Technology and its influence on the manufacturer to practitioner to patient link.
Diane M. Russ, MA, & Deb VanDeVelde, MS
Todays consumers have had an impact on how we deliver hearing health care. The hearing care consumer of today is likely to be younger, more educated and more inquisitive than the patients many of us met during our clinical assignments 15-20 years ago.
As an audiology student in a university clinic nearly 20 years ago, I remember all too many times an elderly patient responding to my offer of more than one suitable hearing instrument solution with a calm You pick, dear; you know whats best. In todays clinics and dispensing practices, patients are much more likely to arrive with their own pre-conceived ideas of whats best. Armed with facts and figures gleaned from an Internet search, chat room conversations or special interest magazines, they (and/or their children, significant others, etc.) have expectations of the power of technology, but may not understand its limitations.
It is the practitioners role to guide the patient (and the patients family) to achieving the most successful fitting appropriate to that particular patients hearing loss, hearing challenges and lifestyle. Product knowledge, of course, is key. Just as patients are smarter and more discerning, so must practitioners be aware of the latest technologies and their applications. What are the features in one brand that may be applicable to Patient A, but inappropriate for Patient B? Only a trained practitioner can offer the knowledge and insight to make that assessment and guide the patient to the best amplification decision.
Patients arent the only ones who benefit from todays computer technology. Manufacturers are making available to practitioners software packages that do more than just program hearing instruments. An example of this is the Beltone AVETM, a system in which patients can listen to realistic sound scenarios through their hearing instruments, necessary adjustments can be made on the spot, and the patient can provide instant feedback about how that adjustment is perceived. Practitioners also benefit from the instant availability of information via the Internet in the form of websites, professional chat rooms, on-line magazines and email with colleagues.
It is important, however, in the flush of technology, not to forget the true value of the practitioners role in patient carethe personal attention and professional expertise the practitioner offers the patient. Its easy to assume the new technology can do everything for the patient: All it takes is to plug in the hearing aid, adjust it with a few clicks and all problems are solved! In fact, relying on the click-and-go method of hearing instrument problem solving can exacerbate the problem, instead of relieving it.
For example, if a patient complains that his/her voice sounds hollow (due to occlusion), its easy enough to reduce the low frequency gain. Still occluded? Bleed out more of the lows. When the patient then says that all sounds are now muffled, is it a defective instrument? Bad programming? No, it may be that the patient needed more venting to reduce the occlusion effect. Relying only on the programming without understanding the underlying cause of the problem (in this case the acoustic effects of occluding the ear canal), can be a disservice to patients.
In other cases, the patient complaint may be the result of unrealistic expectations. If the patient has vague complaints of everything is too noisy and loud, its a simple matter to cut the gain, increase the compression ratio and otherwise manipulate the circuit parameters. But does this really address the problem? A little probing might be in order to understand when and where sounds are noisy and loud. Might it be that the patient is experiencing his/her auditory environment accurately for the first time in many years? Only a skilled practitioner, who practices the art as well as the science of hearing instrument fittings, can make that determination. The most powerful fitting software is still limited because it lacks that personal connectiona connection only the practitioner can provide.
With manufacturers continually releasing new products and software to fit hearing instruments, and patients independently acquiring competing (and sometimes contradictory) information, its understandable for practitioners to feel they are caught in the middle. In actuality, all three players in this drama have interconnecting and equally important roles, and a common goal. Just as the manufacturer cannot stay in business unless instruments are ordered, the dispensing professionals office will not be in business long if patients are not successful with their rehabilitation plan, and patients will not benefit if the practitioner and manufacturer cannot work together. The hearing instrument manufacturer, the practitioner and the patient are all beneficiaries of properly fit hearing instruments. All parties have an equal stake in the patients ongoing satisfaction.
The science of fitting hearing instruments is progressing by leaps and bounds. Smart practitioners maintain their art by keeping their technical knowledge up to date, providing appropriate counseling when necessary, and strengthening their role as the product-to-patient connection.
1. Meskan ME & Robinson JL: A patient-focused approach to fitting hearing instruments. Hearing Review 2000; 7 (12): 52-55.
Diane M. Russ, MA, is manager of audiological services and Deb VanDeVelde, MS, is product manager at Beltone Electronics Corp. Correspondence can be addressed to HR or Diane M. Russ, Beltone Electronics Corp., 4201 W. Victoria St., Chicago, IL 60646; email: [email protected].