Category Archives: Language : English

Take-away from 32c3

I attended the 32c3 last year and watched the talk “Unpatchable“, a talk which is related to hacking medical devices. In this case it wasn’t hearing aids, but pacemakers. Interestingly, the speakers raised similar questions as I did in my talk at 28c3.

The questions being for example:

  • This device is part of my body, why do I not know what code is in it?
  • How can I trust that the device is not vulnerable from the outside?
  • Does a doctor have to tell me when he flashes the firmware or that the device is tracking my very personal data?

Agreeable, the consequences for patients wearing pace makers are more impactful than for patients wearing hearing aids or cochlear implants. However, I still found the talk worth watching, I hope you do too.

 

 

What happened since 28c3?

It has been nearly a year since 28c3, the chaos communication congress where I held my talk “Bionic Ears”. It’s been an interesting time since then with lots of developments that I hadn’t anticipated when I handed in the proposal for the talk. I have been planning to write a “what happened since then” post for a while and now, shortly before 29c3, here it is.

Continue reading What happened since 28c3?

Hearing aid technology in consumer electronics?

The following article proposes to use hearing aid technology to enhance consumer electronics, specifically to tune out annoying noises from your environment.

I personally think he overestimates the current state of the art in hearing aid technology  and especially the quality of today’s signal processing algorithms, but I like the idea. I’d love to see the two markets merge in the future, since it will most probably result in dropping prices for hearing aids and awesome features for consumer headphones.

http://chrismaury.com/post/20294864914/its-time-to-level-up-headphone-tech

Waterproof Hearing Aids

This is the 10th (and so far last) part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

Most hearing aids are not waterproof. That leads to a lot of situations which are perfectly normal for hearing people but exclude hearing-impaired ones. For example: social water sports, pool parties, sauna with friends, a trip to the beach with friends, watching a movie with wet hair after you just had a shower, open air concerts in the rain, muddy festivals, listening to audiobooks or watching TV while lying the bathtub. I could go on and on. Also simply sweat is a problem for many people, especially those who perform a lot of sports.

There are a few hearing aids on the market that claim water resistance, I hope it will be standard and affordable soon.

See also the previous point on my wishlist: Legal certainty for situation related to broken hearing aids.

Legal certainty for situation related to broken hearing aids

This is the 9th part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

When my hearing aids break, I am not able to go to work. I mean I could go there, but I would not be able to communicate with my coworkers properly. Also, I have to spend time at the audiologist, to hand in my hearing aids and get the spare hearing aids (roughly) tuned. Wearing poorly tuned hearing aids cause me headaches, which also reduce my work performance. The audiologist visit takes time, but I have no idea if I can officially call in sick for that. I am wondering if my employer can actually fire me if that happens too often. I asked this question several audiologists and none of them could give me a definitive answer.

Same applies to when my hearing aids break when I was doing something that might be considered “risky” with respect to the hearing aids. For example, am I allowed to attend a martial arts class with my hearing aids? Can my insurance refuse to pay the reparation if they break during that class? What about when I accidentally have a shower with my hearing aids on? (It happens because when you wear them every day, you forget that you are wearing them.) What about when I attend an open air concert, it starts raining and I did not seek cover, because I did not want to miss the awesome performance? Those situations might sound constructed, but actually they happen if you are are not an old grandpa, but a young person with an active life.

There are a lot of situations related to hearing aids where there is no legal certainty for the patient. Sick leave and reparation costs are only examples here.

See also the next point on my wishlist: Waterproof Hearing Aids. Or the previous one: Offer tuning in realistic circumstances, legalize and support self-tuning.

Offer tuning in realistic circumstances, legalize and support self-tuning

This is the 8th part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

In order for hearing aids to improve a patient’s life, they have to be tuned correctly. The tuning is done in many meetings with an audiologist. The process of tuning hearing aids takes months and still after that most patients are not entirely happy with the result.

From my own experience I guess that one reason for this is that the tuning never takes place in a realistic hearing setting, but in the audiologist’s soundproof cabin. The only information he has is what I describe about that situation where I was not able to understand my friend at that party last week. In comparison, if you bring your car to a car repair shop and describe in what situations it makes problems, they for sure will try to reproduce the situation in order to examine it and fix the problem. The only thing audiologists do sometimes is taking you out on the street for a minute or two [1].

So getting your hearing aids tuned is a frustrating and time-consuming experience. As a patient you are totally dependent on your audiologist and spend a lot of your valuable time in his office without being happy about the result afterwards. It is no surprise that there are quite a number of people who started to tune their hearing aids themselves.

The problem with self-tuning is: you need special hard- and software and you need the knowledge. The knowledge is out there, although it might not be too easy, it is possible to teach yourself the required audiology.

The hardware and software on the other hand is hard to get. Officially it is only sold to audiologists and doctors [2]. There is no way to buy it on the free market like on ebay etc., because those hardware is classified as medical devices and as such not obtainable by patients.But for every market, there is a black market and when people are frustrated, they find a way. So, there are quite some people out there which tune their hearing aids, because they can do that wherever and whenever they want and not just when their audiologist is willing to give them an appointment and willing to do the tuning outside his office. So the situation is that there are people self-tuning, but because they have to do it inofficially, they don’t get any support for that. Support means software updates, manuals, maintenance material for the hardware, trainings for the software, warranty for the tuning hardware and their hearing aids etc.

What I want here is that interested and skilled patients are allowed to get a “hearing aid tuning license”. Similar to a driving license, I imagine that you take some classes and maybe have to do a test and in the end you are allowed to tune your own hearing aids. Most hearing conditions are permanent, which means as a young person, you are facing several decades of having to wear hearing aids. In that situation you might as well spend some weeks on learning how to tune your hearing aids yourself in order to be more independent.

Also, it would great, if the software would comply to common standards, meaning that it has open APIs which everyone can use to extend its functionality. The hardware should comply to open standards and be legally purchasable by patients. It would be even better if you don’t need special hardware at all but can use consumer hardware. Why do you need a special device when you hearing aids can talk bluetooth in the near future? So, why can’t I just tune my hearing aids using my smart phone or my tablet PC while I am sitting in the subway?

[1] I heart rumors, that some audiologists come home to people and adjust the hearing aids there. Of the four audiologists that I have seen so far, none of them offered that.

[2]  There is one exception in the U.S: americahears.com

See also the next point on my wishlist: Legal certainty for situation related to broken hearing aids. Or the previous one: Open hardware and software standards.

Open hardware and software standards

This is the 7th part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

This goes along with the 2nd point of my wishlist. Hearing aids and peripheral hardware should be compatible independent of the vendors. For this, standards for hardware and software have to be established. Those standards should be public. This would make the hearing aid market more open and lively since it would open doors for new companies and open source projects to develop hardware and software that is compatible to the established vendor’s devices and as such attractive for the customers.

It would make the market more competitive, (hopefully) leading to more customer-friendliness, maybe even cost-reduction and especially to a market that reacts faster to developments in the general consumer electronics market than it currently does. The market would be open for small companies that cannot offer a full portfolio like the established ones, but might specialize in a niche that is desperately missed by the patients so far.

Open standards would also enable skilled patients to improve their hearing aids themselves. I am dreaming of the day that I can write my own signal processing algorithm against the application programming interface (API) of my hearing aid and thus regain power over (the electronic parts of) my body again.

See also the next point on my wishlist: Offer tuning in realistic circumstances, legalize and support self-tuning. Or the previous one: Affordable hearing aids and full insurance coverage for devices and peripheral hardware and maintenance costs

Affordable hearing aids and full insurance coverage for devices and peripheral hardware and maintenance costs

This is the 6th part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

Insurance companies barely cover the costs of hearing aids [1]. The only devices that are covered are the cheapest and oldest models, which lack a lot of features which are necessary for a person who has an active social and work life. Insurance companies provide their share to new hearing aids at most every five years. That means I basically need to save money every month since I got my last hearing aids in order to buy the new hearing aids. I could decide to not buy new hearing aids that soon and keep the old ones for 10 years. But for a person with an active life, this is not an option. If you consider the progress that the consumer electronics industry makes in 5 years, you can easily transfer that to the hearing aid industry imagine how many chances you miss to get a better signal processing and thus a better social life.

Peripheral hardware such as adapters for phones are not covered at all by the insurances. Insurance companies do not consider it a necessity to be able to talk on the phone. As much as I hate talking on the phone anyway, unfortunately in a business environment it is still communication medium number one.

Also, in order to maintain the functioning of hearing aids, one has to clean and try them frequently and provide them with new batteries every couple of days. Insurances do not cover any of the costs there.

[1] This might only apply to Germany, I cannot give an exhausting description for other markets. Feel free to add comments about that.

See also the next point on my wishlist: Open hardware and software standards. Or the previous one: Longer battery life and non-proprietary batteries in peripheral hardware.