Making Informed Decisions: How NALguide is Helping Demystify Hearing Aid Technology for Consumers

foreign [Music] everybody and welcome to another episode of this week in hearing I am pumped to be joined today by two great doctors coming from Australia at the national Acoustics laboratory down there I have uh Paola and I have Ulrich so thank you to you so much for coming on today do you want to give a little bit longer uh background and introduction of yourselves how long you've been working at Nao and what you two are working on right now I'll kick it over to you sure uh well thanks so much for having us um so my name is Paula kitrick uh I'm the head of audiological Sciences here at uh Nal I've been uh now since late 2021 uh where I joined from a previous academic position in the UK and really you know my role at now um is not only to have the privilege to lead a fantastic Department of research audiologists that work on Mouse studies day to day but also to look after and plan our adult hearing loss strategy and one of the key things that you know we're always focused on with our research on adult hearing losses you know what are the things that either we can create or we can evaluate that can lead to real world solutions that can help people who are either supporting those who might have hearing difficulties those who might be thinking that they might be interested in um seeking a solution or some help with their hearing um and so you know what we're going to talk about today sort of really squarely falls into the type of work that you know we really get excited about it now we're able to get something out there to people um so with that I'll hand over to my colleague um my name's Paula and I'm a senior research audiologist who's been it now for uh since 2009 and again like barric my I guess the important Focus for me is looking at outcomes improving outcomes for people with lived experience of hearing loss and some of my research centers around um for example optimizing devices prescribing electric and acoustic stimulation in same and different ears by modal hybrid to improve outcomes I was uh empowerment in the hearing Health journey of which knowledge is quite an important um important ingredient of that so it fits in beautifully with the Now guide and finally the the I guess the big area for me now is focusing on uh supporting the Australian government Department of Health and aged care and a lot of the questions they want in research to be involved in of which this is where the nail guide stem from that's awesome okay so the the bulk of the conversation today will pertain to the Now guide um so let's just kind of go back to the Genesis of this um you know I that's interesting that you know some of this derives from your work with uh with the Australian government um and and you know the public uh Public Health sphere there um so just kind of give us a background in a in some insight into how this came to be and what the overarching intentions of it is yeah sure um so as Paula said actually the the Genesis of the Nile guide was actually a request from the um Australian government Department of Health and aged care um now we work very closely with them uh and and they support our work um uh because we're funded by the Australian government um and they come to us from time to time with key policy questions where they might need a bit of research on or they need us to help advise uh this was a slightly different case where they came to us and said you know we are providing hearing services to millions of people across Australia through the government-funded hearing programs but we still have real concerns that it's actually quite difficult not just for people who are accessing hearing services but for anybody in the public to really sort of detode the information out there about what hearing devices do what are the differences between different devices and the request from us is you know help us try to sort of demystify and decode hearing devices for your average person on the street because you know this wasn't about um you know something that only gets given to somebody who walks into a hearing service center for example yeah this is about saying yeah they were worried that you know the family members of those who might support somebody um to seek help about a hearing loss or just even the very fact that people will go looking for information and sort of get lost in a sea of terminology and different words and different terms and different you know meanings and and different ways of talking about hearing technology so they came to us and said hey can you help us with this and of course we said yes yes you know this is exactly the type of work that we love to do and so we step back and we really thought okay how are we going to do this um because you know we had several sort of design goals from the very start in in sort of how we went about this so the first thing that we were thinking of is that whatever we create you know we probably want to create something that's really nicely structured it's easy to digest so you know anybody could just pick it up without much background knowledge and and really understand it and the second thing was that you know we didn't want to have to create something that would then need to be updated every few months right if we get something out there um you know if you explain the major features of cars or phones or any other bit of technology that we use in our life sure it changes over time but you know we don't want to have consumers to have to get lost in a sea of terms that have to be updated every three months or six months um we really obviously wanted to make a consumer friendly avoid technical jargon and a key thing that will come on and talk about it about how we went about creating it is we didn't want it to be related to any manufacturer so it had to be manufacturer agnostic is the way we call it but basically you know it's not about trying to um you know use term terms that only some manufacturers use and then probably one of the key things that you know we wanted to incorporate is how can we link the features of these devices to actually what people care about which is you don't go thinking about what do I want in the device you think what do I need help with right what is it that I would like a device to do for me to linking those two things so that was the sort of Genesis of the project it started off with a request to say hey can you give us information we can put on our government website to help all consumers in Australia and then we really took it from there and as Paula will bring you through you know once we have that basic guide we then did a lot more work to really turn it into something that we hope will be useful around the world so maybe father do you want to comment on maybe the process we want yeah to create literally so um over quite a brief period of three months a team with nine researchers that included engineers audiologists and behavioral insights Specialists really got together and we uh we got together and just decided on a process and it was essentially a five-stage sort of process whereby we first had to it was we started with scoping so we first really had to identify the manufacturers that were going to be relevant the product lines and the devices and then we took it to the next phase which was extracting and decoding that sort of information so really identifying the features in these devices and their underpinning technology as well as intended purpose so Gathering all that information and then we actually took all of that information and we grouped it and mapped those into uh feature families so basically we took the features and said what's their intended performance what is their actual what are they saying this does so what we then did was uh what we called a mapping phase which was where we grouped features by their intended perform moments in effect and then we arrange them into feature families so that we could then take that into the next phase which was description and creating this generic description of these feature families and features that were really simple accessible to digest and focusing really on the intended purpose of it and listening goals and then I think the most important part was really the then taking that lexicon or glossary of features and actually going to both our consumers going to manufacturers and also to clinicians and getting them to look at it review it and feed it back so it was really this iterative process that we worked through where we we presented redesigned based on feedback and I think that was really what gave it it's my it was the really critical part because of that involvement with all our key stakeholders and resulting in what you have today which is a simple guide and it has both the high level sort of aspect to it but if you want to dig in if you're interested in more information you can also scan the QR code and dive in and get deeper information about it so it has various levels for different people and how much information they want to absorb and assimilate into knowledge and then take that guide potentially to your clinician your hearing Healthcare specialist and have a conversation and really focus on what are my needs what's my daily life like and activities what sounds are important what goals are important and then have that confidence to discuss it with your your audiologist for example yeah there's a couple comments here I I think that um you know that I noticed when I looked at it the first time one of the things that stood out to me right away that that it is brand agnostic I thought that was pretty interesting and and I think it's important um to have like um an objective sort of non-biased or even being perceived in any way by the consumer as there being like a slant to it um and I I think that you know this whole idea of speaking you know kind of almost reverse engineering of why a lot of these different features exist which um you know this this whole show is is kind of geared toward the Professionals in the industry and so I think we all can relate to this fact that we kind of almost get lost in um the fact that we live and breathe this world and so we kind of forget why some of these different features exist so I love that that you're kind of going back at why these matter to people and what kinds of benefits that they would provide and so I think that you know it ties into a broader theme that I think we're seeing like everywhere now which is this more educated consumer patient um there's so much information online but you know kind of the challenge that that can present is that it's uh you know like paralysis by too much information and so it's really important I think to have dedicated resources that help to distill everything down in a way that feels like you're just sort of getting the the essentials and you're really understanding it so that you feel empowered as a consumer just like you said that you can then go have maybe it's a more meaningful a more worthwhile meeting with the healthcare provider that you know you're kind of saying like here are the things that matter most to me and uh you know I think we can maybe dovetail that into the different sections that you have because I noticed there's about six different sections in the guide so maybe you want to talk a little bit about that of how you decided to compartmentalize it the way that you did why you did the categories and the way that you did so um let's go into that part of it yeah no absolutely um and just before we jump into that I just want to agree with what you said and one of the things that we sort of kicked around as we were developing the guide is you know one of the purposes is that we really want to turn the consumer into someone who is really opinionated about what technologies they want for their needs and I feel like with lots of other areas of technology these days you know we've been we've got very good at that you know we we handle very sophisticated devices like mobile phones at lots of features and we all sort of are pretty clear on the bits that we really want is that the camera is at the size of the screen is that this is a that you know connectivity and and so I think that's one of the key things with this is that we we want it to make sure that the consumer is walking in and saying look I already understand the basic features of these devices and the different types of features and based on my needs I think I need this I think I need that let's have a conversation about it and what we also hope that does is you know we recognize that one of the challenges for audiologists and dispensers of hearing aids is also that there is such a breadth of technology and levels of devices and also that relates to pricing as well sometimes depending on the funding model so it's really challenging to have these conversations and and and and figure out you know how do I get the best for the consumer and make sure that the technology is what's going to meet their needs and they understand the difference between all these devices so I think the more that they can come in really feeling like they've had an opportunity to digest some of that information the better and that's sort of I like I like to call it prehabilitation or pre-conditioning like we do that for lots of things surgery so let's start talking prehabilitation and get people thinking about it before coming in yeah no that's absolutely right I mean assessment and that's exactly why we sort of organize the features the way we did to get back to your questions so as Paula sort of described you know we sort of did a bottom-up approach where we went out and we looked at all of the various features across all the major manufacturers all the major product lines and in that we included both the low level sort of lower levels of technology devices and the absolute premium higher level of technology devices and you know one of the challenges as you do that is even as professionals working in the field you know it's actually quite difficult to figure out what some of the features really are right so it's so even we realized how difficult it is and so as we started to decode them we had this problem which is well how do we group these features like what what what's a sensible way to organize them and what we realized is is that you know fundamentally there are key things that we think matter to the users of technology and that really led a lot of our thinking about how we group them so you know one of the most common things is understanding speech in noisy environments or hearing a noisy environment so you know and a lot of technology has been put into that now we could split that out into multiple smaller categories because there's so much in that area but in reality somebody says well I have problems in noise so you know you want to agree to group things under that and then you'll see the groupings when you look at them things like comfort personalization sound quality you know these are all things really that from a consumer perspective make a lot of sense so in many ways from a technical point of view we could have organized these features in 20 different ways so one of the key things we were thinking about when grouping them was really around you know at that very high level how do we group them in a sensible way that actually a consumer could read and and relate back to their needs and the type of needs they would have you know it's it's um it's unlikely that somebody's going to come along for example with I've got a really specific need to do with my spatial hearing so I'm glad there's a spatial hearing category you know it's more likely they're going to say I really struggle when there's a lot of noise and there's a lot of things going on so that's why for example you see a lot of the directional um uh components of of features under the speech in noise for example so consumer at the top level and then within that we also try to be very careful so one of the challenges of grouping features then so I'll give you an example you know for example um you know you might have features like um directional microphones and gaining compression and frequency shaping and all sorts of things one of the challenges that there's so many terms that manufacturers use that actually trying to find some really clear simple terms that every professional will understand but doesn't actually overlap with anything that's too specific to any manufacturer was a real Challenge and so you know a lot of what you see in the guide is like really powerful choice of terms so that we're confident that you know that consumers can use that term and any audiologist any professional who's dispensing hearing devices will be able to understand what they mean by those right now you can delve deeper right if you're really into your attack as power says you can scan the QR code and go even further a level deeper and say oh I'm interested in the difference between an Adaptive directional microphone in this type of directional microphone so we're not trying to hide away detail from those because we know there's a subset of consumers increasingly who are really interested in the technology right so it's almost like start with that higher level organize it by need to help the consumer gravitate towards okay what types of things should I even ask about they don't necessarily even have to really understand that the nuts and bolts of it but at least they know look I should ask about things like directionality I should ask about things like noise suppression I should ask about things like what's this thing about a device where you know it will learn my preferences over time or be able to automatically adapt in different environments so I don't need to mess with this you know because I really don't want to have to touch the device once it's set up so this is the type of thing that we try to organize it around to really help the consumer have that initial engagement with the features but then from then on it's really based on a very careful consideration of the underlying technology behind different features and grouping them appropriately and one of the things I'll just say finally is that what you'll see in at each level of the guide is sometimes in the guide we say hey look out for terms like this so when people are Googling around or they're reading different manufacturers you know we are giving them the types of turns they might come across and some of those are manufacturer specific but chosen so they're across all the manufacturers so people understand that look the same thing can be called 10 different things right don't be confused actually you should go in and really say I don't care what you call it I want you to explain how it's going to help me so that was the the thinking palette you want to add anything um probably the other thing is um obviously for manufacturers they they didn't want us to homogenize it so much that you couldn't differentiate so another that second level really was to try and help people if they wanted to understand those Technologies those different sorts of Technology we know some are more advanced and some are obviously not as advanced so it rather than it being a homogenizing it actually gives the person an opportunity to understand it the feature and then allow the audiologist to show what is different about a particular product perhaps from one or about a different entry level product so I think in understanding it you're able to actually differentiate what you perhaps is beneficial for one product over another and just to give you an idea of the process we also all those terms and descriptions we googled to make sure it didn't come back up to one manufacturer so we had this process to try and make it as I guess generic as possible in that sense and the other thing that we did was we will create a booklet that will have a how to use it and also allow you to check the features and write notes in the back so we'll be producing a free booklet for people to be able to download or order and then they can just tick and um and take that physical copy to their clinicians to their friends and families to discuss so we're trying to make it as easy as possible for a person to think about what they want and their needs and you know there's probably um important to add that you know it's not uh like we we think that producing this is going to sort of solve the core challenge which is that the environment is just really confusing and and we understand that manufacturers will want to distinguish their products that want to have something that is different in the market and and that's okay that's good that drives new innovation what's key is that the consumer can sort of understand that and make informed decisions so you know one of the things that you know we're we're sort of constantly hoping will happen is that by really engaging with the consumer to say hey let's start a conversation about how we talk about different features of hearing devices what we'd love to see is at least manufacturers may be considering whether they can use some of these terms to help guide consumers so they'll still have their you know specific names for their Technologies but it would be really helpful for example if they said you know this is actually this type of feature it's a special type of feature and we think it's brilliant you know then you know and they can they can tell all the give all the evidence for that But ultimately having the consumer to be able to sort of navigate all of this information using some let's say widely accepted generic terms for these different features at different levels I think would be helpful in the long run for the consumer particularly as now we've got even more choice about how you get devices I know in the US you know with the introduction of OTC legislation you know the the different forms of devices coming on the market is increasing every week and certain the different channels you can get devices so I think it even puts more of an emphasis on making information about devices um accessible so consumers can make um relevant choices about which technology suits them and we actually also passed the guide through a readability Checker to ensure that it was that first level was um accessible to a reader of a level of grade six to grade eight so um that was another really important thing to make sure it would be understood by the consumers I I just I think that it's actually a really pretty a brilliant thing because really what you're doing is demystifying uh the whole buying experience here and I think that the the really a big upside for that is to eliminate or reduce the buyer's remorse because you know you think about again I come from the U.S perspective of things so I know kind of how like the points of care and access come in and how that the distribution model works in the US and there's obviously a growing trend of managed care and there's benefits and stuff like that but it's still a large out-of-pocket cost for a lot of people and so the last thing you want you know know the the statistic that was kind of like going through my head as you were talking was you know the amount of people that buy a device may be reluctantly and then it ends up in the drawer and you know not only did you like do a disservice to that person and that patient but then they're going to speak negatively about the experience so you've created a negative experience that might like radiate in their community and and just kind of reflect reflect poorly on hearing technology and then hearing Healthcare as a whole and so I think that if you can you know think about this like as a way in which you can help get people feeling like they made the right decision because it is probably a feeling of like why did I buy something that was premium technology that had all these different bells and whistles that I had absolutely no idea I did not need and now I can tell like through a guide like this I can really kind of match myself to like these are the most important things that I need and what are my options for that and that really is something that I think there is a big gap right now in um you know I don't want to like generalize I think that it's obviously a spectrum of the types of way in which these conversations are had in the clinic and stuff like that but I think that you are kind of faced with the challenge as a clinician of okay I'm kind of like going off of the objective diagnostic measurements and stuff like that so I have a sense of like what this person needs from you know just like a pure you know um like the kinds of needs that they have from a a prescription standpoint but you know what about all the different softer needs and and things that aren't as tangible for them many of which they don't know how to articulate because they don't really know you know where to even begin so I think it just gives them again a level of empowerment to feel as if they know what they're looking at I think the analogy to the smartphone is actually pretty brilliant is like over the course of time we've all become habituated because we're all smartphone owners of what we like and what matters and you know so it's it's become much easier for you to then buy the next smartphone or something like that you know I think with sharing Healthcare we're looking at a demographic by and large that you know even with um the amount of people that have have kind of come into the cycle today there's just the vast majority of people that need this are would be would be first-time buyers or first-time patients and so I think that it's it's very very important to provide resources for a first-time buyer so that you ensure that they're happy and they're satisfied in the ecosystem and they're not going to just immediately exit yeah no look I couldn't agree more and I guess you know we're always conscious that you know the and you've tapped on it or you've touched on it there you know the first device somebody gets could be the last you know if they have a bad engagement with hearing technology and the use of hearing technology and it doesn't help them you know that it could not only affect them as you say and and but also people they talk to so that's really really important and and I guess this comes from this idea that we really want people to be you know thinking about their needs and actually you know being informed about the technology before they walk in but also there's a really important part of this we haven't yet touched on and it's not something that we thought of initially with the guy but I think it's something that you know we're beginning to think about now which is if somebody does get some higher level technology device and there's a lot of different features in it as you say you know we also don't want people carrying around technology that they don't also know how to get the most out of so we also want consumers to be you know most devices these days there'll be an app you can go in there you can turn on this feature that feature we actually you know really want to make sure also that people feel comfortable that you know they're not going to break anything you know these apps are designed to be used by the user of the device and go in there and make sure that they're thinking about how are these different features going to help me and when might I use them and so one of the sort of knock-on consequences we're hoping is that it might also help people who've already got hearing technology to ask questions like oh can I turn this on does my hearing aid have that can I use it this to help me in that situation and then I think finally you know our commitment at now is you know we'll we've really got to stay engaged with what's what's going to help consumers in this space so you know we've already engaged with consumers as part of the process but we continue to ask questions like are there ways that we can make this more useful more practical ways we can deliver it other use cases that we didn't envisage in initially that we can adapt it to support for and I think it's just something that you know if it's gonna help people navigate here in Tech technology so they get the right technology for their needs and they're able to use that technology effectively which is the other piece that you know we're now talking about then you know this is really important and actually it's to everyone's benefit as you say the audiologist can have a more productive conversation about which technology is going to help them but also manufacturers you know this can help manufacturers if the consumer is more conversant about technology than what we see in things like the mobile phone space and other technology spaces is consumers want manufacturers to offer unique features you know so actually this is a really helpful I think tool to get the consumer more interested in in features that are more personalized to them and then they can sort of make better informed choices and I think you know fundamentally the whole world we're moving to a much more technology enabled digitally connected world and I just think we have to make sure that those who have hearing difficulties and need the support of professionals and hearing devices also you know get the adequate support to navigate this complex landscape I feel like you know if we sit back and we don't help and then at the very least we're not making things easier for people and and I don't think that's compatible with the thing that we all want was from more people to seek help earlier uh and so you know if this goes in any way towards helping with that then you know then that's something that we'll be really happy about yeah and I think also this guide is not an end product it's evolving so we welcome feedback we definitely uh welcome people looking and connecting and contacting us and saying perhaps there might be some other way or something we're missing and we're we're looking to obviously look at these products on an annual basis at the very least to make sure we're keeping it up to date so yeah and and you're they'll always everyone will always be able to find the latest version for free on Nile's website so it's now.gov.eu now guide um you can find our contact details there if you've got feedback or reach out to us on social media and as Paula said you know it's not a fixed thing it's not a living document it's not something you have to pay for we want to know what's going to be useful we want to know which bits of it really people find helpful which they've done so any feedback from professionals from consumers whoever uses this and that's maybe a group we haven't talked about as a nail guy Jesus so much but we're also hoping that professionals will also find this useful you know to for it to be have something that they can offer somebody and when they're you know thinking about what devices or technology might be suitable to them but also something that maybe they can take and frame a conversation around as well and if they have particular needs you know we'll be looking to see how we can address those as well well I'll just make two comments on this one is um I I really agree with you Barack on the point about this actually I think behooves the manufacturers because um you know like you said earlier you are sort of saying okay here's the like uh generic term and then you'll have brand specific terms so look out for these so if you've identified that you know uh sound personalization is like the number one feature category that you that's most important to you then I think it at least gives you an idea of like here are the terms and then you can do your own research to identify here are the manufacturers that might specify in that um which again I think is like it ties into this idea of a more empowered patient I think is a better is a better patient and and then the last point there that you just made about the professional I just had a conversation the other day where I was talking uh to an audiologist about this kind of the same thing which is you know uh one of the biggest challenges that a clinician faces is they don't have enough time they don't have enough bandwidth and so I think that right now they're sort of limited to manufacturer specific um literature and like materials and stuff like that there aren't a lot of these like kind of third-party objective Consumer Reports if you will that are kind of consolidating everything into one um so I do think that like this would be something that would be very appreciated at least by a segment of professionals that would look at this and say Here's a really good way for you to kind of learn more about what you want um you know prior to you coming in read this kind of thing which dovetails to my last question for you all how how do you plan to kind of like disseminate this you just told me how I can go and access it but do you have plans of working with like the Australian government or like public health entity stuff like that to get this in the hands of patients and make them aware that it exists yeah that's a really good question so it's already put on the um Department of Health Website here in Australia so it's already um live there we're um we're starting to produce physical copies um and work with um organizations here in Australia to start trialing them out in particular you know we work with our partner here in Australia who actually is part of this to help um refine the guide to get feedback from clients and clinicians so we'll start introducing those into clinics and we're working with them also to figure out how do we adapt the guide to fit in with a normal sort of literature that a clinic would give um you know to patients as you say before they come in and we will learn things from that that then we can pass on and and to others um you know a key thing is we're constantly trying to think of other ways to raise the profile of it so talking to individuals such as yourself I'm trying to do media interviews and and get it on social media and we're also talking to um uh organizations that own chains of of hearing stores for example not just in Australia but around the world because if we can you know make inroads into some of those big networks of Stores um you know considering that it's a no cost um product to provide that you know will help hopefully their their consumers have a better experience then but you know we really hope that that will be another Avenue to be able to get good uptake the other thing is we're also working with um you know the or making the manufacturers as well as well we've been really actually really I think it's fair to say and acknowledge you know that um the the hearing aid manufacturers Association here in Australia which you know contains all the major manufacturers I've actually been really proactive and positive at engaging with us on this and and really actually helped us make it you know manufacture agnostic and and you know so I think I think you know working with all of those Partners but I think the key thing is that we can't leave it as one thing that just sits still I think a key part of getting this out there is listening to um getting feedback on how it's being used both in clinics that we're working with giving it to Consumers continuing to innovate so we'll be looking at you know new ways to deliver us all the time to see can we improve it can we make it easier can we make it more relevant more accessible and I think that's the the key thing right we'll work with all those stakeholders but the key thing is we've got to keep working on it keep improving it keep getting it out there um so that it's a living thing um and and we keep finding ways to add value to it and I think that's going to be the key thing that's going to drive it I think the proof will be in the pudding right you know if people pick it up and they find it useful they're going to tell people about it clinicians are going to notice and I think that's the ultimate test of this and what's going to really it's better if it's useful things spread pretty fast and and really that's what we're hoping so and I might just add um we're also working with our Australian Audiology it's our Professional Organization for specifically for Australia obviously and so we're doing a bit of a road show and workshops to try and integrate it into the practice and give practical hints and and tips and in order to integrate that into it so um the world tour I guess might start yeah the world tour starts in Australia but we hope it will adapt a workshop for example online for people to do with um with Audiology online for example ultimately like it practical clinicians as well and also just encourage anybody who wants to spread the word and you know if they find it useful and they want to you know spread the word about it then you know please go ahead I mean this is the the whole point that the value for us in it is that it gets out there it gets used right not that we're the ones necessarily talking about it so I think that's the key messages get there use it if you got some feedback we want to hear about it we'll make it 100 that's fantastic well thank you too so much for coming on today really learned a lot I'm excited to watch the uh the NL the Nal guide be disseminated and evolve over time I think it's going to be a great resource for the industry and then more importantly for the uh for the consumer so thank you too thanks for everybody who tuned in here to the end we'll chat with you next time cheers [Music] [Applause] foreign [Music]

2023-09-17 19:30

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