I’ve fixed Audiogram Creator the and the graph images are now displaying properly. I think this has been broken for a few weeks but I never noticed until today. Sorry about that. I’m thinking that the Creator might be due an overhaul so if you use it and would like anything added or changed then please leave a comment or drop me a line and I might include it.

I’ve written before that I think that hearing aid vendors need to split the product from the service so I decided to try and breakdown a hearing aid’s price a bit to find out if it is too expensive or not.

I did a bit of Googling and found that an average price for a top of the range hearing aid in the UK is about £1500. This is the rough ballpark for new models from all manufacturers.

How much would you guess that a hearing aid costs to make? I’m guessing too because I’ve never been able to find out the true cost of the physical product (despite a lot of asking!). An iPod costs around £200 to buy and, like a hearing aid, is packed full of amazing technology. Lets factor in that hearing aids are smaller and that smaller components are presumably more expensive. Lets say a hearing aid costs £500 to make.

So if a vendor is selling the product and the service combined then you are paying £1000 for the service. What’s in that service? You’ll need a hearing test, a fitting and probably a few further visits for re-programming to get things right. You also get a warranty for a number of years, which covers repairs and re-programming. A visit to an audiologist is usually an hour long session. How much is an hour of time worth? It costs me £50 per hour to get my car repaired so lets say £70 an hour. A test, fitting + three more visits = £350. That leaves £650, for the warranty and vendor profit. No idea what manufacturers or repair shops charge for repair but I guess that £650 could get eaten up pretty quick if you have a few problems with your aid.

That doesn’t seem completely unreasonable at first glance, but that £1500 is for one hearing aid; if you need two aids then the numbers start to look a bit more unreasonable. £3000 purchase price: £1000 for hearing aids and £2000 for the service. We aren’t doubling the number of visits needed for fitting or re-programming but a fault under warranty is twice as likely.

My main problem with combining product and service is that people will use different amounts of service. Some people will never use their warranty and only need one re-programming and others will take forever to get the programming right and have faults. People should pay for what they need and no more. When I take my car to the garage I pay for the work done, not a flat fee – people have different problems, different situations and different requirements. What if I don’t want a warranty longer than the manufacturer’s one?

A £3000 purchase is not an easy one for most people. It’s going to mean getting into some debt or going without something else; it’s a big decision. I think splitting the product from the service would reduce the upfront cost massively and make a purchase a much easier decision.

Maybe my numbers above are way off and, to be honest, I think £500 to make a hearing aid is an over-estimate. What do you think? Any comments on hearing aid prices and the way they are sold?

I posted this last week. There’s a comment on that post from Alison in which she says that hearing aid batteries have always been free in the UK – so I decided to check it out because I have always paid for mine!

I phoned the ENT department of my local hospital and asked them if I could get batteries from the NHS even though I had bought my aids privately. The answer? No. Fair enough, I suppose, but I don’t see why I shouldn’t be able to get some? Maybe its a cost issue for the NHS but as a tax-paying UK citizen who is illegable for other NHS treatments, it seems a bit odd to turn me down for some batteries? Ah, well….

It was a visit to my GP surgery that started this free battery hunt off, I’m still waiting to hear back from them as to whether they will supply me with batteries – I may get some luck there but I doubt it as they will be getting them through the NHS too.

australiahears.com.au have an excellent article by Elaine Saunders called: Why is an audiogram commonly used as the basis for fitting a hearing aid?

It explains how audiograms works and how they measures your hearing loss against a benchmark rather than your hearing ability. It also gives a brief history of measuring and diagnosing hearing loss. What’s most interesting though is this snippet:“… a threshold measure of hearing loss is used to estimate how a hearing aid should be set up to work at normal speech and noise levels. It’s not very logical.”

It’s an interesting point, I always understood the audiogram to be the focal point of a hearing aid fitting. I always thought that the result of the audiogram determined my aids settings and I would be more or less ready to wear them after that. I’ve always had the audiologist tweak or change my settings a bit but I just assumed that maybe I was being a bit picky or maybe my hearing loss was a bit unusual or something.

I used to think of a hearing test and resulting audiogram as being a bit like a vision test when I go for new glasses: have the test, get the prescription, pick a make and model and away you go. But Elaine’s article made me realise that really the two are very, very different.

Read the original article on australiahears.com.au

Unitron introduced their Flex:trial hearing aid in October 2012 and it looks set to make the hearing aid buying process a little less painful.

Everyone knows that hearing aids are expensive and people looking to buy are often put off by the big outlay. There has always been a problem with being able to try before you buy: you feel uneasy about handing over your money when you haven’t tried the aid properly and you aren’t  sure if you really want it – and the dispenser can’t give you the hearing aid to try without a payment in case you walk off with it and are never seen again. Stalemate.

Unitron’s Flex:trial fixes this problem: it is essentially time-limited hearing aid. The Flex:trial model allows dispensers to give you a risk-free trial – you don’t have to pay up-front and they aren’t risking giving away a free hearing aid. A dispenser can program the Flex:trial to operate for a fixed length of time – as that time nears its end the aid will beep at you to let you know your trial is nearly over, first it will beep every hour as a gentle warning, progressing up to beeping every minute.

The Flex:trial is a fully-functioning unit. It is exactly the same as the unit you would purchase if you decided to keep it after the trial – the limitation is the time, not features. If you like the trial model then what you buy should be exactly the same.

Dispensers can also configure the aid to operate as any of the models in the Flex:trial line – so you can demo the cheaper offering, then demo the more expensive offering. This is a brilliant way of comparing the features of each model and will go a long way to helping you choose what works for you. I’ve been in numerous situations with dispensers where I’ve been offered several models and when I say, “Well, why is this one £800 more than that one? What do I get for my £800?”, they can’t answer with specifics, they can just say that it works better and I could hear more. Whilst that is probably true it’s not enough information for me to part with £800. But with the Flex:trial you are free to make the comparison yourself.

I really like this idea of a demo unit, in fact, I wrote about it back in 2009! As far as I know the Flex:trial is the first of its sort to hit the market but I’m sure other manufacturers will follow suit at some point because it’s a great idea.

If you try out a Flex:trial then please drop me a line, I’d love to know how you get on with it.

Yes they are. No they’re not. Yes they are. No they’re definitely not.

Siemens have decided to hold on to their audiology division. To reinforce their desire to push forward their hearing aid business, they’ve appointed a new CEO in Roger Radke. A quote from them:

“With this nomination, we hope to reinforce our activities in the domain of hearing aids, especially with the solid experience and vast network that Roger Radke obtained when he worked in the audiology branch of Siemens,” says the group. Stefan Schaller will have new responsibilities within the firm. “We are currently facing several major challenges,” explained Herman Requardt, CEO of Siemens’ Healthcare Sector. “The market has become more and more difficult. It is consolidating more and more. The economic models of our competitors and our clients change. You know that for the past several months we have examined how to better manage this situation and how to lead our audiology activity to success. We considered all the options and, in this context, we examined offers from investors and from other companies. Now, we will again concentrate on our traditional forces and work to recover our market share with new and attractive products, excellent customer service, investment growth and new partnerships.”

A team of scientists from Sheffield University have partially restored the hearing of deaf gerbils with injections created from human embryonic stem cells. Is this the end for hearing aids?

Not just yet.

The Sheffield team, lead by Dr Marcelo Rivolta, saw the gerbil’s hearing improving by an average of 46% – with the improvement taking place over four weeks from the injections. Rivolta said, “We developed a method to drive human embryonic stem cells to produce both hair cells and neurons, or nerve cells, but we only transplanted the neurons. We then used a technique called auditory brainstem evoked responses (ABR), which measures if the brain can perceive an electrical signal after sound stimulation. The responses of the treated animals were substantially better than those untreated, although the range of improvement was broad. Some subjects did very well, while in others recovery was poor”.

The type of hearing loss that was treated in the gerbils was very similar to auditory neuropathy, which means roughly 15% of those with hearing loss could benefit this work. Auditory neuropathy is a type of deafness where the problem lies, not primarily with the hair cells, but in the connection of the hair cells with the brain. Patients can be born with it and there are cases due to a genetic defect where a few responsible genes have already been identified.

Which means, as I understand it, if you have noise-induced hearing loss, age-related hearing loss or sensorineural hearing loss then this treatment would not work for you.

Dr Rivolta is hopeful that if tests on gerbils continue to produce good results and are shown to be safe then human trials could start in as little as two years.

Apple have filed a patent application for a “hearing aid social network” – you can read the actual application here. This has only recently been submitted (July 29 2012) and there isn’t much other information around the web on what a hearing aid social network could actually be – although Engadget and –>Megan have also written about it.

The social network seems to be intending to offer its users the ability to share their hearing aid settings with other network members and allow a member’s hearing aid to be updated with “at least some of the information passed between members“.

The idea is that if members of the social network are near to each other – for example, both in a noisy coffee shop – then their Apple device and hearing aid can automatically connect to the other network member and share information about optimal settings for the coffee shop environment.

But it doesn’t stop there, I haven’t read the whole patent as it’s big, but here’s interesting snippet I did notice:

In one embodiment, a number of different HA profiles can be available based upon, for example, the acoustics of the immediate surroundings of the hearing aid user. For example, a first HA profile can be used for processing external audio emanating from a generally quiet background environment such as a library, whereas a second HA profile can be used to process external audio emanating from a noisy environment such as a rock concert. In one embodiment, the hearing aid wearer can use an image capture device, such a camera, included in a portable device, such as a smartphone, to capture an image of the immediate surroundings. The captured image can then be used to estimate an acoustic environment based upon, for example, the nature of the immediate surroundings (indoor, outdoor, for example) and, if indoor, the dimensions of the room in which the hearing aid wearer is located.

Wow! This could well mean that our future hearing aids could continuously learn optimal settings for specificenvironments. We already have generic settings for music, restaurants, etc that we can have customised to our own preference – is Apple crowd-sourcing data on the best settings for your favourite restaurant? Think about that, you don’t have a generic setting for all restaurants, you have a specific setting for the Starbucks on your street!

Today’s smartphones are all location aware so this is definitely possible. I think my mind has just been blown.

As far as I know there’s been no official word from Apple about this network – they are notorious for keeping quiet on new products and then revealing all in a blaze of glory – so I’m really just guessing based on the legal-speak from the patent. But it is certainly exciting and a game-changer for the hearing industry. Looks like the disruption is here already.

A couple of things that I’m dying to find out more about:

1. How will this work with an individual’s hearing loss? My hearing loss is nothing like yours and so our hearing aids are programmed for our losses – so any automatic location-aware programme changes need to take that into account.
2. It’s easy to see how a setting for specific restaurant could be better than a generic setting for all restaurants, but: how will that be better than a smart digital aid automatically adjusting to its environment? Maybe this is aimed at low-cost hardware with the software running on an Apple iOS device rather than in your ear?
3. If one hearing aid learns the best settings for an environment and passes it onto other members of the social network then why can’t those other member’s hearing aids just learnt he optimal settings too without having to receive them over the network?

Whatever this turns out to be it is guaranteed to be ground-breaking and an industry-changer. Can’t wait!

In the forthcoming iOS 6 software upgrade for the iPhone, Apple have have said that:

We are working with top manufacturers to introduce Made for iPhone hearing aids that will deliver a power-efficient, high-quality digital audio experience.

It would be nice if this meant the birth of an Apple iHearingAid, which blazed a trail through the hearing industry and took hearing aids into the mainstream. Sadly, the reality is a little less exciting, but still very useful: Apple is working with hearing aid manufacturers to make sure hearing aid wearers get the best possible sound quality when using their iPhone – presumably manufacturers/aids that pass this QA test will be able to display a “Made For iPhone” badge.

How are they working to make a “power-efficient, high-quality digital audio experience”? My guess is that Apple will either create a neckloop to allow bluetooth connectivity to iPhones – the iNeck! – or they will do away with the neckloop altogether and provide a small plugin device  that goes into the iPhone power port to allow bluetooth connections. It would be a major advance on what we have at the moment if they did away with the neckloop. Apple will presumably be asking the manufactures to implement their single bluetooth connectivity protocol in order to get the “Made for iPhone” stamp.

I guess this would also open up the possibility of an iPhone app to allow you to change volume, switch programmes and make other changes to your aid. Some manufacturers already have these control apps, and indeed most manufacturers offer bluetooth connectivity, but this will be the first time that devices from different manufacturers could be controlled using a single device.

What’s your take on the Apple hearing aid announcement? With this and the social network, it looks like Apple have one eye firmly on the hearing industry.

Earmeter is web-based software that allows audiology practices and their patients to work more closely during and after hearing aid trials.

Practices can automate communications with patients so that they can provide timely and in-depth information about the new hearing aid(s) on trial, hearing loss and anything else that a patient needs to know to get the most from their trial and new hearing experience. Earmeter aims to make it easier for practices to provide all the information that they know their patients need but can’t cram into a one-hour consultation.

A critical part of any hearing aid trial is the feedback from the patient, Earmeter helps with that too.

Practices can set up questions for the patient to answer during the trial. Questions can be asked once on a specific day of the trial or they can be asked multiple times at different intervals. For example, “You’ve had your hearing aids for a week now, are you able to listen more easily to the TV than you did last week?” could be asked on day 7 of the trial and, “Did you struggle to hear anyone talking today?” could be asked every day, every two days or twice a week. Patients are given a username/password by the dispenser/audiologist and can login to Earmeter from any PC or device, once logged-in they get a set of questions to answer for that day. Earmeter tracks how many and how often patients are logging in and answering and keeps a running total – this allows practices to monitor a patient’s progress and also means that they can offer incentives for a completed set of questions during a trial.

Why I built Earmeter

I built Earmeter in the last 6 months of 2011. My aim was to make the process of buying and trialling a new hearing as simple as possible, for both the seller and the buyer. The seller wants happy customers and the buyer wants the best chance of hearing everything they want to hear. I hope Earmeter can make that happen.