At the ReSound Online Symposium, Hillary Snapp, Assistant Professor at the University of Miami Ear Institute, delivered a presentation on Incorporating Wireless Technology into the Busy Clinic. Below are the highlights from her presentation.
Why Incorporate Wireless Technology?
We all share common goals for our patients:
– Increase access to sound
– Improve speech understanding in quiet
– Improve speech understanding in noise
– Provide comfort with listening in multiple listening environments
– Provide good overall sound quality
The typical hearing impaired patient experiences decreased audibility and clarity and the goal is to improve speech intelligibility in quiet and in noise for better communication. With wireless technology, the signal of interest is brought directly to the ear and can overcome significant background noise and large distances. It can solve three of the most commonly reported complaints: listening in noise, success on the phone and clarity with watching TV.
Evidence Base for Wireless Application
•> 1 million PTs do not use their HAs due to poor benefit, comfort, poor performance in noise (Kochkin, 2010)
•At best, directional mics provide 4-5 dB improvement (Compton-Conley et al., 2004)
•Significant improvement in SNR and speech understanding for use with phone (Picou & Ricketts, 2010)
•Previous FM technology – low acceptance due to cost, difficulty with use, etc. (McArdle et al., 2005)
•Improved technology and better delivery methods could improve PT acceptance (Kricos, 2006)
Candidates for Wireless Technology
•Not just for the young and tech savvy
•Advancements have actually simplified device management
•Older patients can benefit from the ease of use
•Provides accessibility to otherwise challenging listening situations
•Can aid those with physical limitations
•May be most important for those elderly individuals who rely on TV and Phone to stay connected
•Wireless technology should be considered for all hearing aid users
•Communication needs vary by individual and should be assessed during identification and selection process
•When a significant handicap is reported and patient needs cannot be fully addressed by HAs alone, wireless accessories may provide the added benefit for successful outcomes
–Wireless accessories should match the needs identified during prefit subjective measure
The optimal candidate is one who demonstrates increased SNR loss on objective speech-in-noise measures and reports a significant communication handicap
–Should be addressed during initial counseling
–Establish realistic expectations for HA benefit
–Patient should be counseled on accessory options for increased benefit
Incorporating Wireless Technology into your Clinic
•76% of patients with above average success are fit within 1 – 2 visits
•Only 1/3 of clinics are using verification and validation
•Incorporating verification and validation measures into the fitting not only improves patient satisfaction but reduces visits by one half million!
Developing a clinically feasible protocol:
You want to ensure that from start to finish you are following evidence based practices to ensure that when the time comes to introduce the patients to wireless accessory options, they are already in an optimal fitting.
Widely accepted key components include:
–Comprehensive audiologic assessment including speech-in-noise measures
–Selection of appropriate ear level devices
–Subjective assessment of initial disability and perceived handicap
–Establish realistic expectations
–Electrocacoustic measures
–Fitting using Real Ear Measures
–Fine tuning
–Post treatment validation
Using an evidence based approach to your evaluation and fitting can actually make your practice more efficient, reducing the number of visits and increasing patient satisfaction.