By Catherine Palmer
Implementation science is the study of methods to promote the adoption and integration of evidence-based practices into routine health care. Clinicians can be at different points along a continuum in terms of readiness to change practices. The continuum moves through (1) pre-contemplation, (2) contemplation, (3) preparation, (4) maintenance, and (5) relapse, hopefully settling in maintenance. Sound familiar?
We think about these stages with our patients every day and we design interventions based on where the patient finds themselves at a moment in time. We know where our patients are on this continuum by listening to them. We can often pinpoint where our colleagues are on this continuum if we listen.
As we are faced with a variety of disruptors in hearing health care, including the impending availability of over-the-counter (OTC) hearing aids, we must ask ourselves: What differentiates us from direct-to-consumer devices and/or online audiological services? The answer: Customization.
Evidence-based practice allows us to provide customization in hearing health care. This starts with the customization of a solution through the measurement of hearing, lifestyle, and communication needs—the physical customization of the device.
Acoustic customization is accomplished by putting a microphone in the ear canal to measure the output of the hearing aid so an audible signal is achieved across frequency and input level. The treatment (intervention) for hearing loss is audibility.
Currently, the most efficient way to verify if you have achieved audibility based on the patient’s hearing and ear-canal acoustics is to perform real-ear aided measures. Colleagues in the “contemplation” stage of evidence-based practice often say, “there is no evidence that using real-ear measures is a better treatment.” That is because real-ear measures are not a treatment. Audibility is the treatment. Real-ear measures are just currently the fastest, most accurate way to verify that you’ve achieved audibility. Finally, we offer the important customization of orientation, auditory training, and follow-up.
The recent MarkeTrak 10 survey reported that most hearing aid and direct-to-consumer product owners believe that the hearing care provider helped, or would have helped, with their devices. People understand the need for customization when it comes to their health care and communication needs. We need to make sure we are providing customization that cannot be accessed elsewhere; that is evidence-based practice and that is what we bring to the table.
Does the Academy have a responsibility to empower members to provide evidence-based care? Absolutely. We also need to extend the same consideration we would with our patients. We need to meet people where they are and offer customized solutions.
I encourage you to figure out where you are on the continuum (Contemplating change? Ready to change? Relapsed?) in your areas of practice and join us at AAA 2020 + HearTECH Expo in a way that will move you forward. You will find learning labs, featured sessions, hands-on pavilions, industry support, and colleagues everywhere who can help you on your professional journey.
This article is a part of the March/April 2020 Audiology Today issue.