Preserving the Role of the Audiologist in a Clinical Technology, Consumer Channel, Clinical Service Model of Hearing Healthcare

Abstract

The past decade has been characterized by significant changes in the distribution and sale of hearing aids. Alternatives to the clinical technology, clinical channel, clinical service (i.e., traditional) hearing healthcare delivery model have been driven by growth in hearing aid dispensaries housed in large retail establishments and direct-to-consumer hearing aid sales by internet-based companies unaffiliated with major hearing aid manufacturers (e.g., Eargo). These developments have been accompanied by acceleration in the growth of teleaudiology services as a direct result of the COVID-19 pandemic. The resulting development of nontraditional hearing aid distribution and sales models can be categorized into distinct archetypes as reviewed earlier in this publication. This article will review the Clinical Technology–Consumer Channel–Clinical Service model as exemplified by Jabra Enhance. We will describe a completely digital model of hearing aid distribution and sales that maintains the professional service component throughout the client journey to include an online tone test, the use of a risk mitigation questionnaire, virtual consultations, remote hearing aid adjustments, and the establishment and monitoring of client-centered treatment goals. Furthermore, this article will review the Jabra Enhance model within the context of consumer healthcare decision-making theory with a focus on the Consumer Decision-Making Model.

Keywords

hearing aids - teleaudiology - online hearing test - Consumer Decision-Making Model

Publikationsverlauf

Artikel online veröffentlicht:
14. Juni 2023

• References

• 1 Powers TA, Rogin CM. MarkeTrak 10: hearing aids in an era of disruption and DTC/OTC devices. Hearing Review. 2019; 26 (08) 12-20
• 2 President's Council of Advisors on Science and Technology. Aging America & Hearing Loss: Imperative of Improved Hearing Technologies (Letter Report to the President). Washington, DC: Executive Office of the President; 2015
• 3 National Academies of Sciences, Engineering, and Medicine. Hearing Health Care for Adults: Priorities for Improving Access and Affordability. Washington, DC The National Academies Press 2016
• 4 Bennett RJ, Meyer CJ, Eikelboom RH. How do hearing aid owners acquire hearing aid management skills?. J Am Acad Audiol 2019; 30 (06) 516-532
• 5 Bennett RJ, Donaldson S, Kelsall-Foreman I. et al. Addressing emotional and psychological problems associated with hearing loss: perspective of consumer and community representatives. Am J Audiol 2021; 30 (04) 1130-1138
• 6 Bennett RJ, Barr C, Cortis A. et al. Audiological approaches to address the psychosocial needs of adults with hearing loss: perceived benefit and likelihood of use. Int J Audiol 2021; 60 (Suppl. 02) 12-19
• 7 Abu-Ghanem S, Handzel O, Ness L, Ben-Artzi-Blima M, Fait-Ghelbendorf K, Himmelfarb M. Smartphone-based audiometric test for screening hearing loss in the elderly. Eur Arch Otorhinolaryngol 2016; 273 (02) 333-339
• 8 Barczik J, Serpanos YC. Accuracy of smartphone self-hearing test applications across frequencies and earphone styles in adults. Am J Audiol 2018; 27 (04) 570-580
• 9 Sandström J, Swanepoel W, Carel Myburgh H, Laurent C. Smartphone threshold audiometry in underserved primary health-care contexts. Int J Audiol 2016; 55 (04) 232-238
• 10 Corona AP, Ferrite S, Bright T, Polack S. Validity of hearing screening using hearTest smartphone-based audiometry: performance evaluation of different response modes. Int J Audiol 2020; 59 (09) 666-673
• 11 Kleindienst SJ, Dhar S, Nielsen DW. et al. Identifying and prioritizing diseases important for detection in adult hearing Health Care. Am J Audiol 2016; 25 (03) 224-231
• 12 Kleindienst SJ, Zapala DA, Nielsen DW. et al. Development and initial validation of a consumer questionnaire to predict the presence of ear disease. JAMA Otolaryngol Head Neck Surg 2017; 143 (10) 983-989 [ Erratum in: JAMA Otolaryngol]
• 13 Klyn NAM, Kleindienst Robler S, Bogle J. et al. CEDRA: a tool to help consumers assess risk for ear disease. Ear Hear 2019; 40 (06) 1261-1266
• 14 Dillon H, James A, Ginis J. Client Oriented Scale of Improvement (COSI) and its relationship to several other measures of benefit and satisfaction provided by hearing aids. J Am Acad Audiol 1997; 8 (01) 27-43
• 15 Abrams HB, Chisolm TH, McManus M, McArdle R. Initial-fit approach versus verified prescription: comparing self-perceived hearing aid benefit. J Am Acad Audiol 2012; 23 (10) 768-778
• 16 Valente M, Oeding K, Brockmeyer A, Smith S, Kallogjeri D. Differences in word and phoneme recognition in quiet, sentence recognition in noise, and subjective outcomes between manufacturer first-fit and hearing aids programmed to NAL-NL2 using real-ear measures. J Am Acad Audiol 2018; 29 (08) 706-721
• 17 Boothroyd A, Mackersie C. A “Goldilocks” approach to hearing-aid self-fitting: user interactions. Am J Audiol 2017; 26 (3S): 430-435
• 18 Mackersie C, Boothroyd A, Lithgow A. A “goldilocks” approach to hearing aid self-fitting: ear-canal output and speech intelligibility index. Ear Hear 2019; 40 (01) 107-115
• 19 Sabin AT, Van Tasell DJ, Rabinowitz B, Dhar S. Validation of a self-fitting method for over-the-counter hearing aids. Trends Hear 2020; 24: 2331216519900589
• 20 Groth J. An innovative RIE with microphone in the ear lets users “hear with their own ears.”. Can Audiol 2022;7(5). Accessed April 15, 2022 at: https://canadianaudiologist.ca/resound-feature-2/
• 21 Folkeard P, Pumford J, Abbasalipour P, Willis N, Scollie S. A comparison of automated real-ear and traditional hearing aid fitting methods. Hearing Review. 2018; 25 (11) 28-32
• 22 Denys S, Latzel M, Francart T, Wouters J. A preliminary investigation into hearing aid fitting based on automated real-ear measurements integrated in the fitting software: test-retest reliability, matching accuracy and perceptual outcomes. Int J Audiol 2019; 58 (03) 132-140
• 23 Powers TA, Carr K. MarkeTrak 2022: navigating the changing landscape of hearing healthcare. HearRev 2022; 29 (05) 12-17
• 24 Customer Guru. Top promotor score benchmarks for top brands. Accessed July 8, 2022 at: https://customer.guru/net-promoter-score/top-brands
• 25 Healthcare consumerism 2018: an update on the journey. McKinsey & Company. Published July 9, 2018. Accessed April 14, 2022 at: https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/healthcare-consumerism-2018
• 26 How COVID-19 has changed the way US consumers think about healthcare. McKinsey & Company. Published June 4, 2021. Accessed April 14, 2022 at: https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/how-covid-19-has-changed-the-way-us-consumers-think-about-healthcare
• 27 McCormack A, Fortnum H. Why do people fitted with hearing aids not wear them?. Int J Audiol 2013; 52 (05) 360-368
• 28 Jenstad L, Moon J. Systematic review of barriers and facilitators to hearing aid uptake in older adults. Audiology Res 2011; 1 (01) e25
• 29 Knudsen LV, Oberg M, Nielsen C, Naylor G, Kramer SE. Factors influencing help seeking, hearing aid uptake, hearing aid use and satisfaction with hearing aids: a review of the literature. Trends Amplif 2010; 14 (03) 127-154
• 30 Kochkin S. MarkeTrak VIII: the efficacy of hearing aids in achieving compensation equity in the workplace. Hear J 2010; 63 (10) 19-24 , 26, 28
• 31 Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol 1992; 47 (09) 1102-1114
• 32 Manchaiah VK. Health behavior change in hearing healthcare: a discussion paper. Audiology Res 2012; 2 (01) e4
• 33 Laplante-Lévesque A, Hickson L, Worrall L. Stages of change in adults with acquired hearing impairment seeking help for the first time: application of the transtheoretical model in audiologic rehabilitation. Ear Hear 2013; 34 (04) 447-457
• 34 Laplante-Lévesque A, Brännström KJ, Ingo E, Andersson G, Lunner T. Stages of change in adults who have failed an online hearing screening. Ear Hear 2015; 36 (01) 92-101
• 35 Amlani AM. Application of the consumer decision-making model to hearing aid adoption in first-time users. Semin Hear 2016; 37 (02) 103-119
• 36 Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ Q 1988; 15 (02) 175-183
• 37 Saunders GH, Frederick MT, Silverman SC, Nielsen C, Laplante-Lévesque A. Health behavior theories as predictors of hearing-aid uptake and outcomes. Int J Audiol 2016; 55 (3, Suppl 3): S59-S68
• 38 Saunders GH, Frederick MT, Silverman S, Papesh M. Application of the health belief model: development of the hearing beliefs questionnaire (HBQ) and its associations with hearing health behaviors. Int J Audiol 2013; 52 (08) 558-567
• 39 Rosenstock IM, Kirscht JP. The health belief model and personal health behavior. Health Educ Monogr 1974; 2: 470-473
• 40 Blackwell RD, Miniard PW, Engel JF. Consumer Behavior. Fort Worth, TX: Harcourt Brace College; 2001
• 41 Gordon D, Ford A, Triedman N, Hart K, Perlis R. Health care consumer shopping behaviors and sentiment: qualitative study. J Particip Med 2020; 12 (02) e13924