Everything You Need to Know About Real Ear Measurements

Are you having difficulties with patients returning their hearing aids because they are still having trouble hearing?

Are you finding that your patients keep coming back to your clinic, complaining of hearing troubles even when wearing their hearing aids?

Are you spending significant time troubleshooting hearing aid problems, which is preventing you from seeing new patients and/or negatively impacting other key performance indicators (KPIs)?

If you answered YES to any of the above questions, you likely did not use Real Ear Measurements (REM) to verify your patients' hearing levels.

Studies have repeatedly shown that using REM during hearing aid fittings delivers better results and happier patients. Unfortunately, REMs have not been widely embraced in the audiology industry, with less than 30% of Hearing Care Providers (HCPs) using REM to verify hearing aid fittings, even though it is recommended as the gold standard by many global professional bodies.

This disconnect is startling, especially considering this approach has been proven to work exceptionally well. Happier patients mean less returns, less follow up consults, more referrals, and more profit.

Increasingly, customers are faced with more hearing aid choices. These new channels might also ensure that new paid services, like verification of fit, or the customization of over-the-counter (OTC) or direct-to-customer (DTC) devices, may be attractive to customers.

As regulations change and more hearing aid provision channels become available to customers, differentiation of your offerings will be crucial to your success. Providing best practice hearing care elements, such as REM, are essential.

This Guide Covers

1. Why Real Ear Measurements Are Crucial for Success

2. Looking Ahead and Using REM as a Key Differentiator

3. Misconceptions that Put Professionals off

4. How to Perform Real Ear Measurements

In many parts of the world, including Denmark, the UK, Germany, France, Australia, New Zealand, and Canada, hearing aids are provided either free at the point of access or heavily subsidized.

Several countries include REMs either as mandatory parts of the fitting process or actively plan to do so. Private practices in these countries must perform REMs and document them to get paid. While the United States has different reimbursement models, there's still substantial evidence that REMs should be applied – even if this is not a country-wide mandate.

Experts predict that more regulatory bodies and insurers will demand REMs for compensation. REMs have also become a "cause celeb" among many hearing loss advocates, patient advocates within the hearing care space, and audiology influencers. Patients are more aware of – and interested in – REMs and more knowledgeable about the benefits that REMs provide. Already some patients are demanding them as part of their fitting – a trend that will likely continue.

OTC Hearing Aids: What You Should Know

In 2022, the FDA approved over the counter (OTC) hearing aids. The changes in provision channels impact how practices offer services and care. New OTC and DTC devices will directly impact patients' attitudes concerning hearing aid testing and fitting.

If patients can self-test using an app that produces beeps and whistles, what's the point of attending a private practice that appears to do the same?

To answer this question, keep in mind that these new channels might ensure that paid services – like verification of fit, or the customization of OTC or DTC devices – may be attractive to customers. Since regulations changed and more hearing aid provision channels are available, differentiation of your offerings is crucial to your success. Providing best practice hearing care elements, such as REM, are essential. Also, REM requires patients to visit your clinics, thus driving foot traffic.

Hearing aids purchased online – or OTC devices – are delivered straightforwardly. A customer buys them, a vendor provides them, and the customer self-tests and self-fits. As previously stated, the process of getting an OTC involves no best practice, such as speech discrimination, QuickSIN testing, or independent fit verification.

A business that offers all these best practice procedures differentiates itself immediately, and that differentiation is crucial to your clinic's successes. Since only 30% of hearing care businesses follow these best practices, you will also be differentiating your business from your competitors.

With the increasing commercial pressure from internal and external forces, hearing clinics will need to innovate to survive. They will also need to offer high-quality, best practice care to remain relevant and appealing to today's patients.

REM equipment is more affordable and more mobile than ever before. The Measure Audiometer offers REMs as an add-on module that integrates well within the hardware. The extra speaker and transducers are small and easy to carry. Setting them up is quick and easy: just plug the speaker and transducers into The Measure Audiometer. Undertaking the verification protocols is as simple as pressing a button and following the automatic process.

Clinics that use REM equipment also see fewer returns in hearing aids, saving significant money.

REMs offer many significant benefits for your business. On the commercial side, they are best practice tests demonstrating to your patients that you offer the highest levels of hearing care.

Evidence shows that REM leads to better outcomes and happier patients. That means less return visits and troubleshooting hearing difficulties and more patient loyalty, retention, and recommendations. REMs are effective revenue drivers for any hearing practice. Additionally, offering REMs will differentiate your business from OTC or online providers, as well as other hearing clinics in your area that still don't provide them.

On the clinical side, REMs:

• Increase confidence in fitting accuracy because it is an objective and scientific measurement of the dB SPL in the ear canal.

• Show the actual performance of the hearing aids, removing the guesswork from your fittings.

• Provide a more accurate initial fit, reducing the risk of overfitting or underfitting.

• Increase patient satisfaction and reduce the number of time-intensive follow-up visits, troubleshooting, patient frustrations and returns.

• Allow the accurate monitoring of hearing aid performance after the initial fitting to guide ongoing adjustments.

REMs actually take no more than five minutes when a professional is proficient with the protocols. While initially, it may take a little longer, practice makes perfect.

The Measure software will guide you through the process in a clear step-by-step manner. It can be very useful to use software like this, especially if you've never used REM and are initially feeling unsure of the protocols.

The Measure software also has a helpful nudging feature that guides clinicians through the workflow to ensure best practice standards are consistently followed.

Another prevalent misconception is that inserting the probe tube could hurt the patient or damage the tympanic membrane (TM). This is highly unlikely since the probe tube is extremely thin, flexible, and made from a very soft material. In addition, the transducer has an integrated measurement tool, helping the hearing provider set the proper depth.

Untangle Fitting Experiences and Increase Patient Comfort
The new Wireless REM Probe provides accurate fittings with fewer cables. With a cabled REM probe, there's a constant battle with getting caught in patients' hair and clothing, and potentially with hearing aids, too. Auditdata's new Wireless REM Probe eliminates these issues and elevates patient comfort.

Enjoy reliability This solution offers remarkable battery life for precise, seamless measurements and hours of dependable, continuous operation.

Improve care This innovative technology helps elevate audiology practices and enhance patient satisfaction.

Boost usability The measurements – and the functionality – are identical to the probes with wires, boosting usability.

This is a prevalent argument about REMs, but it makes no sense. If you fit a full prescription using REMs at first fit, the patient may not like it because the louder sounds with the hearing aids may be initially jarring. However, that's why acclimatization features exist. Fit the patient to full prescription, undertake REMs to verify it, then set the gain to an acceptable level using the auto acclimatization feature.

It means that you will slowly, but surely, introduce the gain they need over some time. This process will give a patient time to acclimatize to the required gain, and it won't seem as drastic initially.

If you explain the process and the benefits, most patients will be happy to move forward with REM. When you discuss why you're doing REM – and how it will help them – the patient will appreciate that you're delivering the service in the best possible manner for them. Even if the patient gets to full prescription and does not like it, that's not a REM failure.

Everyone is different and some people like a slightly diminished sound. Show your willingness to customize the hearing aids – and the experience – as you care for each patient as an individual.

If your hearing aid has an acclimatization feature, we recommend you fit the hearing aid to match the final target. After fitting to final target, activate the acclimatization feature and the hearing aid will gradually increase the gain to allow the patient to get used to their properly fitted hearing aids.

In the Measure software you can place the curves in so-called "On-top mode". This enables you to easily monitor the REAR, while at the same time adjusting the hearing aid gains using the manufacturer's separate fitting software.

The Measure REM offers a very useful tool called Match-to-Target (MTT). This functionality warns you if the hearing aid gain deviates too much from the prescribed target during a REM hearing aid fitting. The max deviation can be set by the user for each measured frequency. Both SPL and gain can be used as references.