Hearing Economics is pleased to announce Brian Taylor as a new columnist. Dr. Taylor plans to help us get to core concepts in a series of bimonthly discussions entitled “Signal & Noise.” Today’s post marks his debut column, describing actual data to bear on outcomes from available ear-level amplification technologies. Welcome, Brian, and thanks for bringing data with you!
A recent McKinsey report builds a strong case for the growing demand of medical devices that are “good enough. ” In essence, these are devices that are lower priced and don’t possess many of the value-added features that are often found in the premium category. According to the report, this new segment of the market – one that values no-frills solutions – is growing twice as fast as the industry as a whole in many medical device categories.
Quoting the report, “as decision makers become more cost conscious and competition intensifies, opportunities to serve value-oriented customers in medical devices are growing fast…..the key to success does not always lie in changing the product itself, but could involve altering sales models and service offerings.” Although this report doesn’t directly mention hearing aids, it is not too big of a leap to draw parallels to the commoditization of technology occurring within our own profession.
Outcomes Data for Hearing Aid and PSAP Technologies
As this recent peer-reviewed article attests, higher cost, premium hearing aids do not provide superior outcomes when compared to lower cost, basic level technology. In a carefully designed study involving 25 participants, the researchers compared laboratory speech understanding tests, standardized self-reports, and open-ended diary entries for four pairs of hearing aids: two basic and two premium level.
Results of the month-long field trials showed no statistically or clinically significant differences between the premium and basic level hearing aids on any measures of outcome for either new or experienced hearing aid users. The results of this study suggest that hearing aids, regardless of technology level or price point, provide patients with favorable laboratory and real-world outcomes. It should be noted, however, that all hearing aids evaluated in this study were painstakingly fitted using best-practice protocols, which likely contributed to the across-the-board positive outcomes.
Similarly, in an unpublished research study that compared basic and premium devices to two different high-quality PSAPs, the researchers found that both types of conventional hearing aids were rated higher than PSAPs for listening to conversations in quiet. Conversely, for two other listening conditions, listening to everyday noises and music, the PSAPs performed as well as the conventional hearing aids. Like the previously mentioned study, all the devices were meticulously fitted using standard protocols.
Emerging Trends in the Data
Obviously, more research examining the benefit of various levels of amplification technology is needed, but some trends are beginning to emerge:
- Following a best-practice protocol trumps the level of technology being dispensed. In other words, hearing aids with basic technology fitted by a professional using a standardized approach are likely to outperform premium products taken straight out of the box and placed onto a patient’s ears using a minimalist protocol.
- Feature creep adds complexity, cost and time, but not necessarily value. Every 12 to 18 months hearing aid manufacturers launch a new product with updated features. For about two decades, this has been an effective strategy because the marketplace (audiologists and hearing instrument specialists) is on a quest to provide patients with the latest innovations to address their needs. According to the peer-reviewed study cited above, these incremental improvements in feature performance don’t equate to incremental improvements in patient outcomes. Cost controls by third-party payers and large purchasing organizations as well as the use of evidence-based decision making by clinicians may be the only ways to stymie feature creep.
- High-quality PSAPs that meet a strict performance criteria may be “good enough” for some patients – it’s up to hearing care professionals to ensure those criteria are well-defined and verified for every individual.
If It’s Good Enough for Consumers, Is It Good Enough for Audiologists?
The commoditization of amplification technology does not necessarily mean the sky is falling for the profession. After all, professional expertise and judgment are needed to verify that any amplification device, regardless of sophistication and price, has a smooth, undistorted frequency response, along with other acoustic characteristics of a well-fitted hearing aid. Expertise, judgment, and patience are also necessary in the long process of helping people overcome the myriad behavioral and societal consequences of gradual, adventitious hearing loss in adults.
Rather than the sky falling, the rise of the “just good enough” market is an opportunity for audiologists, hearing instrument specialists and others associated with our professions to broaden the scale and scope of patient offerings.
This is Post 1 in the Signal & Noise series. Click here for post 2.
Brian Taylor, AuD, is the Director of Practice Development & Clinical Affairs for Unitron. He also currently serves as the Editor of Audiology Practices, the quarterly publication of the Academy of Doctor’s of Audiology. During the first fifteen years of his career, he practiced clinical audiology in both medical and retail settings. Since 2005, Dr. Taylor has held a variety of leadership & management positions within the industry in both the United States and Europe. He has published over 50 articles and book chapters on topics related to hearing aids, diagnostic audiology and business management. Brian has authored three text books: Fitting and Dispensing Hearing Aids (co-authored with Gus Mueller), Consultative Selling Skills for Audiologists, and Quality in Audiology: Design & Implementation of the Patient Experience. His latest book, Marketing in an Audiology Practice, will be published in March, 2015. Brian lives in Golden Valley, MN with his wife and three sons.
feature image courtesy of Cambridge in Color