Independent Audiologists Blog

74th Annual General & Scientific Meeting

Thu, 11 Mar 2021 00:54:56 GMT

New Zealand Society of Otolaryngology, Head & Neck Surgery

9th - 12th November 2021 - Wairakei Resort, Taupo, New Zealand

On behalf of the Organising Committee we wish to invite you to attend the 74th Annual General and Scientific Meeting of the New Zealand Society of Otolaryngology, Head and Neck Surgery, to be held at Wairakei Resort, Taupo, New Zealand from 9-12 November 2021.

Workz4U Conference Management Ltd

Donna Clapham

+64 21 325 133

conferences@w4u.co.nz

Australian Hearing Services Pays Penalties

Fri, 28 Sep 2018 00:00:00 GMT

Australian Hearing Services has paid penalties totalling $37,800 after the ACCC issued three infringement notices alleging the Australian Government owned corporation engaged in false or misleading conduct in connection with the supply of hearing services to consumers.

The ACCC also accepted a court enforceable undertaking from Australian Hearing, which has admitted that its conduct breached the Australian
Consumer Law.

Australian Hearing competes with other hearing clinics to provide hearing services to consumers under the Australian Government Hearing
Services Program. It owns and operates Hearing Help, a service that provides hearing advice to consumers by phone or via Facebook.

Australian Hearing has admitted that it:

engaged in misleading conduct by representing that Hearing Help is “unbiased” in circumstances where Hearing Help is owned and operated by
Australian Hearing and one of its primary objectives is to increase consumer referrals to Australian Hearing falsely represented that Hearing Help was government funded.
Hearing Help is entirely funded by Australian Hearing which largely operates on a ‘for profit’ basis in competition with other hearing clinics sent renewal reminder letters to clients of the Australian Government Hearing Services Program that falsely represented that payment for annual subscriptions for maintenance services for hearing aids was mandatory when it was not.

Consumers pay a fee of around $50 for these subscriptions and providers like Australian Hearing receive a subsidy of around $75 to $200 for each
customer they sign up.

“This is the second time we have acted recently against a hearing services provider after we put the sector on notice in 2017 about concerning business practices in the industry” ACCC Commissioner Sarah Court said.

“Hearing clinics need to ensure that they are not misleading customers in order to sell hearing aids. Hearing clinics must be truthful in the
way they promote and deliver their products and services, whether in their advertising materials or in their direct communications with
consumers.”

“The customers of these businesses are often vulnerable due to their hearing loss or age, and are often on a pension. We will continue to
take enforcement action to protect vulnerable consumers where we see wrongdoing" Ms Court said.

As part of the undertaking, Australian Hearing has also committed to publish notices on Facebook and in its next round of annual reminders to
advise consumers of its misrepresentations. Australian Hearing has also undertaken to implement a comprehensive compliance program.

A copy of the undertaking is available at: Australian Hearing Services - Section 87B

Notes to editors:

Around 80 per cent of hearing aids supplied in Australia are provided under the Australian Government Hearing Services Program.

The Hearing Program is administered by the Department of Health. Around 300 providers, including Australian Hearing, are accredited by the
Department of Health to provide hearing devices to voucher holders under the Hearing Program.

The Hearing Program provides access to subsidised hearing services and devices (via “vouchers”) to eligible persons, such as Pensioner Concession Card holders, veterans, and Australian Defence Force personnel. Vouchers can be used to obtain fully subsidised hearing devices, or to cover some of the cost of partially subsidised hearing devices, with the consumer paying the remainder of the cost directly to hearing clinics.

When a consumer obtains a hearing device under the Hearing Program, the provider will also generally offer the consumer an optional maintenance service agreement. This service is optional, but recommended by the Department of Health.

Should Audiology be a registered health profession?

Thu, 13 Sep 2018 07:08:49 GMT

Disclaimer: the author is an independent audiology clinic owner-practitioner in Kapiti (Raumati Beach and Waikanae), and thinks the public would be better off if audiology was registered.

Here’s a question: if you had the choice, which would you rather go to?
A registered or a non-registered plumber?
A registered or non-registered electrician or builder?
A chartered accountant or a non-chartered accountant?
A doctor who is a member of the Royal New Zealand College of General Practitioners or a…quack?
Who would you advise your kids to go to? Or your mum or dad?

At the moment, in New Zealand, 21 health professionals are registered under the HPCA Act (Health Practitioners Competency Act) 2003. If you want to know which ones, go to: http://www.health.govt.nz/our-work/regulation-health-and-disability-system/health-practitioners-comp...
This list includes podiatrists, opticians and optical dispensers, psychologists, and more obvious ones such as dentists and pharmacists. Key concepts here are “regulation” and “competence”.
Currently, social workers are also being considered for registration. http://www.stuff.co.nz/national/politics/opinion/78774522/Get-on-with-it-compulsory-registration-for...

In order for a profession to be considered for registration, they must be able to show “risk of harm” to the NZ public – and their professional association, if there is one, must want to go ahead with registration. Note, this is not “Risk of Death”, or even “Risk of physical harm”; it’s “Risk of Harm”.

Audiology is not registered in New Zealand (although Australia has been looking into it, and a Parliamentary select committee there has recommended it). There seem to be three objections to registration here:
1) No risk of harm to the NZ public stems from audiology;
2) It is too expensive to do;
3) The Executive Council of New Zealand Audiological Society (the voluntary “self-regulatory” body of those audiologists who choose to belong to it) is not currently interested in registration.

Let’s look at these three obstacles.

1) Risk of harm

This could be risk of harm to a person’s physical well-being:
- where someone with an acoustic tumour is not referred to a specialist, or a hearing aid is set too loudly, harming the person’s hearing; or they are not diagnosed with a serious hearing loss until it is too late (for children) to develop speech, or for surgery due to age and risk to the person’s balance organs (all cases seen in my practice with patients fitted elsewhere).
This could mean risk of psychological or psychosocial harm:
– when someone feels so isolated due to hearing loss that they commit suicide; or so isolated that they become seriously depressed https://vestibular.org/news/09-13-2012/link-between-untreated-hearing-loss-mental-health ; or they are not diagnosed early enough and do not develop the ability to speak; or they miss out on educational opportunities, or job opportunities, so that their earning potential is diminished; or are bullied or called stupid, because they can’t hear. Older people may fail dementia tests because they appear confused as a result of not hearing; or may mishear instructions https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5069696/ .
There is also increasing evidence that untreated hearing loss is strongly and positively correlated with cognitive decline. (Lin F et al, 2013, Hearing loss and cognitive decline in older adults. JAMA Intern Med.173,4; 293-299 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1558452) .

This could mean risk of financial harm:
Perhaps it is this last one that is the real obstacle, and also the most obvious risk. That is, people may feel they pay too much for hearing aids, or not get “value for money” for the “treatment over time” that is the process required for a hearing aid fitting. They may, for example, pay for premium technology hearing aids, when in fact they are being fitted with very basic ones. They may also think they are paying for the skill of the professional who fits them, when in fact, in the absence of registration, anyone in New Zealand may fit hearing aids. Historically, hearing aid prices have bundled the cost of the hearing test (so the cost of the initial hearing test does not reflect the real costs to the clinic) and the fitting and follow up costs into the cost of the hearing aid. You are buying a treatment. The costs to patients of treatment from businesses without layers of management, or shareholders, may be substantially less than from a larger corporate group of clinics. Patient choice is important, so that cost comparisons can be made, involving all factors: type of aids, level of technology, length of treatment.

Hearing healthcare (when it involves hearing aids) is big business. This is why you may hear the term “Hearing Industry” rather than “Audiology Profession”. Hearing aids are not cheap, in general, to the audiology clinic that buys them, although part of the cost to the patient usually includes the fitting and the follow-up appointments. You pay for the expertise of the trained audiologist – this can be up to 6 years of study. But how do you know that you have a trained audiologist, or a trained audiometrist? (Audiometrists, called “Hearing Aid Dispensers” in some countries, generally also undergo training). You don’t. Only registration gives name protection, with defined scopes of practice that can be enforced. You may just be seeing a sales person.

Kitting out a single properly sound-treated and equipped clinic room can cost up to $100k in equipment alone. The cost of paying for audiologists, receptionists, layers of management, shareholders’ dividends (where these exist), rents, insurance, training, upskilling, etc are all recouped, in the main, from the price of hearing aids. Private clinics are, after all, businesses. Properly fitted hearing aids are customised to a person; the sound pressure level near the ear drum should be objectively measured against a known quantity, taking into account the geometry of the person’s ear canal; a computerised software program is applied to the hearing aids and tweaked according to the person’s subjective responses as well as results obtained from testing in a sound-treated environment. The brain gradually rewires itself over several weeks to the new input, and the aids will usually be adjusted over this time. Several follow-up appointments within a trial period are routinely part of the fitting process. Generally, if you are not happy with the aids at the end of the trial period, you can return the aids with no financial loss to yourself. However, when you see a sign that says “Free Hearing Tests”, or “Free Batteries”, or “Free Lunch”, be aware that the cost of this time spent doing the tests must be recouped by the clinic in other ways.

In some business models, there are pressures on audiologists to “upsell” aids, or to sell equipment, such as smart-phone-linked aids, to elderly people who…don’t have smartphones. Pressure may also be applied to audiologists to sell aids to people who don’t yet need aids, or who are not ready to get aids. Take a family member or a friend with you to give you support, and to help you remember what is said. http://www.abc.net.au/news/2017-03-02/consumer-watchdog-puts-hearing-aid-industry-on-notice/8319738
Hearing aids also come in different levels of technology; essentially, the more you pay, the more features on the computer chip in the aid are activated. Cheaper aids, while using the same chip, have fewer features activated, although the aids will look exactly the same. This means that you need to be able to trust the person who is fitting you, and trust that there is oversight in the form of a Registration Board.

Why would you want to separate a Health Profession from embedded commercial interests?
• The purpose of a Health Registration Board is to safeguard the New Zealand public.
• The purpose of an Industry body is to safeguard and support its commercial interests.

Neither approach is wrong. But be clear of what we have here. Currently in New Zealand we have a powerful lobbying group: the NZ Hearing Industry Association. Their views on registration for audiology are not officially known. However, we feel that it is up to audiology clinicians to make this decision.

2) Registration too Expensive to do

There are costs involved in setting up a new registration board. Scopes of practice have to be written, people have to be paid. So why not set up an Audiology Registration board under the auspices of an already existing authority? (The Medical Sciences Registration Authority has expressed interest).

Scopes of practice and practicing standards have already been developed by the NZ Audiological Society (a voluntary and self-regulating group, but which has embedded links to industry) over many years; these could be used if Regulation was supported by the NZAS. An audiology practice quality control program has been developed by Independent Audiologists NZ (link within our website here). Many of the regulatory requirements are already met by clinics. Most registered health professions have both a Registration Board and also a Professional Society. There is no reason why Audiology, which already has a Society, could not be the same.

3) Lack of interest in registration from the NZ Audiological Society

Their position is currently that “We are not looking at registration”. It may also be because some long-standing members of NZAS no longer practice audiology, and have not done so for many years or they work for industry groups that may be opposed to registration. In order to belong to a Registered Health Profession, you have to practice clinically, and keep current with new developments in your field. While their knowledge and experience is valuable within the NZAS, they would not be able to join a registered group, but could remain a part of the Audiological Society.

At the New Zealand Audiological Society 2018 annual conference held in Auckland, 97% of audiologists, Audiometrists and post-graduate students surveyed on the question: “Should Audiology be a registered health profession?” voted “yes”.

At the Acurity Conference for GPs held at Te Papa in Wellington in 2015, 100% of GPs thought that Audiology was a registered Health Profession, and many expressed surprise and dismay that it was not.

At the Acurity Conference for GPs held in the same location the following year, 100% of GPs surveyed thought that Audiology SHOULD be a registered Health Profession.

If you think so too, write to the Minister of Health, the Associate Minister of Health, or to your local MP and ask why it’s not. For your own protection.

Jeanie Morrison-Low. MNZAS. 2018.

Quality Control program for Audiology Practices

Thu, 01 Feb 2018 00:00:00 GMT

Quality Control for audiologists involved in adult hearing rehabilitation

Based on NZAS Professional Practice Standards, Section 88 Hearing Services Notice, The Australian Commission on Safety and Quality in Health Care, the NZ Ministry of Health Auditing Requirements, and other NZ legislative requirements relating to health professional practices.
The Ministry requires that audiology practices “have systems and processes for the ongoing improvement of the quality of … hearing aid services”. (Section 88 Hearing aid Services Notice 2011)

It is suggested that self-auditing is performed by IANZ clinics for two years consecutively, using “Sound Practice” auditing system by Geethal Systems (password-protected); third year has external auditor (done electronically, using “Sound Practice” system, with specific documents scanned and sent if requested to a range of participating doctors and Ear-Nose-and-Throat and other specialists who have agreed to be auditors for IANZ.

Auditing requires that when requested, policy and other documents, and examples of files with names of patients redacted are sighted; training records etc are sighted.

Rights

Patient Health and Disability Rights – Copy on wall clinic; English and Maori.
Patient and Clinician Rights statement specific to audiology visible.
Prices for clinic services visible/available.
Disclosure of ownership and links to manufacturers – statement visible in clinic.
Complaints procedure/information available in waiting room.
Privacy Act staff awareness: training record; dates; names of those attending, what covered.
Section 88 of the Hearing Aid Services Notice; staff awareness of requirements; record of training.
Copies of Section 88 and Privacy Act and Privacy Code available in clinic; staff training recorded.
Confidentiality agreements signed by all staff regarding patient and clinic information.
Cultural awareness; understanding of the Treaty of Waitangi and its implications. Training record.

Human Resources/Workforce Management

Name of HR company available to Practice for advice, unless Practice large enough to have own HR dept.
Job descriptions available.
Contracts in place for all staff.
References followed up and documented for new staff.
Practice has a documented orientation procedure for new staff/clinicians.
There is a resource about the practice procedures available for new staff/clinicians
Performance reviews that support individual development and improvement done at least annually.
Regular staff meeting records kept.
Clinicians have access to continuing education to keep them up to date with recent developments in hearing aid products, software and other hearing-related technology. Records available of this over past year.
Mechanisms are in place to monitor that the clinical workforce are working within their agreed scope of practice. (Supervision records, clinical files reviewed, dates when reviewed and what reviewed; any action taken recorded)
Clinicians working with children have police clearance, and therefore comply with Vulnerable Children’s Act.
Supervision of the clinical workforce is provided whenever it is necessary for individuals to fulfil their designated role.
The clinical and relevant non-clinical workforce have access to ongoing safety and quality education and training for identified professional and personal development.
Procedures to encourage teamwork exist. Records/ description available
Analyse feedback from the workforce on their understanding and use of safety and quality systems.
Holiday and leave policy in place. (Copy of policy sighted)
Flexible work policy in place. (Copy sighted)
Staff have information about how to comply with Health and Disability Consumers’ Rights.
Processes are in place to support the workforce to recognise and report complaints.
Feedback is provided to the workforce on the analysis of reported complaints, and used as an opportunity for improvement.
Workforce access to training on patient-centred care and engagement of patients in their care.
Checks of staff understanding of how to focus the clinic on patient and family-centred care.
Maori greetings and other phrases for use by staff in eg emails, when appropriate, available.

Dispute Resolution

Written policy in place. (eg membership of Medical Protection Society, available for IANZ clinicians gives access to free dispute resolution services as well as legal advice).

Code of Ethics

Copy available in clinic on request (NZAS or IANZ/IAA, or both).

Complaints Policy

Clinic Complaints policy and procedures understood by staff. Training record available.
Complaints Brochure/information available to patients in waiting room.
Information regarding patient right to complain to Health and Disability Commissioner/Privacy Commissioner available to patients.
Health and Disablility Code advocates contact information available to patients.

Clinician Qualifications and Activity

Continuing Education Points (CEPs) kept up to date – current certificate on wall of clinic.
Other relevant clinician qualifications on wall of clinic.
Clinicians working with young children outside scope of adult rehabilitation; paediatric certificates up-to-date.
Supervision: supervisor signs off on supervisee work as per NZAS requirements.
Supervision: records of activities, evaluation of progress, summary of feedback etc given as per NZAS requirements (NZAS Professional Standards part B, sect 3, page 24)
Identity of clinician doing work and making notes recorded clearly in patient file.
Clinicians work within their scopes of practice (eg only MNZAS audiologists may do ACC work; paediatric certificate-holders can do paediatric work; Audiometrists’ scope of practice available).
Clinicians refer to another professional when work falls outside their scope/ expertise/ training. Examples of referrals on request.
Conflicts of interest recognised and dealt with/documented.
Information on interpreters available in each clinic.
ACC and ENABLE clinician provider numbers available for each clinician doing funded work.
If available, WINZ CURAM number for individual audiologists to be a registered supplier with WINZ on behalf of patients.
Information regarding other funding options for patients (eg NZAS, Vincentian Foundation) in clinic.
Ownership of clinic, “Statement of Independence” or other ownership links displayed.

Equipment for Adult Hearing Aid Clinic

Electrical safety of equipment certified and tagged by electrician. Sighted/ photograph sent.
Calibration dates up to date on test equipment; specifically, on audiometers and tympanometers. Calibration certification sighted.
Most recent ISO certification of sound-treated test area; certification done by accredited lab visible on wall of each clinic room that is sound-treated or has a sound-treated booth. Certification sighted. (Certification is five-yearly).
Minimum of: otoscope with spare bulbs, otoclip for listening to aids, audiometer for pure-tone air-conduction, bone conduction and speech testing; tympanometer; Real Ear Verification machine; portable dremel or fixed grinder/polisher; hearing aid cleaning equipment such as microvacuum, equipment for taking ear impressions for moulds – ideally in each clinic site.

Clinic Entrance and Waiting Area

Parking close by. (Photographic evidence if requested)
Disability access to clinic entrance (Photographic evidence if requested).
Waiting area clean, comfortable (Photographic evidence if requested) .
Relevant information about the service provided, in a way accessible to patients
MOH subsidy and Funding brochures and other information brochures available.
Seats with arms (to help elderly patients get up more easily)
Carpets, if any, secure (eg double-sided tape securing rugs if on a wooden floor.
Feedback invited/suggestion box/feedback forms/other method of feedback collection used
Names of clinicians and their qualifications (Audiologist; Audiometrist; MNZAS; Provisional etc) visible in waiting room.
Building consent (if clinic new) document(s) available.

Clinic Rooms

Clean, private clinic area, where door can be closed for confidential counselling of patient and discussion of needs.
Adequate heating and cooling available.
Adequate lighting.
Seating for family member or other person(s) if required in clinic room.
Hand-washing area in clinic room, or hand-sanitiser, if wash basin is in another room.

Toilets

Toilet access for the disabled available.

Documentation

Accurate, integrated and readily accessible patient clinical records available to the clinical workforce.
Patient identifying information documented.
Clinician carrying out testing clearly named.
Ethnicity data collected in accordance with Ministry of Health protocols.
MOH Ethnicity data protocols document available to staff.
Patient General Practitioner/doctor noted in file.
Relevant patient case history taken.
Needs assessment/ communication goals (this may be noted according to patient descriptions, or using verified questionnaires such as the HHI, COSI etc).
Audiometric test results recorded according to accepted NZ conventions.
Calibration date of audiometer recorded on test results
Test results and any issues (eg non-organic, hyperacusis, misophonia) described in notes.
Summary of post-assessment discussion with patient/ significant others.
Description of specific recommendations (Assistive Listening Devices, Aids, level of technology in relation to communication needs/budget, counselling, referrals, communication training, do nothing, etc).
Estimate of costs and number of visits (eg quotes saved/scanned in file).
Note made of when to follow up, and follow-up appointment notes recorded.
Hearing aid fitting procedure and fitting activities (if aids fitted).
Real Ear Measurements or other hearing aid verification measures (if aids fitted) with reference prescription.
Specific recommendations for further management, if required.
Copies of any correspondence/ medication lists (letters, emails etc).
Signed consent forms when required to release health/audiological information.
Other signed agreements (eg trial agreements, finalisation agreements, second-hand hearing aid waiver forms etc).
Costs: clear indication of bundled or unbundled costings, and what is included/not included. Expected maintenance/ongoing costs. Copy in file.
Record of outcomes, patient feedback forms available.
Data collected from patient feedback systems are used to measure and improve health services in the organisation.
Other professionals and services involved in multi-disciplinary management recorded.

Assessments

Assessments are carried out by a named clinician, using agreed and documented testing procedures (eg NZAS standards/protocols), which are available to clinicians.
The use of agreed clinical guidelines by the clinical workforce is monitored by a designated audiologist within the practice.
Reasons for truncated tests noted in file.
Hearing tests are carried out in an ISO-certified sound-treated environment (room or booth).
If hearing testing not carried out in ISO-certified sound-treated area, note made on hearing test/in file with reason (eg in-home test due to disability/illness).
Appropriate cross-checks must be performed wherever possible (eg bone and air conduction in audiometry; speech testing of some kind; immittance testing etc).
Where cross-checks not performed, noted in file/on audiogram and reason.
Appropriate masking is used and recorded where indicated.
Audiometric equipment calibration date recorded on audiogram/ in file.
Vestibular testing follows recognised standards/protocols.
Electrophysiological tests follow recognised standards/protocols.
Auditory Processing Disorder and other testing such as Tinnitus Assessments follow recognised standards/protocols. If departing from these, then reasons recorded (eg APD testing under the age of seven).
Hearing aid verification is performed using Real Ear Measures whenever possible; record in file.
Annual reviews encouraged for patients with genetic, likely progressive hearing losses.
Test results are stored securely in patient file (electronically or paper form)
Test results are given or sent to patient on request, and a copy offered on day of test if appropriate.
If hearing aid being considered, copy of Ministry of Health Subsidy Scheme or Funding Scheme provided to patient.
If a hearing aid is not being considered, record in file of other hearing rehabilitation course followed using other means to help patient.

Hearing Aid/Amplification Device Fitting

(For details of recommended amplification procedures and policies, see NZAS professional Practice Standards Part B Section 14, Amplification, pages 96 and 97)

Evidence of needs assessment regarding patient and requirements.
Evidence that patient has been offered a choice of products/devices in file.
Evidence in file that aid is appropriate for patient.
Evidence that patient has been given an adequate trial period in file: ie fitting appointment with a minimum of 2 follow-ups and a trial period of at least 4 weeks for a first-time user.
Hearing aid programming information saved in computer
Acoustics set appropriately in software
Feedback manager run
Objective Real Ear Measures performed appropriately and saved in file.
Notes on fitting procedure/problem solving/ subjective responses of patient to sounds/balance between aids etc in file.
Evidence that patient is satisfied with aids, referring to initial patient needs assessment if possible.
If an insurance claim replacement, evidence that the aid is at least the same level of technology that the patient had prior to loss or damage. (Specifically to avoid providing lower technology but claiming for more advanced technology).

Teleaudiology

Teleaudiology, if practiced, must have a named MNZAS audiologist at one end of the connection.
The teleaudiology connection must be secure and private.
All aspects of procedure documented and signed off by named clinician.
The remote hearing assistant must have adequate training in:
1. Otoscopy and earcanal/eardrum conditions (including when to refer);
2. Taking ear impressions safely;
3. Measurement of receiver lengths;
4. Understanding of appropriate acoustic coupling;
5. Grinding and polishing moulds which are uncomfortable;
6. Real Ear Measurement probe tube placements;
7. Troubleshooting and repair of aids;
8. Cleaning and micro-vacuuming equipment, and access to this equipment;
9. Explaining and showing patient how to insert and maintain hearing aids;
10. Cerumen management.

Referral Pathways

Clear referral pathways to other health professionals: ENTs, GPs, Hearing Therapists, Deaf-Blind coordinators, Vestibular experts, neurologists, psychologists, Cochlear Implants etc
Referral letters (incoming and outgoing) kept in patient file
If referral is indicated, permission obtained from patient and referral made to appropriate specialist (NZAS Professional Standards part B section 18 page 113)
“Resources for older people and their families” document available for patients

Infection Protocols

Written procedures available.
Sterilistion of equipment – written protocols available.
Staff trained in procedures – dates of training.

Health and Safety

Hazards list/Hazards register checklist available in each clinic.
Staff accident report template available.
Significant events – template to record this is available.
Each clinic has a designated health and safety officer who does regular checks and reports.
At least one staff member in each clinic has an up-to-date First Aid Certification.
Earthquake evacuation procedure visible in clinic.
Fire Exits clearly marked.
Exit doors can be opened from inside without a key.
Disability toilet.
First aid kit available.
Fire extinguisher available.
Emergency radio in clinic.
Emergency cell-phone in clinic, or staff cellphone designated for emergency use.
Earthquake strapping used to secure cupboards, shelves etc.

Patient Consent

It is assumed that by contacting the clinic and making an appointment, that the patient consents to be seen by the audiologist. However, in the case of trialling/purchasing of equipment:

The patient will sign their understanding regards trial period and costs – copy in file.
The patient will sign their agreement to keep the equipment/device once the designated trial is completed successfully – copy in patient file.
If patient unable to sign or understand treatment, designated carer will do so.
If c) is the case, then record of Health Power of Attorney in file.
Records in patient notes or quote forms that a choice of products/technology levels/manufacturers were offered.
Patient offered time to think about choice/discuss it with family/others if required.
Patient encouraged to bring family/other to appointment. Eg Notices in waiting room/ information given over phone/on website encouraging patient to bring family /whanau /other support person to come to appointment if desired.
When referring to other health professional (eg GP, ENT, neurologist, etc) permission obtained from patient for release of notes and noted in/scanned into file.

Patient Records

Patient records secure (electronic security/ paper-based, locked room, alarm)
Regular electronic backup if held in electronic form
Patient files/ patient management database password-protected (if electronic format)
When clinician out of clinic room, computer locked (control/alt/delete) or screen monitor on timer.
Notes made in file are linked to/signed by responsible clinician.
Scanned or unneeded documents with patient information are shredded or disposed of by a security company.
Records are legible.
Abbreviations understood by others, or list of abbreviations available
Records (including complaints) held for at least 15 years or more, given audiology treatment may last for decades.
Transfer of files only done with patient permission; signed copy of patient permissions held on file.
Requested files provided to requestor (either patient, or health-power-of-attorney holder; or other health professional who can provide patient-signed release of notes request within three days or less.
Evidence of power of health attorney in file where patient unable to sign themselves.
Patient given the right to choose their provider in the event a practice ceases to exist or splits.
Regardless of l) patient has the right to choose their health provider/practitioner.
If practice ceases to exist, records must be provided to patient, or transferred to another entity which agrees to accept responsibility via Power of Attorney.
If a practice is jointly owned, a policy is written when practice set up, covering what will happen if the practice is split, including what happens to records of patients being seen by more than one practitioner.

Business Continuity Plan

The impact on patient safety and quality of care is considered in business decision-making.
The business must operate on sound business principles. (Letter from accountant attesting to this available on request to auditor).
Business continuity plan in place. (See www.getprepared.org.nz/businesses )

Business continuity plan includes:

Business insurance up-to-date and adequate coverage held.
Indemnity insurance held. (Eg Medical Protection Society or other).
Sensitive business information held securely in one place (IRD#; bank account#; passwords to access various things such as patient database required for running of business).
Secure cloud-based storage for company information, eg Tresorit, or other
Up-to-date Standard Operating Procedures manual; copy in each clinic, held electronically or in paper form.
Written contingency plan in the event of earthquake, flood or other emergency sighted.
Chartered accountant used by Practice, and holds copies of accounts and finances
Secure cloud-based or other accounting system used – password protected if electronic
Secure cloud-based or other patient database used – password protected if electronic

IT Policy

Written IT/computer/social media policy available in practice.
Confidentiality forms signed by staff.
IT management company or expert used by practice.
Anti-virus-software in place and up-to-date.
Electronic data storage policy in clinic

Last updated February 2018

Hearing aid industry put on notice by consumer watchdog

Fri, 03 Mar 2017 00:00:00 GMT

The consumer watchdog has fired a warning shot at the hearing aid industry, with a new report raising concerns about patients being ripped off.

The Australian Competition and Consumer Commission (ACCC) report shows some sales are being driven by commissions rather than the needs of customers.

"Consumers were telling us that they were being sold products that were expensive and that they ultimately may not have needed," ACCC commissioner Sarah Court said.

"These products can be very expensive, they range up to $15,000 for a pair of hearing aids."

She said some clinics appeared to be inflating prices, which was partly being driven by commissions of up to 15 per cent which were not disclosed to patients.

"Some consumers said they paid $10,000 for hearing aids and then found them online for half the price," she said.

"These consumers are really vulnerable, often they're elderly, obviously they've got hearing difficulties and they're being placed in what we might loosely call a hard-sell situation to make these purchases."

The ACCC has been consulting with the top 10 hearing clinic providers and also conducted a survey for consumers and clinicians.

"One of the things we're talking to the industry about is whether you get rid of commission-based selling in this area," Ms Court said.

"Particularly where those going in are undergoing what are effectively medical evaluations and thinking they're getting an objective assessment as to their requirements."

Louise Collingridge from Independent Audiologists Australia said abolishing commissions was a good idea.

But she said some young audiologists feel they have to accept contracts that work to commissions.

"People within the audiology field I think feel to some degree their hands are tied," she said.

"It's also a relatively young and growing profession so a lot of audiologists are relatively inexperienced and it's difficult to negotiate a job contract when you're starting in the field."

Audiology Australia CEO Tony Coles said the industry took the ACCC's concerns "very seriously".

"We encourage any member of the public who has concerns regarding the clinical services provided by an audiologist to contact Audiology Australia," Dr Coles said.

"If the clinician is a member of Audiology Australia, anybody with concerns regarding the clinician's conduct can lodge a formal complaint regarding a potential breach of our code of conduct.

"If the clinician is not a member of Audiology Australia, we can help them to find another organisation or body that can help them."

Retiree told to buy hearing aids for $12,000

Retired film producer Tony Buckley, 79, experienced hard-sell tactics first hand when he first visited an audiologist three years ago.

"The hearing aids they felt were appropriate for me were $12,000 which I thought was a bit rich to say the least," he said.

"Then I noticed the partnership of specialists were also connected to a hearing aid company, and the specialist concerned referred me back to the audiologist I'd been sent to originally.

"They then became wary that I was connected to the media and the specialist suggested I get an independent audiologist of my own choosing."

Mr Buckley found a similar product at a different audiologist for $5,000.

"There's a conflict of ownership and a conflict of partnerships," he said.

Better Hearing Australia president Michele Barry said there were many reputable clinicians in the industry, but part of the problem was the sector was self-regulated.

"The fact is it's not regulated. I don't know if it would help the industry at all but self-regulation is certainly not producing the outcomes that we would always like to have in our sector," she said.

She said someone should always take a trusted family member or friend to their appointment and avoid making decisions on hearing aids straight away.

The ACCC has released its report to mark World Hearing Day and is encouraging consumers and clinicians to contact its centre on 1300 302 502 if they have concerns.

How do independent audiologists work for you?

Thu, 28 Apr 2016 00:58:00 GMT

As Independent Audiologists we’re not a chain and we’re not owned by a hearing aid manufacturer, so we’re free to recommend to you every and any solution available on the market. It means, when you visit an Independent Audiologist you can be sure we’ll recommend the hearing solution that really is the very best for… Continue Reading How do independent audiologists work for you? The post How do independent audiologists work for you? appeared first on Independent Audiologists (IANZ) - find an independent audiologist.

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Why isn’t audiology a registered profession?

Thu, 28 Apr 2016 00:54:00 GMT

Healthcare professions are recognised by governments and the public as having defined scopes of practice and expertise that require predetermined levels of education and competencies. Recognition of scope of practice and required education affords the rights and responsibilities associated with earning a living from delivering healthcare services. In New Zealand, 21 health professions are registered under the HPCA Act, 2003. These are: chiropractic (Chiropractic Board); dentistry; dental hygiene; clinical dental technology; dental technology; dental therapy (Dental Council); dietetics (Dieticians Board); medical laboratory science, anaesthetic technology (Medical Sciences Council of New Zealand); medical radiation technology (Medical Radiation Technologists’ Board); medicine (Medical Council); midwifery (Midwifery Council); Nursing (Nursing Council): Occupational Therapy (Occupational Therapy Board); Optometry and optical dispensing

Read the full PDF paper here.

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Patient Centred Audiologic Care – What it means.

Wed, 27 Apr 2016 02:35:00 GMT

Patient-centred care means: That we only have qualified audiologists treating you in our clinics. That we ask you what your needs are That we never pressure you That we look after you long-term That we are responsive to you That we welcome your family and whanau into our clinics whenever you wish them to be… Continue Reading Patient Centred Audiologic Care – What it means. The post Patient Centred Audiologic Care – What it means. appeared first on Independent Audiologists (IANZ) - find an independent audiologist.

Patient-centred care means:

The post Patient Centred Audiologic Care – What it means. appeared first on Independent Audiologists (IANZ) - find an independent audiologist .