Since this post was originally published on April 30, it has drawn a number of thoughtful and provocative comments, which follow the main text. This revised post also contains a response from Jan Topholm, a prominent EHIMA member, to a query that I sent him in writing the original post.
By David H. Kirkwood
BRUSSELS/KIRKLAND, WA–The European Hearing Instrument Manufacturers Association (EHIMA) and the Bluetooth Special Interest Group (SIG) have announced a partnership to develop a new wireless standard for hearing devices. 
By teaming up, EHIMA, which represents the six major hearing aid manufacturers, and the Seattle area-based Bluetooth SIG, which authorizes manufacturers to use Bluetooth® wireless technology, hope to develop a standard for new hearing aids that will improve existing wireless functionalities and create new ones, such as stereo audio streaming from mobile devices.
However, last month’s announcement has raised concerns among some advocates for people with hearing loss. They worry that an industry commitment to a new wireless standard that won’t be available for years may lead to neglect of telecoils and looping systems, which benefit hearing aid wearers now.
MANY BENEFITS SEEN FROM BLUETOOTH STANDARD
In their announcement, EHIMA and the Bluetooth SIG said that tens of millions of people with hearing loss have been largely left out ofthe recent revolution in smartphones, personal music players, TVs, and tablets, because few hearing aids offer direct connectivity to these devices. The organizations added that while the low-power, intelligent connectivity provided by Bluetooth Smart offers great potential to hearing aid users, that potential is largely untapped because there is no wireless standard for hearing aids. 
Soren Hougaard, secretary general of EHIMA, said, “It is important that we connect to and serve all kinds of smartphones and multimedia sound signals. To achieve that, we must define a standard everyone can implement. We want to avoid the situation that occurred in the market for videotapes in the 1980s where customers had to choose among three to five tape formats and corresponding VCRs.”
Hougaard anticipates that a new Bluetooth standard will be finalized within two years, at which time it could be rapidly adopted by consumer electronics manufacturers.
Jan Topholm
EHIMA LEADER SEES A SLOW PROCESS
In preparing this post, I sent a letter to Jan Topholm, who was listed in EHIMA’s announcement as the press contact. Topholm, who is CEO and president of Widex AS, sent a reply on May 20. In it, he said:
“The industry is seeking a common solution in order for all manufacturers to be compatible with one system for communication between hearing instruments and surroundings. Bluetooth Low Energy was chosen because it is in widespread use already and thus the equipment for communicating with telephones, TV-sets and broadcasting is already developed and in mass production and thus relatively cheap.
“We need to develop a special protocol for hearing instruments and to integrate low energy bluetooth transmitters/receivers adapted for this purpose. This is already being done.
“I expect a slow transition from telecoils to BT transmitters over the next many years. BT hearing instruments will come in some models at first, but not in all, as battery requirements are higher for this type of transmission. Installation of BT transmission in homes and public rooms is much simpler and cheaper than installing telecoil systems, and this will drive the transition.
“A guess (mine) could be that in 10 years 75% of the transition to BT transmission will have taken place. For the hearing instruments the driver will be connectivity to all sound-generating devices.
“This is as I see the situation, but the future is always difficult to predict.”
REPLACING THE TELECOIL
The joint EHIMA-Bluetooth SIG statement said, “Currently, the only standard for wireless reception of audio signals in hearing aids is the telecoil, which dates back to the 1950s. This technology is difficult to incorporate into smartphones. Furthermore, the number of installed loop systems that can transmit audio signals to hearing aids with telecoils varies greatly from country to country. As a result, hearing aid users have limited access to high-quality audio signals from external sources.”
The statement continued, “Building on the existing Bluetooth standard that is widely supported in today’s smartphones, tablets, and personal computers will give more hearing-impaired users the same choice of products and opportunities as everyone else.”
TELECOILS FAR FROM OBSOLETE, SAY ADVOCATES
David Myers
David Myers, who has worked with other hearing advocates on a nationwide campaign to have induction loops installed in auditoriums, churches, and theaters to make them accessible to hearing aid and cochlear implant wearers, has long predicted that some improved technology would eventually replace telecoils and hearing loops.
The Hope College social psychology professor (and www.hearingloop.org creator) is no Luddite. He enjoys using Bluetooth connectivity between his iPhone and his new hearing aids. However, said Myers in response to a query from Hearing News Watch, it will be a long time before Bluetooth or any other alternative wireless connectivity can match the virtues of looping, such as:
- ease of use by people of all ages,
- availability in nearly all hearing aids
- affordability (no cost to users beyond the price of the hearing aid)
- energy efficiency (little or no battery drain), and
- universality,with the same signal serving everyone, no matter their location or brand of hearing aid.
Per Kokholm Sørensen
How long will it be before some better alternative renders looping obsolete? Per Kokholm Sørensen, director of R & D Electronics for Widex, addressed that question in his presentation at the 2013 International Hearing Loop Conference.
Sørensen, a member of EHIMA’s Technical Committee, said, “Loop systems as we know them today will stay around for many years to come.”
Conny Andersson, owner and technical director of the Swedish company Univox, which makes audio induction loop systems, shares Sørensen’s view. Andersson, who was a member of the Bluetooth Interest Group when Bluetooth was first developed, said, “The question of incorporating Bluetooth in hearing aids pops up every now and then.“ But, he said, “No technology in the near future has the same practical possibilities as hearing loop systems, basically for two reasons: power consumption and that there is an international standard [for hearing loops], which is accepted globally.“
Cynthia Compton-Conley
Cynthia Compton-Conley, one of America’s leading authorities on assistive hearing technology, expressed doubt that any new technology would soon replace telecoils and loops, largely because the current technology is so inexpensive to use and requires negligible battery power. Compton-Conley, a former professor of audiology at Gallaudet and now an independent consultant, also pointed out “The hearing loop Initiative is making inroads in this country.”
A FINAL THOUGHT
David Myers offered some advice to hearing aid companies from his perspective as a consumer: “The hearing industry would serve its own interests, as well as those of people with hearing loss, if it would not prematurely discourage the spread of hearing loops—and the increased hearing instrument functionality they provide. How much better to celebrate the modern spread of hearing loops in the UK, Scandinavia, and now the USA—with more delighted customers. When the industry can meet the criteria in the bulleted list above with an alternative technology, then do so.“
Hearing technology has advanced remarkably in the, (yikes!) 40 years since I began using it. New and improved isn’t always improved, more like new and that will be $800. Thank you. The telecoil is the universal standard; the international universal standard. If the companies would just spend a little bit of time developing and perfecting that platform, they could really make a difference for the millions who need hearing aids and access instead of making millions for their stockholders. R & D is important but not at the cost of providing access to millions today. Yes, I have a roger pen that connects to my phone +, but I can also hear very clearly with just my windows phone and any one of three telecoil programs on my Phonak bolero’s. Consumer’s need options and they need public access today.
Right on Cheri! There are many hearing assistive technologies that go beyond hearing instruments that work very well for people who use them. They depend on strong telecoils built in to the hearing instruments they connect with. BT presents a different platform, but few realize how complex this is compared to telecoil connectivity. For those of us with serious hearing loss, telecoil equipped hearing aids are a must; and for the millions of others with less severe hearing loss, they are a positive eye-opener once experienced. Trying is believing. We all want to hear in ALL situations, close-up and far away; at home, for performing arts, and elsewhere. A grassroots effort has succeeded in getting a Loop America initiative rolling. Let’s go out and get more people involved. Numbers matter.
The hearing aid industry needs to develop new wireless devices but they must be effective and work. New and cool is irrelevant if the person cannot hear because their hearing aid cannot connect to the bluetooth or the bluetooth drains their hearing aid batteries. My cell phone regularly does not connect to my bluetooth device. I have the option of switching to a standard headset. A person with a hearing aid does not have that option. If the bluetooth doesn’t connect then they cannot hear. Battery drain doesn’t mean they need to recharge their hearing aid batteries but means they must quickly replace non-rechargeable and expensive hearing aid batteries.
The induction loop doesn’t have connectivity issues nor battery drain. So, while I understand the need for hearing aid manufacturers to constantly introduce new devices, lets not do it at the expense of people not being able to hear.
Janice Schacter Lintz, Chair, Hearing Access Program
People who seek hearing aids want them to help in background noise and in all adverse listening environments with poor acoustics. Telecoil and Bluetooth technology are therefore NOT mutually exclusive: in fact they complement each other. Users who are given access to both options (https://ow.ly/wvb59) benefit from telecoils in public venues where large area hearing loops or FM or Infrared technology with neck loops are offered and are able to connect wirelessly to their cell phones or TV via Bluetooth in their made for iPhone hearing aids or streamers. For the end users it is all about hearing everywhere for which Sergei Kochkin so eloquently pleaded in his article “Increasing Hearing aid Adoption through Multiple Environmental Listening Utility” (https://ow.ly/wvbc9)
Readers of this blog and hearing device providers would do well to watch the Brain Series with Charlie Rose on PBS (bit.ly/BrainSeries). Towards the end of the program, Charlie Rose asks why people don’t address their hearing loss and Ruth Bentler, PhD, of the University of Iowa, responded that she believes vanity and financial constraints are only secondary motives why this is so. In her opinion the OVERRIDING reason for not doing so is that hearing aids are unable to deliver in the challenging environments where they want and need to hear better.
I agree with the previous commenters: Users don’t want small or “cool” hearing aids – they want to hear. Everywhere.
This part of the joint statement is patently false:
“In their announcement, EHIMA and the Bluetooth SIG said that tens of millions of people with hearing loss have been largely left out ofthe recent revolution in smartphones, personal music players, TVs, and tablets, because few hearing aids offer direct connectivity to these devices.”
…as for the latest HIA data reported for the first half of 2013, fully 70% of all hearing aids and 80% of BTE/RIC’s sold in the US have digital wireless capability: This means every one of these users can use 10.6 mHz HF, or 900 or 2450 mHz VHF along with a streamer. Now granted, many of the 10.6 mHz streamers are awkward (with a dubious Honorable Mention to the Widex M-Dex); however the Starkey and GN ReSound UHF systems don’t even use a bodyworn streamer when watching TV.
No, the real problem is that you have six different hearing aid manufacturers, and **no** standardization for digital audio reception, save for the Bluetooth 4.0 Low Energy (“BLE”) as we see in the Made for iPhone (MFi) hearing aids.
When you look at the 10.6 mHz wireless offerings from Oticon, Siemens, Widex and Phonak/Unitron, you’ll quickly notice that although they all use the same slice of the electromagnetic spectrum, each has their own proprietary data encoding.
About twenty years ago, the manufacturers got together to create HIMSA to stave off the then-burgeoning nightmare for hearing aid programming hardware & software: It’s time for the manufacturers to either come up with an appropriate 10.6 mHz data standard, or discontinue it and move to the evolving BLE industry standard.
At the 2002 Biennial General Meeting of IFHOH (International Federation of Hard of Hearing People) in Slovenia, Rob Rademaker from the Netherlands enthusiastically reported about the new project “Blue Ear.” The European Union had made a big grant to researchers to integrate the new Bluetooth-technology into hearing aids.
The project was started and very soon was stopped again because, among other reasons, “Bluetooth” drains too much power in hearing aid batteries.
Bluetooth technology was primarily invented to connect a computer mouse wirelessly to a computer or connect a mobile computer wirelessly to a printer (I still have a seven-year-old HP laptop computer with a Bluetooth mouse hidden in an extension slot. It is very handy because I do not have to have an extra mouse when I am travelling. But it really drains the battery of my laptop).
The promising “Blue Ear” project has been stopped. Now, in 2014 (12 years later), EHIMA and the Bluetooth SIG agreed to form a committee to try to set up a new Bluetooth standard that will also work with the batteries of hearing aids.
Will we have to wait another 12 years for this new standard implemented in hearing aids? Will the technology this time really work and completely replace the telecoil and induction loops? To do so it will need to be like telecoils: similarly simple, inexpensive, available with all hearing aid brands and models, energy efficient, with no time delay, and able to provide listening assistance in places both small and private and vast and public.
So why not have “hybrid” hearing aids with virtually free telecoils (for public assistive listening) and Bluetooth (for private connectivity, such as to one’s SmartPhone)? Consumers then use whichever they need (for example, using telecoils when listening at a ticket window, airport, theater, a lecture hall, or house of worship) or listening to stereo music from their personal SmartPhone or tablet.
There are hybrid cars on the market using gasoline and electric batteries. Why not have hybrid hearing aids?
Siegfried Karg
Winterthur, Switzerland
Convener of the First International Hearing Loop Conference in 2009