Revolutionizing Audiology: The impact of mHealth apps on hearing health

Advancements in mHealth applications

Mobile phones have become indispensable in today's tech-driven world, used for everything from ordering food to paying utility bills, and extending all the way to healthcare services. This has led to a significant rise in mobile app use across the healthcare industry. The COVID-19 pandemic led to the rapid adoption and widespread implementation of eHealth services, including telehealth and mHealth (Mobile Health), which has continued to grow ever since ^[1,2,3]. Electronic Health (eHealth) integrates electronic communications and medical information technology, including health records, prescriptions, telemedicine, and mHealth ^[4]. mHealth is a general term for the use of mobile phones and other wireless technology in medical care ^{[5 ,6]}.

Key characteristics of mHealth apps ^{[6, 7 ,8]}

For the purposes of this article, we’re considering the use of mHealth applications in two main categories, namely: point-of-care in healthcare environments, and consumer use.

The following characteristics are key to consider in the development of mHealth applications for both user categories.

1. A user-friendly interface with intuitive navigation is essential for enhancing engagement in mHealth apps. This usability is crucial in audiology, where clear communication and ease of use support patient interaction with hearing health data and treatment plans. Research has shown that 52% of US adults prefer accessing their health records and communicating with healthcare providers via secure online platforms[4]. This highlights the need for thoughtfully designed apps that simplify use and encourage consistent interaction.
2. Nowadays, mHealth apps provide increased integration with wearable technology to accurately monitor aspects like fitness and heart rate. In an audiological setting, this extends to monitoring hearing aid usage patterns and environmental noise exposure, providing audiologists with comprehensive data for personalized treatment strategies.
3. Customization and personalization features enable users to tailor their profiles, set goals, and receive notifications that suit their individual health needs. This can help to encourage continued engagement and adherence to health objectives, improving patient outcomes.
4. Clinical accuracy and reliability is essential for mHealth apps to be effective and trusted by users, The health data, advice, and recommendations included should be based on validated medical science verified by healthcare professionals, and certified to the highest international standards.
5. Interoperability with other health systems facilitates seamless data flow across different platforms, ensuring that healthcare providers have access to the most updated patient information.
6. mHealth apps must address concerns about data protection and privacy and comply with specific regulatory and security requirements due to the sensitive and personal nature of the data that is processed.

mHealth use cases and benefits in hearing healthcare ^{[7 ,8, 9, 10, 11, 12]}

mHealth apps offer a wide range of functionalities that enhance hearing healthcare delivery and patient support:

Consumer use:

1. Patient engagement and education: By providing educational resources, mHealth apps can help patients understand their hearing health, the use of hearing aids and assessment solutions, and how to protect their hearing. These resources can include videos, articles, and interactive tools. The hearWHO app is a prime example. Developed by hearX® for the WHO, the app enables public access to a hearing screener to check your hearing status and monitor it over time. The app is easy to use and clearly displays the user’s results and keeps a personalized track record of their hearing status over time.
2. Hearing aid management: Apps are available that enable users to control and adjust their hearing aids via their smartphones. This includes changing volume, switching between programs, and checking battery status. With the deregulation of hearing aids in the USA to allow for OTC hearing aids, self-fit hearing aids and accompanying apps are cleared through the 510(k) process with the FDA to ensure device safety and efficacy. Apps and user experiences like those developed by the award-winning Lexie Hearing, are leading the way in providing clinical-practise-equivalent outcomes for patients, using mHealth technology
3. Noise exposure monitoring: Recently, the use of mobile apps and wearables for noise exposure monitoring has significantly increased. These apps enable users to become more proactive in monitoring their hearing health by providing data on noise exposure and making recommendations for the appropriate protection. Other apps can measure daily sound exposure from music listening devices and provide information about environmental noise, which can contribute to more comprehensive hearing health management.

Point-of-care clinical solutions:

1. Tele-audiology: mHealth applications are increasingly used for remote hearing assessments, allowing audiologists to administer hearing tests and provide instant feedback on hearing health without being physically present. This makes hearing care more accessible to patients in remote or underserved areas.
2. Data tracking and management: mHealth apps can track and store hearing-related data, which can be shared with audiologists for real-time reporting and patient care. This includes hearing test results, hearing aid usage, and environmental noise exposure, as mentioned earlier.
3. Community-based hearing care: mHealth apps can be instrumental in delivering hearing health services in community settings. One such example is conducting hearing screenings and hearing aid delivery in low-income, resource-limited communities. Studies have shown that if innovative, scalable service delivery models can be implemented using mHealth technologies, it can significantly improve access to hearing healthcare in low-income, underserved communities.
4. Hearing conservation programs: These programs play a vital role in protecting workers' hearing health by implementing measures to control noise exposure and conducting regular hearing tests. Such tests are essential for regulatory compliance and help to identify early signs of hearing loss and prevent further damage. By maintaining a proactive approach, employers can ensure a safer work environment and promote long-term auditory health among their workforce.
5. Improved accessibility and decreased cost: Mobile access to hearing health resources and support services provides wider access to information and service delivery at a fraction of the cost by leveraging a decentralized model, contributing to better global access and health outcomes.

Taking hearing health forward: Emerging trends in mHealth applications ^{[13, 14, 15]}

1. Remote health monitoring: Agile technologies in mHealth facilitate remote monitoring of hearing health metrics, enabling audiologists to track patients' auditory responses and adjust treatment plans without in-person visits, particularly beneficial in remote or underserved areas.
2. Consumer wellness: Wellness apps integrated into wearable devices monitor fitness, lifestyle habits, and nutrition, enabling users to set and achieve health goals. For audiology patients, these apps support the management of lifestyle factors crucial to hearing health, such as monitoring noise exposure. This proactive approach can enhance overall care and lead to improved outcomes.
3. Chatbot integration: Integrated chatbots can assist audiology patients with hearing aid troubleshooting and adherence to treatment protocols. Additionally, they can serve as a support channel for general inquiries when hearing health practitioners conduct app-based hearing assessments. The rise of AI chatbots holds promise for addressing global hearing health disparities, however it will require a collective, united effort in research, technology development and policymaking to ensure these advancements are ethically sound and universally accessible.
4. Big data: Leveraging big data, researchers and hearing health practitioners can analyze trends in hearing health metrics across populations, guiding public health initiatives and personalized treatment strategies for optimal patient outcomes.

mHealth at hearX^{® [16]}

In 2019, hearX developed the hearWHO app for the World Health Organization (WHO) - a free mobile app for hearing screening. This collaboration exemplifies our dedication to hearing screening services globally. Based on validated digits-in-noise technology, hearWHO enables public users to check their hearing status and monitor it over time. A recent study highlighted the app's significant role in hearing health promotion, particularly among younger adults, making it a vital tool for public health advocacy and prevention.

hearWHO stats over the past 2 years:

• Used across 191 countries.
• More than 250,000 end-users tested.
• More than 263,800 app installs since launch.
• Available in English, Spanish and Mandarin.

The central point of integration with all hearX apps, is mHealth Studio - our comprehensive data management portal, available for free with our clinical or screening product subscriptions. The portal ensures secure communication and synchronization between our hardware solutions and the mHealth web portal, enabling you to access patient and test data online effortlessly.

The mHealth Studio App serves as a mobile platform for capturing and managing patient data, designed to seamlessly integrate all mHealth solutions in a user-friendly way.

In addition, the mHealth Studio Cloud functions as an electronic health record (EHR) web portal, offering capabilities such as asynchronous telehealth, referral management, report generation, data downloads, and bulk patient uploads. This ensures secure real-time data monitoring and efficient management of results.

The diagram below illustrates how all of our applications integrate with mHealth Studio:

These mHealth applications link seamlessly with mHealth Studio, providing point-of-care clinical solutions that enhance the efficiency and effectiveness of hearing healthcare delivery.

Conclusion

In recent years, the adoption of mHealth has been accelerated by users’ need for personal health control and the shift to virtual care that was brought on by the COVID-19 pandemic. These apps are becoming essential in healthcare services, offering continuous monitoring, advanced diagnostics, and personalized treatment plans. In audiology specifically, this translates to greater access to hearing health services, enabling patients to manage their hearing health remotely and proactively. Furthermore, mHealth makes reporting more efficient and cost-effective, streamlining data management for healthcare providers.

This efficiency also enhances the sales and user experiences of OTC hearing aids by providing real-time access to hearing data and easier device management. With more service providers addressing security measures and regulatory compliance that were initial concerns, mHealth apps are increasingly being embraced as a support channel in healthcare and several other industries.

Looking ahead, the impact of mHealth in audiology promises greater empowerment and accessibility for patients and hearX remains committed to staying at the forefront of hearing health tech innovation, to ensure that hearing health becomes a reality for those who need it most, globally.