The Hearing Disruptions series seeks to cover the rapid changes taking place in hearing healthcare. Today’s post is the final portion on one presentation culled from recent topics presented to the Institute of Medicine’s (IOM) Committee on Accessible and Affordable Hearing Health Care for Adults.
Informing to Compel Consumption Choices
Price, limited access and stigma are the big costs for hearing aids; unknown benefit and possible inferior goods are risks which raise the costs of acquisition of PSAPs and other ear devices. Those of us who participate in hearing healthcare have a duty, and a vested interest, to improve the value to consumers to a tipping point that makes ear devices compelling. We can do this in at least three ways.
Inform to Compel
We can awaken consumers’ understanding of the importance of healthy hearing, the interactive nature of chronic hearing loss with other body systems, and the importance of amplification to restore audibility. This is not a new or innovative idea, but that does not diminish its importance now and in the future. Educating and informing are part and parcel of the manner in which successful clinicians approach every patient and physician encounter.
But it is not necessary or desirable to wait for the patient-clinician encounter. Some in hearing healthcare and consumer electronics use speaking, writing, and research skills to reach a larger consumer population through a variety of media. Individual practitioners educate through their websites and via presentations to consumers and policy makers.
Others write books, articles, posts on a variety of topics which encompass technology, research and current events associated with hearing, listening, and hearing loss. HearingHealthMatters’ stated goal since its inception has been in this vein:
Timely information and lively insights for audiology professionals and everyone who cares about hearing loss.
By all sorts of means, before, during and after hearing loss onset, we have opportunities and expertise to educate consumers and other healthcare professionals on ways in which ear devices can leverage hearing and afford competitive edges in work and social environments.
In the futuristic lexicon of hearing devices, ear level enhancement and augmentation could eventually make the devices “part of being human,” as described by Brent Edwards, PhD, CTO, EarLens, regardless of whether hearing is “normal” or “impaired.”
Innovate to Compel
User Control. Consumers familiar with phone apps will expect similar self-efficacy in ear devices, including self-fit and self-adjustment apps for enhanced control of their sound environments.
Unique Uses. Phones will eventually be supplemented or replaced by all-in-one devices, including multi-functional, wireless ear devices. Hearing aids and Hearables are already on the threshold of enabling real-time monitoring and content streaming.
Comfort. Hearing aids are sufficiently comfortable and unobtrusive to encourage full time use by most wearers. Current consumer ear devices are not. PSAPs and Hearables can borrow from hearing aid design knowledge to improve and expand their use.1
Convenience. Devices designed for low maintenance (e.g., eliminate device incompatibilities, automate pairing, and improve charging) will make it less onerous for consumers to adopt ear devices. Enabling direct purchase will satisfy a strong desire expressed by consumers in the CES survey.2
Image. Device design will aim for desirability, distancing hearing aids from stigma and PSAP/Hearables from cheap or geeky-awkward Bluetooth looks.
Data Directed Development to Compel
Benefits, not data, sell product, but it takes good data to discover unrealized benefits and turn them into compelling products. That “value by design” is by far the most important means of eliminating barriers and growing the market for hearing devices. Fortunately, value by design is an inherent part of the Hearables vision for many developers.
Using deep, real time data from device wearers to guide development3 affords more value for consumers, which shifts the demand curve and translates to more people using instruments that were acquired at lower cost. At the same time, it encourages R&D by rewarding the most innovative manufacturers.
Just as importantly, data driven development affords the opportunity to develop individualized outcome measures such as satisfaction measures sampled in real time at successive intervals. Outcome measures can be linked to other health-related outcomes in epidemiological studies, reaping further benefits.
Finally, solid, deep outcome data can inform policy making decisions which may prove helpful when reviewing hearing aid regulatory requirements.
Shifting the Discussion to Shift the Demand Function
Real economists’ answer to any question is “it depends.” I’m not an economist, but that answer seems best here, too. The uptake and pricing of hearing devices in the US:
- depends on how the market is affected by converging and opposing forces;
- depends on how quickly and completely hearing aids, PSAPs and Hearables blur into a homogeneous market with a continuum of Price points for different features and services;
- depends on how definitions and regulations on the books and under review respond to competing stakeholder claims and converging market forces.
As a start, moving the FDA’s exclusionary definition of PSAPs toward a more inclusive definition of ear amplifiers would remove confusion for consumers and encourage innovation by manufacturers large and small. It could encourage us to think of hearing processes as a function of natural aging instead of dichotomized categories of normal and impaired.
It all depends, but one thing is clear: all stakeholders in this debate are in desperate need of data to inform their decisions. Until we have serious real time data that can be modeled econometrically, there may be wisdom in allowing the economic forces to sort things out without regulatory intervention.
1The CES survey found that only 10% of PSAP wearers used their instruments full time. Bluetooth headset use has declined steeply since 2011.
2CEA 2014 suvey report: 69% of HD and 63% w/o HD want direct purchase; few oppose it.
3Development thanks to technology, analytics, cloud-based storage, and large longitudinal health studies. ear devices can serve as two-way communications centers, servicing wearers’ individual needs and wants while simultaneously storing and sharing real-time post-fitting preferences and sound environments for analysis and prediction. Cloud-based storage, and health information exchange structures enable and encourage storage and sharing of “stripped” data.
Complete Source List for parts 1 – 5 of this series
- Abrams H & Kihm J. Introduction to MarkeTrak IX: A new baseline for the hearing aid market. Hearing Review, 2015; 22(6): 11-21
- Amlani AM & De Silva DG. Effects of economy and FDA intervention on the hearing aid industry. Am J Aud. 2005;14, 71-79.
- Amlani AM. Influence of perceived value on hearing aid adoptions and re-adoption intent. Hearing Review Products. March 2013; 8-12.
- Amlani AM. Improving patient compliance to hearing healthcare services and treatment through self-efficacy and smartphone Hearing Review. 2015;22(2):16-20.
- Amlani AM et al. Utility of Smartphone-based hearing aid applications as a substitute to traditional hearing aids. Hearing Review. 2014; 20(13): 16-18.
- Boltyenkov A. A Healthcare Economic Policy for Hearing Impairment. 2015; Leipzig: Springer Gabler.
- Buschle N-B. The impact of consumer behavior on technological change and the market structure. dissertation. Dresden Technical University, 2002.
- Consumer Electronics Association. 2014 CEA Personal Sound Amplification Products (PSAPs) Study.
- Hosford-Dunn, H. If hearing aids were hula hoops. HearingHealthMatters.org, June 17, 2017.
- Hosford-Dunn. H. Hearables series. HearingHealthMatters.org, Feb 3-June 23,
- Hunn N. The market for smart wearable technology: A consumer centric approach. 8/07/2014
- Kilgore S. The work impact of untreated hearing loss. May 9, 2014.
- Kochkin S. MarkeTrak VIII: 25-year trends in the hearing health market. Hearing Review. 2009;16(11):12-31.
- Kochkin S. MarkeTrak VIII: Utilization of PSAPs and direct-mail hearing aids by people with hearing impairment. Hearing Review. 2010;17(6):12-16.
- Kochkin S. MarkeTrak VIII: The key influencing factors in hearing aid purchase intent. Hearing Review. 2012; 19(3): 12-25.
- Kochkin S. A comparison of consumer satisfaction, subjective benefit, and quality of life changes associated with traditional and direct-mail hearing aid use. Hearing review, Jan 2014.
- Lin FR et al. Hearing Loss and Incident Dementia. Arch Neurol. 2011;68(2):214-220. doi:10.1001/archneurol.2010.362.
- Lin FR et al.Hearing Loss and Cognitive Decline in Older Adults. JAMA Intern Med. 2013;173(4):293-299. doi:10.1001/jamainternmed.2013.1868.
- Meyer M. (2015). Two cheers for corporate experimentation: The A/B illusion and the virtues of data-drive innovation. Colorado tech Law J, 13(273).
- Meyer MN & Chabris C. Please, corporations, experiment on us. NYTimes, June 19, 2015.
- Van Tasell D , et al. Smartphone control apps for hearing devices: Caveat emptor. org, Dec 3, 2013.
- Van Tasell D. Hearing aids, enabling technologies, barriers. IOM Committee on Accessible and Affordable Hearing Health Care for Adults. April 27, 2015.