With the widespread use of programmable and DSP hearing instruments which provide exceptional fitting flexibility, several engineers in the hearing care field have pointed out that it’s no longer a problem to manipulate virtually any parameter, etc., within a hearing aid; the problem is figuring out how to configure the aid for the unique needs of a client’s residual hearing, lifestyle, listening environments, amplification experience and even unique auditory processing capabilities. Thus, one might logically conclude that it is fitting technology and/or methodology, and not the actual hearing instrument itself, that will represent the next “quantum advances” in amplification. If this is true, then computers—and anything remotely connected to them (literally)—will gain even greater importance in the future of dispensing professionals.

The hearing care field continues to see novel approaches to the selection, fitting and verification of hearing aids. It’s likely that hearing care professionals of the future will use more intelligent hearing instrument fitting systems designed to identify the specific patient needs through both established and new diagnostic approaches, as well as through upcoming psychoacoustic insights. Verification systems like the ones described by Mary Meskan in this issue and the GEERS system in the October HR (p. 68) are two examples of fitting approaches using simulated environments and pyschoacoustic data in the sound booth. The merging of technologies, such as computers, surround-sound, wireless and personality profiling, with hearing instrument fitting and verification procedures is an exciting prospect. When coupled with the kinds of computerized delivery systems described by David Smriga and the kinds of system set-ups described by Scott Peterson in this issue of HR, its obvious that computers will continue to dramatically change the face of hearing instrument dispensing.

Peter Mark points to the Internet as a necessary means for providing “24-7” service, information, counseling and marketing to a new, upcoming breed of consumers—people who rely on next-minute service. One can even imagine in the future automated online teleprogramming services where people can plug their hearing instruments into an interface box, answer a series of questions on the computer screen and/or hear a series of signals generated specifically for their problem, then wait as their instrument is tweaked by the professional and/or fitting program online. Entire suites of counseling and acclimatization programs may become available online or be packaged with the hearing instrument, aiding new users in the remediation process—in the comfort of their own homes. Interactive hearing exercises may be developed that respond to the patient’s answers by adjusting gain in a particular frequency, kneepoints, etc., and/or reporting the responses to the hearing care professional. 

Computers are sometimes eyed with suspicion because they are perceived as cold, calculating entities at the top of the “technological food chain” and an uneasy symbol for the technocracy that culture has been wrestling with for over a century. In Stanley Kubrick’s 2001: A Space Odyssey, an astronaut wages a futile battle against his omnipresent shipboard computer, Hal, repeatedly commanding, “Open the pod bay door please Hal,” while Hal gently responds that it doesn’t make sense to open the door. While computers may be the most important tool in the future of dispensing, they will remain only great tools, not great healers. As any of the authors in this issue of HR will tell you, the human element in dispensing is unlikely to ever take a backseat to fitting formulas or software programs. The individual who is struggling with all the emotional components of a hearing loss is unlikely to find his/her answers on a computer screen. However, it is possible (and somewhat ironic) that the computer in hearing health care may ultimately fulfill its greatest role in helping us to understand and implement strategies in response to patients’ human needs. Unless, of course, your computer is named Hal. 

We hope this issue of HR provides new insights into the use of computers and what your office can do to prepare for the future. The staff of The Hearing Review wishes you the greatest peace and joy during this Holiday Season and advent of the new millennium.

Karl Strom
Editor-in-Chief