We Must Be More than the Device
Calvin Staples, MSc, will be selecting some of the more interesting blogs from HearingHealthMatters.org which now has almost a half a million hits each month. This blog is the most well read and best respected in the hearing health care industry and Calvin will make a regular selection of some of the best entries for his column, Other People’s Ideas.
As we know the hearing health care industry and the role of the audiologist has changed drastically in the past 5−10 years. As a result of these changes, I have begun to wonder what hearing health care will look like in 2020. In reflecting on my own practice and my own clinical and career ambitions I am reminded of CAA 2010 in Montreal. Dr. Richard Gans, the keynote speaker of the 2010 conference left us all with some valuable questions and self-reflection; to paraphrase one of Gans’ key messages at the CAA conference − “we must be more than the device.” I have a strong opinion that if the practice of audiology continues to focus almost exclusively on hearing aid sales and service than the future of the profession may come into question. Hearing aid sales and service are definitely a key part of the audiology profession and we need to improve this area drastically too, but there appears to be a gap between the study and practice. The non-hearing aid training appears to be left in student clinic and lecture halls. I must confess here that I love working with patients with hearing impairments and maximizing the performance of hearing aids to optimally serve them, but I think audiology or audiologists simply need to do more. The simplest answer may be that audiologist, through practice, push to close this gap to ensure future of audiology reflects the developmental work of its past. The blogs this month are all directed in some fashion towards what we may see in the distant tomorrow.
A recent study out of Switzerland essentially posed the question “How much impact does a specialty vestibular clinic have on the correct diagnosis and effective management of patients complaining of dizziness or vertigo?” They attempted to answer this question by looking at the suspected diagnosis made by the referring Primary Care Physician (PCP), and comparing it to the final diagnosis made after undergoing specialty examination. As the director of a specialty vestibular clinic, the results did not surprise me, but I think some health care management types might want to pay attention to this study.
The first group addresses those referred with “unclear dizziness.” Close to 70% of patients entering the specialty clinic were classified as “unclear dizziness.” After specialty examination, only about 10 to 12% remained unclear. I will help with the math. That means 88% to 90% of patients referred to the specialty clinic left with a firm diagnosis. I think we all agree that treatment is more effective when you know what you are treating. This might be a good time to mention that studies reviewing the effectiveness of performing cranial CT Scans or cranial MRI’s on dizzy patients report that they help provide a firm diagnosis somewhere between less than 1% and almost 4%, respectively.
The authors make the valid point that the 70% classified as “unclear dizziness” most likely do not represent the general population, as those with clear diagnosis at the PCP level are less likely to be referred for specialty examination. This author (me) makes the equally valid point (I think) that the take home message is that the specialty clinic could provide a firm diagnosis in about 90% of patients seen.
Soundhawk, a high-tech start-up company with an impressive pedigree, began taking advance orders last week on its web site for a $279 “smart listening system.” According to Soundhawk’s founder, Rodney Perkins, MD, an otologist at Stanford University School of Medicine and founder of the California Ear Institute, the new system “is the culmination of a lifetime of hard work in the hearing sciences to bring a life-changing device to the mass market that has the potential to fundamentally improve the lives of hundreds of millions of people.”
While extravagant assertions from a company’s chairman are nothing new, Perkins’s track record as founder of numerous hearing health companies, including ReSound, which quickly grew into one of the world’s “big six” hearing aid companies, gives his words added credence. So does the $11.2 million in venture capital that the Silicon Valley-based company has attracted since its establishment a few years ago.
Although the Soundhawk system is designed to help people hear better, the company emphasizes that it is not a hearing aid and is not intended to be used as a substitute for hearing aids. The distinction is important, in part, because if it were a hearing aid, Soundhawk would have to comply with Food and Drug Administration (FDA) regulations and the product would have to be dispensed through licensed professionals rather than marketed directly to consumers via the Internet or retail stores, as the company plans.
However, as Michael Kisch, the company’s CEO, pointed out in a June 27 interview with Hearing News Watch, the Soundhawk is different from hearing aids in a number of ways.
For one thing, said Kisch, a former executive at Cisco Systems, “It is intended strictly for situational hearing, say to converse in a noisy restaurant.” Soundhawk anticipates that buyers will use it for only two to four hours a day, and its battery needs recharging after only about eight hours of use. That is in contrast with hearing aids, which are generally intended for much greater daily use and have batteries that last for days.
Drew Dundas, PhD, chief scientific officer at Soundhawk who also spoke to this blog, said, “We are not anti-hearing aid.” He added that there is no reason for his company to have “an adversarial relationship” with audiologists and hearing aid specialists.
Indeed, the former director of audiology at the University of California at San Francisco said that the Soundhawk “is a potential boon” for hearing aid providers. He explained, if hearing professionals recommend it to someone who doesn’t feel his present hearing loss justifies a $4000 hearing aid, two or three years down the road if his hearing worsens, the person may remember the audiologist who told him about Soundhawk.
ABOUT THE SYSTEM
While audiologists and dispensers who do fit FDA-regulated hearing aids may reject Soundhawk’s claim that it is not competing for the same market, the new product’s design is very different from that of typical hearing aids.
The system includes the “scoop,” a rather conspicuous earpiece; a wireless microphone; and a free smartphone app. This patented app uses dozens of algorithms to filter, mute, amplify, or otherwise alter sound. The user moves a finger across his smartphone screen to adjust the sound to a level where he can hear what he wants and and isn’t distracted by ambient noise.
The scoop uses adaptive audio processing to enhance key sound frequencies while reducing background noise. It connects wirelessly to a smart phone or tablet, allowing the user to talk hands-free and directly access Siri or Google Now by voice to place calls, search for places of interest, get weather updates, etc.
When it is placed near the source of a sound the user wants to hear, the system’s wireless mic delivers clear sound to the scoop in even noisy environments.
The Soundhawk system also comes with a portable charging case that can recharge both the scoop and wireless mic twice before having to be plugged back into a wall outlet.
COMING TO MARKET THIS SUMMER
Although Soundhawk began taking orders on June 24 for its “smart listening system” at an introductory rate of $279, the product will not actually become available until later this summer, when the price will increase to $299.