In the near future, most computer software in the hearing care field will require 32-bit operating systems. This article describes the benefits of these systems, factors that might lead hearing care professionals to choose one operating platform over another and the benefits that can be ascribed to the new networking capabilities of the 32-bit systems.

Computer technology is an integral part of the hearing health care industry’s ability to program hearing instruments, perform diagnostic testing and manage patient data. As new software and networking technologies become available, it is important to understand what these advances can do for you and your practice. The following article presents information on:

  • Operating Systems: Currently Microsoft has five 32-bit operating systems on the market. This causes one to wonder if Microsoft is producing new operating systems to make more money, or do the new operating systems lend real value to the specific needs of business users? And, if so, which operating system is the correct choice for your hearing health care office?
  • Networking: Many offices in the hearing health care industry have decided to network their office or may be considering a network system. NOAH 3 and other applications have been designed to take advantage of new network technologies available in 32-bit operating systems.

Which Computer Operating System is Right for You?

It is difficult to tell how many offices have made the switch to a 32-bit operating system such as Windows 95 or 98. Some hearing care professionals (mostly in hospitals and other large organizations) have even decided to implement Windows NT or 2000. If you still have a computer that is using Windows 3.11, you will need to upgrade to a 32-bit operating system soon, because, increasingly, software choices on the 3.11 platform will be limited. 

What is all the hype regarding 32-bits about? Essentially, there are four main advantages to 32-bit systems:

  1. Better Stability: Programs running on the system will be better protected from errors caused by other programs.
  2. Multitasking: The operating system provides the ability for many different programs to run simultaneously.
  3. Better User Interface: Using functions within the operating system and software applications are more logical and easier to operate.
  4. Better Development Tools: This feature may not mean much to the average hearing care professional, but it certainly does to the companies who develop the software that are used in diagnostic, fitting and verification programs. Development tools are software applications used to build the programs. The new 32-bit development tools allow programmers to make better applications, and to produce the software faster and at a lower cost.

Features of the 32-bit Operating Systems

Currently, Microsoft has five operating systems on the market: Windows 95, 98, Me (Millennium Edition), NT 4.0 and 2000. Although these systems may act and look very similar, there are some important differences. For reasons identified below, these five systems can be divided into two groups: 1) Windows 95, Windows 98 and Windows Me, and 2) Windows NT 4.0 and Windows 2000.

Windows 95, 98, and Me Advantages:

  • Easy for the user to install, configure and maintain.
  • Compared to NT or 2000, there are more 95 and 98 installations throughout the industry. Because these operating systems are more prevalent, there are more support technicians and consultants trained to lend operating system help in the event of a problem.
  • Fairly easy network setup. Provides for a network in which you can share files and run shared applications, such as NOAH or other hearing-related software, in your office.

Windows NT 4.0 and 2000 Advantages:

  • More stable operating systems. When properly configured, these operating systems are very resistant to the whole system locking up if an application crashes or an unexpected error occurs.
  • Better security options. These operating systems provide the ability to setup a more robust set of security levels, which may be important for certain hospitals, clinics, etc.
  • More advanced networking options. 
  • Optimized to run in a “distributed” network environment in which networked applications can split the workload between many different computers.

Windows 95/98/Me are defined by Microsoft to be the preferred operating systems for home users, while NT and 2000 are the preferred operating systems for business users. Does this mean that you should not choose Windows 95, 98 or Me as the operating systems for your practice? Absolutely not! The decision to determine the appropriate operating system for your office should be made by the computer technician in your office or a computer consultant that understands your entire computer needs. Generally, the choice hinges on the size, needs and budget (NT and 2000 cost more and may require a consultant to help set it up) of your facility. Some of the items that are important to consider during this process are:

  1. How many computers are present in your office?
  2. Are you running a network?
  3. Has the overall experience with your current operating systems been good?
  4. If you choose a more advanced operating system, such as NT or 2000, will you have somebody to help with support when a critical issue arises?

More details on the features of different Windows operating systems can be found on Microsoft’s web site,

Advances in Networking

With new versions of Microsoft operating systems come advances in network design. These advances in technology promise to help the hearing health care industry run applications in a network setting with better stability (reducing the chance of a “crash”). To understand these improvements, it is important first to understand how networks typically run today and then compare how they will run in the near future using 32-bit platforms.

To better explain networking concepts consider the following comparison between paper-based file systems and computer-based file systems. Let’s imagine that an end user is working in an office with five hearing care professionals, and all of the patient files are stored in one common file room. To keep things more organized, the office has hired an assistant who delivers files as needed to users so that work can be done, and then the assistant returns the files to the file room when the work has been completed.

Today, the most common way an application, such as NOAH 2, is configured in a network is referred to as a File-Server setup. The “File-Server” can be thought of as the office assistant bringing the patient files to your desk. Let’s say that you are sitting in your office and would like to retrieve a patient’s file. In a File-Server application (Fig. 1), you would request the file from your office assistant. The office assistant would then dutifully go into the file room, grab all of the files in the drawers (yes, all of them), wheel them into your office, and set them on your desk. The assistant would then smile nicely and pull out the file requested, placing it in front of you, whereupon he/she would then return the remaining files to the file room.

Seems like a lot of extra work just to get one file, doesn’t it? But this is how most current network applications work. Thankfully, computers are very fast. Therefore, the work is done so quickly that we do not notice the difference. Sometimes networks can get overwhelmed with activity and become slow or unstable. Just imagine five testing rooms in which the office assistant is running back and forth between all the different rooms. There might be times when the office assistant is overwhelmed with requests and, as a result, you have to wait. Or, as a result of being overworked, the office assistant may drop some files on the floor or decide to take a break and “reboot” in the break room. 

The new concept of networking in Microsoft’s 32-bit operating systems is called Multitier Architecture, and NOAH 3 is designed to take advantage of this new technology. The term “Multitier” means that the work is being distributed on many different levels. In other words, the work is shared between many computers in the network. In a Multitier application (Fig. 2), all of the database work (i.e., file sorting) is performed on the server and only the requested data is sent to the workstation. 

Going back to the previous example, our scenario will change a bit. In a Multitier network application, you would pick up the phone in your office and call your office assistant, requesting a patient’s file. Instead of bringing back all of the office’s files to your desk, the assistant would pull only the requested file while in the file room and bring it to your desk. So, as the office assistant runs between all of the different rooms in your office, serving all the different requests, he/she can move much faster because there is only one file to carry. Now that the office assistant has less work to do, he/she is less likely to drop files or go on break.

At first glance, this advancement may not seem like a big improvement, but keep in mind that, in any given network, there may be many software applications running across that network simultaneously. Each application running on the network adds to the network traffic. Running a Multitiered software application across the network will help ensure that the entire network remains stable for all users.

Will the new 32-bit operating systems, combined with new software applications like NOAH 3.0, guarantee that your computer system will never freeze up or “crash” again? In truth, no. However, the new systems will be more stable and permit a greater variety of useful features (and flexible interfaces) to be incorporated into the programs with the intention of bringing computer-driven audiological activities to a new level of performance.

Why is NOAH Upgrading to 3.0?

The NOAH System, developed by the Hearing Instrument Manufacturers Software Assn. (HIMSA), is designed specifically for the hearing care field, and is designed to provide dispensing professionals with a unified system for performing client-related tasks. The heart of NOAH is its “integration framework,” supported by over 70 hearing care companies worldwide.

With NOAH, it is possible to measure a client’s hearing loss—with audiograms, speech tests or loudness scaling, for example—using a tool from one supplier. The results are then passed automatically to the common database for use by any of several fitting systems from other suppliers. One can also use NOAH to record journal notes regarding the client session.

What are the primary differences between versions 2.0 and 3.0? NOAH System 3.0 has been rebuilt from the ground up for more effective data processing, improved database stability and greater overall performance. For example, users will now be able to: 

  • Minimize, maximize, resize and move NOAH windows;
  • Display multiple windows—for example, an audiogram module and a fitting module—side-by-side;
  • Display the complete list of clients stored in the system database and search through client information based on many different variables, from birth date to hearing instrument type;
  • Display client session information in three “tree-structure” views for more efficient handling of session data;
  • Record hearing evaluation results with the system’s improved audiogram module, called NOAHaud.
  • Import and export client data more easily.

NOAH’s new interface is designed to be more intuitive and easy to use, making client and session handling easier. A wide range of new customization features allow the hearing care professional to configure the system in a way that makes sense to them and their office/computer set-up.
More information on NOAH 3.0 can be found on HIMSA’s website at

Correspondence can be addressed to HR or Scott Peterson, HIMSA, 2550 University Ave. West, St. 241N, St. Paul, MN 55114; email: [email protected].