INCREASING PATIENT SATISFACTION WITH WIRELESS TECHNOLOGY. Rena Appleby, Au.D.

Transcription

1 INCREASING PATIENT SATISFACTION WITH WIRELESS TECHNOLOGY Rena Appleby, Au.D.

2 AGENDA How satisfied are hearing aids users? What is wireless technology Accessories Future Forecast Q&A

3 CE CREDIT INFORMATION

4 HOW SATISFIED ARE HEARING AID USERS AND WHY DOES IT MATTER? 18.6 % return aids-of those 49 % report returning aids because of problems w/background noise (Kochkin, 2010).

5 CUSTOMER SATISFACTION WITH HEARING AIDS IN VARIOUS LISTENING SITUATIONS HEARING AIDS ARE <= 4 YEARS OLD One-on-one Small groups T.V Outdoors Leisure activities Listening to music Car While shopping Restaurant Place of worship Percent Very satisfied Satisfied Somewhat satisfied Neutral Dissatisfied Kochkin, MarkeTrack VIII

6 Satisfaction with HA benefit SATISFACTION WITH BENEFIT IS HIGHLY DEPENDENT ON THE NUMBER OF LISTENING SITUATIONS HEARING AIDS WORK AND SOMEWHAT SATISFIED IS HARDLY AN ENDORSEMENT Very Dissatisfied Dissatisfied Somewhat dissatisfied Neutral 23 Somewhat satisfied 31 Satisfied 64 Very satisfied % listening situations satisfied or very satisfied Kochkin, MarkeTrack VIII

7 % of HA owners WHY IS SATISFACTION IN MULTIPLE LISTENING ENVIRONMENTS SO IMPORTANT? IT IS HIGHLY RELATED TO BRAND REPURCHASE AND POSITIVE WORD OF MOUTH ADVERTISING None Percent of 19 listening situations Recommend hearing aids Would repurchase HA brand Kochkin, MarkeTrack VIII

8 WHAT WOULD IT TAKE FOR HEARING AID NON- ADOPTERS TO PURCHASE HEARING AIDS? 39.3% of individuals with moderate-severe hearing loss would be highly motivated to adopt hearing aids if they could hear soft sounds and 34.2% would be highly motivated to purchase hearing aids if the hearing aids worked perfectly on the phone. MarkeTrak VIII: The key influencing factors in hearing aid purchase intent, kochkin 2012

9 IN SUMMARY THE SURVEY DATA SHOWS US Clinicians have the potential to reduce hearing aid returns by addressing hearing in noise problems. Clinicians can directly impact hearing aid user brand repurchase and positive word of mouth advertising by improving hearing aid satisfaction in multiple listening environments. Clinicians can turn non-hearing aid adopters into hearing aid users by offering a product that would make soft sounds audible and make telephone use seamless. Digital Wireless hearing aid technology can make all of these goals achievable

10 WHAT IS WIRELESS TECHNOLOGY? Electronic products and systems that interact by using electromagnetic energy, to carry information between them, so they can communicate with each other. Electromagnetic energy involves 2 things w/hearing aids: 1. Signal (acoustic) or information 2. Means to carry the information from one place to another

11 HOW DOES WIRELESS TECHNOLOGY WORK WITH HEARING AIDS? Electromagnetic information can be carried via analog or digital technology. 1. Analog technology transmits signals through electronic pulses: o Telecoils o FM systems

12 ANALOG WIRELESS TECHNOLOGY 1. Telecoil (t-coil)- Improves S/N ratio and listening in multiple sound environments that have an inductive loop installed Advantages: Signal is received directly by the hearing aid user s instrument s, low cost. Disadvantages: Requires inductive loop.

13 ANALOG WIRELESS TECHNOLOGY 2. FM system-using radio waves, the FM system sends speech signal(s) to the listener, who wears a FM receiver Advantages: Long range transmission, easy to install Disadvantages: Requires additional hardware be connected to hearing aid, prone to electrical interference

14 HOW DOES WIRELESS TECHNOLOGY WORK WITH HEARING AIDS? 2. Digital technology uses a binary code of 0 s and 1 s to represent the signal. Offers additional functionality including: o Communication between ears o Synchronized volume control/pushbutton o Enhanced signal processing o Communication with Bluetooth Electronics so that sound can be streamed directly into the hearing aids from cell phones, TV s, ipods etc.

15 WHAT DOES BLUETOOTH HAVE TO DO WITH DIGITAL WIRELESS HEARING AID TECHNOLOGY AND HOW DOES IT WORK? Bluetooth is a digital wireless communications technology which enables electronic devices to talk to one another without having to use wires or cables. Bluetooth got its start in 1998 when several companies collaborated on a way to get their products to communicate with one another. Electronic devices that use Bluetooth have a small computer chip that contains the Bluetooth radio and some software that allows the user to connect one product or device to another without having to use cables ( The devices communicate wirelessly through short range networks (personal area networks up to 164 feet) that are automatically established when Bluetooth-capable devices come within range of one another and make a connection.

16 DO HEARING AIDS COMMUNICATE DIRECTLY USING BLUETOOTH TECHNOLOGY? There are currently around 12,000 different products using the proprietary Bluetooth 2.4 GHz open protocol, which means that communication protocols for Bluetooth must be broad and flexible enough to accommodate many uses which results in high power consumption. Bluetooth is simply not feasible for direct implementation in hearing instruments due to its power consumption. The current drain is so high that if Bluetooth were in a hearing aid with a size 10 battery, it would last about 1-2 hours. (Kuk, 2010).

17 TO FACILITATE DIGITAL WIRELESS HEARING AID COMMUNICATION WITH BLUETOOTH TECHNOLOGY Hearing aids currently communicate in one of three different ways: to 15-MHz near-field magnetic induction (NFMI) GHz industrial scientific medical band (2.4 GHz-ISM) MHz industrial scientific medical band (900 MHz-ISM) Differences in the three types will effect: How data is transmitted How the end user interfaces with the desired technology

18 HOW DOES NEAR FIELD MAGNETIC INDUCTION (NFMI) WORK? NFMI uses an inductive loop, which is similar to a telecoil, for short range communication (device to device) and to the intermediary device, which is often worn around the neck. The intermediary device (neck loop, Gateway device) then acts as a go-between for the hearing instruments and the Bluetooth-enabled electronic equipment.

19 WIRELESS SYSTEMS BASED ON NFMI COMBINED WITH BLUETOOTH (RF) OR PROPRIETARY RF Most hearing instruments that use an intermediary device for streaming use a Bluetooth-based system called Advanced Audio Distribution Profile (A2DP ). The latency for this protocol exceeds 40 milliseconds, and is commonly up to 125 milliseconds depending on the audio compression technique that is used.

20 NFMI + ACCESSORY USE Advantages: NFMI has a strong short range signal, low battery consumption and is easy to implement. Disadvantages: Requires an intermediary device in order to stream from Bluetooth electronics. Lip synch/echo issues when streamed sound is combined with amplified sound when watching TV for devices using a Bluetooth-based system (A2DP).

21 HOW DO WIRELESS SYSTEMS USING PROPRIETARY 900 MHZ RF AND 2.4 GHZ RF WORK? For 2.4 GHz and 900 MHz wireless systems, an antenna located in the hearing instrument itself is used to communicate between ears and to communicate with Bluetooth electronics. A proprietary streaming device is used to connect to electronic equipment. Built-in antenna

22 WIRELESS SYSTEMS BASED ON PROPRIETARY RADIO FREQUENCIES (RF)USING 900 MHz AND 2.4GHz (RF) A/D Coding (proxímity) Radio 2.4 GHz 900 MHz/US 868 MHz/EU Radio The radio frequency is used for direct communication between the accessory and hearing instruments

23 2.4 GHZ ADVANTAGES/DISADVANTAGES Advantages: Does not require a Gateway Device, low latency (processing delay) so no echo problems and no lip synchronization, world wide applicable and multiple hearing instruments can be paired to one accessory. Disadvantages: Higher battery consumption. Requires an adaptor to stream from Bluetooth electronics. Requires a specially designed antenna.

24 HI info HI info HI info HI Info 2.4 GHZ IS CONGESTED-AVOIDING THE TRAFFIC THROUGH FREQUENCY HOPPING Channel Bluetooth Wireless keyboard Wireless mouse Wireless network Time

25 900 MHZ ADVANTAGES/DISADVANTAGES Advantages: Does not require a Gateway Device, low latency (processing delay) so no echo problems and no lip synchronization, multiple hearing instruments can be paired to one accessory. Disadvantages: Requires an adaptor to stream from Bluetooth electronics. Requires a specially designed antenna. 900 MHz RF not applicable worldwide.

26 ISM BANDWIDTH ISM bandwidth is defined by the ITU-R (International Telecommunications Union) for radio communication

27 WIRELESS ACCESSORIES/APPLICATIONS

28 ACCESSORY: PHONE Talking on your cell phone gets easier with wireless technology. Using a Bluetooth adaptor or gateway device, the sound from the Bluetooth phone is sent to the hearing aids, turning them into a hands-free headset. Benefits: Can receive signal binaurally Telephone placement on ear is no longer an issue No concern for feedback

29 ACCESSORY: TV/STEREO Wireless technology offers a clear connection, so hearing aid users can watch TV at the same volume level as everyone else. Even when in a noisy room, hearing aid users will have an advantage for TV listening. When using a Bluetooth adaptor or gateway device, the signal from the TV will be streamed and sent to the hearing instruments.

30 BLUETOOTH AUDIO DELAY 18 ms 64 ms 120 ms Original signal Echo threshold Lip sync threshold Time delay

31 ACCESSORY: REMOTE MICROPHONE Remote microphone is worn by friend, spouse, speaker or placed near or connected via cable to TV etc. Sound is streamed directly into hearing instruments. Significant improvement in S/N ratio Makes far-field sounds audible

32 DISTANCE EFFECTS Adaptive directional SRT Remote mic SRT Remote Mic + HI mic SRT Dantale II w/speech weighted noise using HATS (head and torso simulator

33 ACCESSORY: REMOTE CONTROL Enables hearing instrument users, even those with dexterity issues, to easily make volume/program changes. Enables hearing instrument users to manage accessories more easily. Enables hearing instrument users to make volume changes even when hearing aids do not have a physical volume control on them.

34 ADDITIONAL WIRELESS APPLICATIONS: Connectivity and programming Synchronized volume control and pushbutton Enhanced signal processing Using wireless capability to make a feature work better/provide better benefit Binaural processing Using exchange of data to do any or all of the following: Maximize speech audibility Maintain listening comfort Facilitate spatial hearing

35 HEARING AID SURVEY-WIRELESS ACCESSORIES Hearing healthcare professionals Country Completed Surveys U.S. 150 France 152 Germany 152 Total 454 Market research (Groth & Anthonsen, Hearing Review, June, 2010)

36 % accessories purchased HEARING AID SURVEY FINDINGS WIRELESS ACCESSORIES 75% 60% Accessories were included in less than 30% of fittings of HI with wireless features 45% 30% 15% 39% 34% 30% 18% 31% 28% 29% 26% 27% 27% 24% 16% 27% 15% 11% 7% Total US. France Germany 0% Remote control Cell Phone connectivity device TV sound streaming Other Type of accessory

37 % wireless/non-wireless HEARING AID SURVEY FINDINGS WIRELESS ACCESSORIES 30% 27% 25% 21% 20% 18% 15% 14% 12% 15% 11% 14% 12% 12% 12% 12% 11% Total (WL) Total (non-wl) 10% 9% 5% 0% Younger than 55 years of age years years years years years Older than 80 years Hearing aid user age

38 GOOD NEWS: 70% of dispensers report that end-users fit with hearing aids with wireless features are more satisfied than those fit without wireless features. Dispensers report rate of returns or follow up for end-users fit with hearing aids with wireless features to be no worse than those fit with nonwireless technology.

39 WIRELESS DIGITAL TECHNOLOGY ACCOMPLISHES THE FOLLOWING GOALS. Reduces hearing aid returns by addressing hearing in noise problems. Device-to-device communication, remote mic, remote control Increase hearing aid user brand repurchase and positive word of mouth advertising by improving hearing aid satisfaction in multiple listening environments. Telephone/TV streaming, remote control, remote mic, device-to device communication Increase hearing aid adoption rate by making soft sounds audible and make telephone use seamless. Remote mic, device-to-device communication, telephone streamer (bilateral)

40 FUTURE PREDICTIONS FOR WIRELESS HEARING AIDS

41 FUTURE INNOVATIONS DIRECT HEARING AID COMPATIBILITY WITH APPLE IPHONE According to Apple insider, Apple is working with hearing-aid manufacturers to introduce Made for iphone hearing aids, which will be compatible with ios 6 and work with iphone 4S. Submitted Apple patents for hearing aids: 1. iphone or ipad receives live voice, converts it into computer-generated speech and then sends the signal back to a hearing aid, with the ability to modify frequency or speed. 2. iphone is able to detect a sound such as a doorbell and send an audible indicator to the hearing aids. 3, iphone can be used to remotely update the settings on a hearing aid and save different configured profiles for specific circumstances. (

42 THE FUTURE: Bluetooth will eventually make its way into hearing aids in a low energy (BLE) format called Bluetooth 4.0. Devices using Bluetooth 4.0 would consume a fraction of the power of classic Bluetooth-enabled products. Low latency delays and offers up to 50 meters wireless connectivity.

43 WHAT DOES THE FUTURE HOLD FOR WIRELESS HEARING AID USERS? Direct connection from the hearing aid to Bluetoothenabled electronics Direct connection to the Internet Instead of a telecoil, direct connection to sound systems in theatres

44 QUESTIONS

45 THANK YOU FOR ATTENDING! To be eligible for CE credit Be sure to get your CE page from your directory hole-punched as you exit! Rena Appleby These presentations slides will be available at ihsinfo.org