. “The study modeled where tympanometry would help and whether it would reimburse. Our next study, which will be published this fall, did examine tympanometry’s effects on antibiotic prescriptions. Unsurprisingly, we found that using a better diagnostic tool led to fewer inappropriate antibiotics,” Dr. LaCour said.

Dr. Russell agreed stating, “...this study was step one, a proof-of-concept, but we are already seeing urgent care operators persuaded by the data. This gives us a chance to examine what happens when Intellivisit and tympanometry are actually implemented together in urgent care centers.”

“Medical progress can be frustratingly slow,” he continued, “but I believe in the next few years we will see rapid adoption and demands for tympanometry in urgent care, both from clinicians and patients.” Dr. LaCour noted that awareness of tympanometry and understanding when it should be used seem to be the greatest barriers to adoption. “Our study showed that a tool like Intellivisit can guide clinical staff about when to reach for a tympanometer. Modern tympanometers are so easy to use that once clinicians start recognizing when to use them, we’ll all be wondering what took us so long.”

Research Methodology

This was a retrospective cohort study of 140,894 de-identified, real-world urgent care encounters collected via Intellivisit (IV) software between May 2024 - March 2025. A regularized linear regression model was developed to predict encounters in which tympanometry use would be indicated. Two board-certified otolaryngologists independently validated the model’s predictions. Then, the model was used to estimate tympanometry use across 10,000 random, real-world urgent care encounters. A financial analysis was conducted to estimate the expected revenue associated with tympanometry implementation in urgent care facilities.

About UCP Merchant Medicine and Intellivisit Solutions

UCP Merchant Medicine is the backbone behind some of the most successful urgent care platforms in the country. We partner with health systems and operators to build urgent care that works the way it should—lean, fast, and clinically precise at scale. Our strategic advisory services reshape front-end care delivery, integrating operational redesign with real-time clinical execution. The result: platforms that are easier to staff, simpler to manage, and consistently deliver high performance. Across 3 million+ annual visits, our model achieves an average 94 net promoter score and half the industry average financial breakeven at only 16 visits per day, with average door-to-door times of 34 minutes. At the center is Intellivisit Concierge—our clinical intelligence platform. More than decision support, it re-engineers intake, sharpens provider thinking, and ensures every patient encounter is aligned to clinical Standard Operating Procedures. Built on 40,000+ hours of physician-led development, it delivers structured, actionable insight—before the provider even walks into the room. Learn more at https://www.intellivisit.com/.