Tele-Audiology

 

Harmony Hearing’s Remote Care

Harmony Hearing’s Remote Care (Tele-Audiology)

 

With Harmony Hearing’s Remote Care (Tele-Audiology) you can have effective hearing services anywhere!

 

Using the phone, internet and specifically designed Apps we can provide our hearing services remotely. Now you don’t have to attend in person to receive personalised hearing services.

You really don’t have to be tech savvy to enjoy the great benefits of our Remote Care services. They are made for easy use and we enjoy showing you how.

Services Harmony Hearing can provide you remotely:

  • Home hearing test (2 Types)
  • Hearing aid programming and Adjustments (Real World & Real Time)
  • Hearing aid coaching in use and management (Video chat & demo’s)
  • Routine follow up consultations
  • Tinnitus treatment & counselling
  • Auditory training as part of rehabilitation

3 Ways to Consult Your Audiologist: There a several ways you can have a remote consultation with your Audiologist.

Via –

 

  1. Phone Call: You can make a time to have a phone consultation with your Audiologist.
  2. Video Call: You can have a video call with your Audiologist using most video call applications including Zoom, Skype and Facetime. Simply line up a time. Having the visual cues of a video call really helps ease of communication especially for people with hearing loss.
  3. Applications (Apps): Most leading hearing aids brands provide an App that can be downloaded to your smart phone or tablet that embeds a video call facility, In-Situ hearing test and hearing aid programming.

 

 

Great Benefits of Harmony’s Remote Care

Harmony Remote Services provides numerous benefits:

  • Convenience: Easy, quick access to appointments is the comfort & safety of your own home or anywhere. No need to commute into a busy clinic. This saves the hassles and expense of having to drive in, park and wait in the clinic for your appointment. You are not isolated by distance or due to immobility from illness, frailty or injury. You still receive face to face communication (via video chat if desired).
  • Safe: Why risk attending a public clinic visited by many people from all walks of life when you don’t have to? Remote Care maintains safe social distancing and you still keep in touch.
  • Real World Programming Your hearing aids are programmed in your ‘real world’ environments. Whether that’s at home, the workplace or an environment of your choosing. Traditionally hearing aids are programmed in a clinician’s quiet office and you just have to hope that the adjustments translate to real world benefit. Now you can talk with those around you and immediately see whether any adjustment has made an improvement.
  • Real Time Programming: Relay feedback immediately to your Audiologist to guide further fine tuning. This saves a lot of back and forth frustration. It enables us to more accurately and efficiently set the hearing aids just right for you in your places of communication.
  • Cost Efficient – Save Time, Energy & Money As well as reduce the costs and time associated with having to attend a clinic in person our efficient Remote Care service enables us to offer some of the most competitive hearing aid prices in Australia. We are globally competitive.
  • Timely access to quality services. Research is showing that Tele-Audiology services delivered remotely are just as those in traditional in-person consultations. You are afforded more frequent & timely access to our care. This is great for individuals with fluctuating hearing loss. as timing is everything.

4 Easy Steps to Great Hearing

The flow of our Remote Care Hearing Rehabilitation program usually follows this sequence of steps. We like to include around 3- 4 appointments to really ensure you are getting great benefits from your hearing aid investment.

  1. Initial ConsultationFREE (Appointment 1)
  2. Hearing Test (Appointment 2 or Email us your Audiogram)

Hearing Aids are Programmed & Shipped (If indicated)

  1. Remote Fine Tuning & Coaching (Appointment 3)
  2. Follow Up Reviews (Appointment 4 +)

Remote Hearing Care Model

Initial Consultation (Free)

We can have an initial consultation via phone call or live video chat. This is opportunity to learn about your hearing, communication needs, preferences and unique lifestyle. We like to document some hearing and communication goals so that if we take a course of action we can look back at these goals and gauge your level of improvement and plan next steps. If you don’t already have fairly recent hearing test results (Audiogram) we recommend having a test. You can have a hearing test at home in one of the following two ways.

 

Home Hearing Test (2 Options)

Option 1. Remote Hearing Test Kit.

We register mail you our Remote Testing Kit. Upon receiving the kit, you can complete either the automated hearing test or an assisted test. This is an accurate and clinically validated method of obtaining all your necessary test results.

Steps:

  1. Remote Video Otoscopy: You are guided to place a probe in your ear with a fitted tip that has a light and small camera mounted to the tip. This takes a photo or brief video of your ear canals and ear drums (tympanic membranes). It is an important first step to make sure your ear canals are free from wax and debris that could affect your hearing test results.

We may advise you to have the debris removed first before moving on to test your hearing levels. An excellent feature of the video Otoscope is that it has a form of artificial intelligence AI and photo library that helps us analyse the photos of your ear canals. Your Audiologist can quickly & easily classify and ear disease if present.  We can then make a recommendation whether treatment is required first or if we can continue on to conduct the Audiometric testing.

Remote Audiometric Testing: You can either complete an automated hearing test or one that we assist you remotely. We obtain your air conduction hearing thresholds across a full frequency range and then move on to directly test your inner ear using bone conduction testing (assisted). We also perform a speech discrimination test.

Results Discussion & recommendations

Our web based system enables us to receive your results in real time. We explain the results in easy to understand terms and discuss follow up recommendations. This can be done on the phone or by video chat on iPad used for the testing.

Shipping of the equipment:

We ship the equipment by registered express mail so it typically arrives within 3 days within Australia and within 7 days globally. Upon completion of the testing you return it to us via the enclosed mail satchel. We take ID/credit card details just as security and track postage to protect the movements of this valuable equipment.

Cost: We charge $130 for this hearing test method and postage costs are included within Australia. The following diagram illustrates the process.

Note: Requested Permission to use this illustration, but they said unfortunately No! So we need to redevelop an illustration like this (previously mentioned this)

 

 

Option 2: In-situ Audiometry (Senso-gram)

Another effective way we can test your hearing is using the very hearing aids we intend to fit. The hearing aids themselves to produce the test tones in your ears. We remotely measure your responses to the test tones and record the very softest tones you can hear on a graph called a Sensogram. It is similar to an Audiogram.

In-Situ Audiometry is an accurate way of testing your hearing for the purpose of hearing aid programming for the following reasons:

  1. There’s no ear coupling volume difference. When your hearing is tested at a hearing clinic, the tones are presented through either head-phones which have a large volume when coupled to your ears or insert earphones with a smaller volume when coupled to the ears. Either way there is coupling to the ear volume differences compared to the way the hearing aid is coupled to your ears. This coupling volume difference introduces inaccuracies or a degree of hearing threshold measurement error.

 

  1. No differences due to intentional or un-intentional sound leakage.

 

  1. Unique resistance (impedance) of the individual’s middle ear system to sound at different frequencies.

 

  1. Associated resonances with the use of ear mould tubes. These are some of the variables that can contribute to changes in the Sound Pressure Level (SPL) in the ear canal.

 

A traditional diagnostic hearing test is important for diagnosing the nature of the hearing loss and identifying underlying ear health conditions. Whereas In-situ Audiometry or a Senso-gram is better for hearing aid fittings as there are no electro-acoustic discrepancies. The very acoustic coupling of the hearing aid/s to the ear delivers the test tones and then the directly calculated amplification.

Alternatively:

Email Us Your Hearing Test: You can book in for a hearing test at a local hearing clinic and most G.P. medical centres (usually air conduction audiometry). Request in advance a take home copy of your hearing test results or Audiogram. The fee may range from about $90 to $140 for a full hearing test. Then simply scan and email it to us.

Link to Form (with File Attachment option)

6 Main Hearing Aid Brands Remote Support Apps:

  1. Oticon Remote Care: Oticons “Remote Care” App is one of the most user friendly and effective on the market. It works with both Apple iOS and Android devices. It embeds a video call function and enables remote programming and fine tuning of Oticon hearing aids. Unfortunately, it locks certain features such as their feedback manager and In-situ audiometry.

 

  1. Phonak Remote Support: The MyPhonak App enables Phonak’s “Remote Support” which is quite versatile. It also embeds a quality video call facility and enables In-situ Audiometry to obtain a senso-gram for hearing aid programming.
  2. Resound Assist: This is a form of what’s called asynchronous Remote care where you use the Resound Smart 3D App to complete a series of questions as to how you’d like your hearing aids adjusted. Your request is sent to the Audiologist who is notified of your request. They then make the adjustments using their software and send you the adjustments you can then choose to upload to your hearing aid via the App. One of the benefits is you don’t have to make an appointment, but the changes do not occur in real time (hence asynchronous).

 

  1. Signia Remote Support: The Signia App embeds live video calls and live hearing aid adjustments. It supports all Signia X and Nx hearing aid models.

 

  1. Starkey Remote Care: Using the Starkey Thrive App enables real time hearing aid programming and includes live video call. It is compatible with both Apple iOS and Android devices. It is available to all styles of Livio Edge AI, Livio AI and Livio hearing aid models.

Initial Hearing Aid Programming & Configuration

Once we have obtained your hearing test results we can configure your hearing aids with the appropriate acoustic coupling (domes & speaker units). If you would like custom fitting ear moulds you would need to mail us your ear impressions. We generally find the right size and type of rubber dome that is acoustically suitable for your hearing

We’ll then program the hearing aids to your hearing levels using manufacturer recommended prescription.  After all their years of research and refinement this prescription is quite accurate, acoustically comfortable and beneficial. However, when possible it is good to attend a clinic in person to have Real Ear Measurement (REM) verification performed. This may identify if some fine tuning is required. The best verification is how much benefit you get in terms of improved speech clarity.

Real World, Real Time: Fine Tuning & Coaching

Upon receiving your hearing aids with maintenance kit, we can make an appointment to fine tune the hearing aids as needed and coach you through the use and management of them. This is where live video chat is helpful as we can show you with demonstrations management methods and techniques. In adjusting your hearing aids using the internet and the hearing aid app you can immediately check whether an improvement has occurred in your environment. We encourage you to talk with others in your space, listen to the TV or radio. You can then relay feedback to us immediately to guide further fine tuning. This is the best way to program and fine tune hearing aids in your “real world” settings and in “real time”. Gone are the days of having them adjusted in a clinician’s quiet office and just having to hope for the best that it works “out there” for you.

Follow Up Reviews:

Approximately 2 to 4 weeks after some fine tuning we like to have another appointment with you to follow up. This can be conducted by phone Call, video Chat or via the Hearing Aid App video chat. We review the goals we discussed at the initial consultation and learn about your experience in using the hearing aids. We can then perform any fine-tuning adjustments and even increment up the adaptation level if you’re ready. We can see how it sounds. We can also review your management and troubleshoot any concerns you have. It is approximately at this point you can decide whether you are happy with the outcome and want to keep the hearing aids, whether you would like to try and alternative or whether you’d prefer to return the hearing aids and be refunded. In any case, we like to work with you to reach the best outcomes possible. That is why we call the trial period a satisfaction guarantee. So, with remote hearing aid fittings even though you pay for them in advance you are assured of a full no quibble refund should you decide not to keep the hearing aids.

Facilitating Adaptation:

With any new hearing aid fitting there’s a phase of adaptation or acclimatisation where your brain has to get used to the quality of the new sound and making use of the new auditory information. We are working with the plasticity of the brain helping reinforce existing neural pathways and even stimulating new neural pathways. This takes time! It can take a number of months to fully acclimatise to the amplification and we rarely set the hearing aids at their full prescription in the first fitting. This is why having a number of follow up appointments is important so we can increment the amplification up to the full prescription as you comfortably acclimatise. What I mean by full prescription is the full level of amplification recommended for your hearing levels across the frequency range that maximises your ability to hear speech. Due to individual differences, there’s no fixed time frame to get you to your full prescription and this is generally gauged at the follow up appointments on a case by case basis. The follow up appointments also afford us more opportunity to check your usage, coach you in hearing aid management and troubleshoot any concerns you have.

The sound quality can seem strange at first even a little unnatural. Not what you have been used to for a long time. If like most people, you have hearing loss mainly in the higher frequency ranges having all the high frequency content back can sound quite trebly or a little “metallic or tinny.” I routinely counsel my clients that this is normal and settles down over time. A lot of people notice it especially in their own voices that sound a little sibilant or “ss-ei” Most people find after about two weeks this has settled right down and their own voice is more comfortable.

Aftercare Packages or Pay Per Appointment

You can choose from one of our three excellent value aftercare packages to ensure you have the support and guidance that best suits your needs and budget (link to Service packages). Or, you may prefer just to pay per remote care appointment for which we charge $150 per one hour appointment