Association of Hearing Instrument Practitioners of Ontario
Hearing Instrument Specialists H.I.S.
Statement of Purpose
This document provides a general description of Hearing Instrument Specialists (H.I.S.) in Ontario, highlighting the range of hearing healthcare services they provide. It includes their scope of practice, qualifications and ethical standards as AHIP members.
This document is intended as a resource for Hearing Instrument Specialists (H.I.S.), healthcare professionals, government agencies, health insurers, educators, consumers and the general public.
Scope of Practice
Hearing Instrument Specialists (H.I.S.) of Ontario are AHIP-certified hearing healthcare professionals in the practice of testing hearing, selection, fitting, counseling and dispensing hearing aids and associated devices, and the removal of cerumen from the external ear canal where a member’s practice includes it.
As AHIP members, Hearing Instrument Specialists (H.I.S.) are ethically bound to provide services that are consistent with the scope of their competence, education and experience.
- Testing Hearing
The management of hearing loss often begins with an otoscopic exam, case history and a hearing assessment to identify the presence or absence of a problem that may warrant further consultation. Hearing Instrument Specialists (H.I.S.) are trained to refer individuals to a physician for further investigation if any recognized Ontario Medical Association OMA – Red Flags exist.
Hearing assessments conducted by Hearing Instrument Specialists (H.I.S.) assess the type and degree of hearing loss. Hearing assessments are provided in accordance with the AHIP Standards of Practice Policy (March 2015).
- Hearing Aid and Assistive Devices Selection
Hearing Instrument Specialists (H.I.S.) recommend/select hearing instruments and assistive devices in full consultation with the patient/client taking into account their case history, complete hearing assessment and their physical and lifestyle requirements.
- Dispensing and Counselling
Hearing aids are dispensed by a Hearing Instrument Specialist (H.I.S.) pursuant to a prescription from either an Ontario physician or audiologist in accordance with section #31 of the Regulated Health Professions Act, 1991 S.O. 1991, c19.
Verification and validation procedures are conducted as an essential component of a successful hearing aid fitting.
Hearing Instrument Specialists (H.I.S.) provide: earmold impressions as necessary, programming, instruction and counselling for the proper use and care of hearing aids and assistive listening devices.
They offer ongoing follow-up counseling to support and encourage the continued use of the hearing aids and/or assistive listening devices. Hearing instrument dispensing services must be provided in accordance with the AHIP Standard of Practice Policy of AHIP (March 2015).
- Note: Testing hearing, selection and dispensing of hearing aids and associated devices are not controlled acts under the Regulated Health Professions Act, 1991 S.O. 1991, c19.
Qualifications
Hearing Instrument Specialists (H.I.S.) in Ontario must successfully complete a provincially recognized, Hearing Instrument Specialist (H.I.S.) program and a one thousand (1,000) hour Hearing Instrument Specialist (H.I.S.) Internship Program,and pass an International Licensing Examination (ILE).
The practice of cerumen removal requires advanced accreditation which meets the required educational principles outlined in the AHIP Cerumen Removal Policy (December 2014).
Recognized by Government & Industry
Hearing Instrument Specialists (H.I.S.) are recognized authorizers with the Ontario Ministry of Health, Assistive Devices Program.
Hearing Instrument Specialists (H.I.S.) are also recognized by all other Government agencies including: the Ontario’s Workplace & Insurance Board (WSIB), Veteran Affairs Canada and the Ontario Ministry of Children, Community and Social Services.
Hearing Instrument Specialists (H.I.S.) work with insurance companies to facilitate access to and proper administration of private and/or company hearing aid benefit plans.
Ethical Standards
As AHIP members, Hearing Instrument Specialists (H.I.S.) in Ontario have an obligation to act in the best interest of the patient /client , to uphold the dignity and honour of the profession and to practice in accordance with the ethical principles set out in the AHIP Code of Professional Conduct (Schedule 1 of AHIP’s By-Laws). The code sets standards of professional integrity and practice including legal requirements and conduct with patients/clients, colleagues, other health care professionals and the general public.
Professional Association
AHIP represents and guides Hearing Instrument Specialists (H.I.S.) in their practice in the best interest of the hard of hearing of Ontario. AHIP responsibly administers entry to practice, standards of practice and consumer complaint management. Hearing Instruments Specialists (H.I.S.) must be practicing members of AHIP in good standing in order to maintain authorizer status with the Ministry of Health, Assistive Devices Program.
To obtain more information about Hearing Instrument Specialists (H.I.S.), please call 1-888-745-2447 or go to our website www.helpmehear.ca
Association of Hearing Instrument Practitioners of Ontario
Use of Telepractice in the Delivery of Hearing Healthcare Services
Statement of Purpose
This document provides a general guideline for AHIP members regarding telepractice services.
“Telepractice” is a form of electronic care and services which uses information and telecommunication technology (which may include, but is not limited to, the use of land lines, cellphones, faxes, internet, video & audio conferencing and computer information systems) to assist people without always engaging in in-person contact.
The term “hearing healthcare telepractice” means the delivery, management and coordination of care and services provided through telepractice.
AHIP asserts that hearing healthcare telepractice is meant to serve as an “extension” of the hearing instrument practitioner’s care and services and should be delivered as such. The integrity and value of the patient/client relationship should be maintained and should not be diminished by the use of telepractice technology.
AHIP Supports:
AHIP supports the use of telepractice technology / hearing healthcare telepractice, if done so in an appropriate and competent manner, and may include, but is not limited to, aural rehabilitation, counselling, follow-up care, adjustments of /with hearing aids or other forms of assistive technology and troubleshooting. See also “AHIP Does not Support” below.
AHIP Does not Support:
AHIP does not support the use of telepractice technology / hearing healthcare telepractice for primary clinical care and services, including hearing evaluations, otoscopy, hearing aid fittings, hearing aid dispensing, initial hearing aid counselling and orientation, verification, validation and programming.
Principles of Care
AHIP members are ethically bound to provide care and services that are consistent with the scope of their competence, education and experience.
The AHIP By-laws, code of professional conduct, standards of practice, quality assurance and professional practice policies relating to members conduct and practice apply equally to hearing healthcare telepractice and to in-person care and services.
Consent, Confidentiality & Security of Information
The same professional obligations that exist for consent, confidentiality and security of information in in person care and services also exist for hearing healthcare telepractice.
AHIP members are responsible to ensure that all laws, rules or regulation applicable to the provision of hearing instruments and associated devices are upheld. This includes, but is not limited to, the Personal Health Information Protection Act (PHIPA) and the Personal Information Protection and Electronic Documents Act (PIPEDA).
In order to facilitate obtaining informed consent, patients/clients should be provided with information about care and services as well as how technology will be used in delivery of the care and services. This may include, but is not limited to, any information about how information is transmitted, and any
risks associated with confidentiality e.g. the risks associated with email information that is not encrypted. Patients/clients should always provide written consent for any taping/recording of a conversation and be provided with information about how the taping/recording will be used and how it will be stored (where, for what period, who has access to it).
Records must be maintained in a format that ensures retrieval. All records relating to the services provided to the patient/client must be recorded and kept on file for a minimum period of ten (10) years or ten (10) years past the 18th birthday of a minor. Where records exist in electronic format, there should be attention given to the capacity to retrieve and print the record throughout the full retention period, even as systems and software changes are made.
Hearing instrument practitioners engaging in hearing healthcare telepractice should understand the security risks in all the information technologies they use and do what is necessary to manage all risks (which include, but are not limited to, risks related to potential breach of confidentiality). All reasonable steps must be taken to ensure that the technology and protocols used in hearing healthcare telepractice and its documentation are designed to protect against loss, tampering, interference or unauthorized use or access.
The above reflects only some points in relation to this topic. For detailed assistance on all consent, confidentiality and security of information matters, whether it be in relation to hearing healthcare telepractice or in-person care and services visit https://www.ipc.on.ca. Ultimately, each AHIP member is responsible for his or her delivery of care and services, whether in-person or through telepractice, in an appropriate and competent manner.
References
College of Dietitians of Ontario, “Guidance on the Confidentiality and Security of Records used in Telepractice”
College of Audiology and Speech-Language Pathologists of Ontario Position Statement, “Use of Telepractice Approaches in Providing Services to Patients/Clients. May 2004, Reformatted, 2014
College of Nurses of Ontario “Practice Guideline -Telepractice”, February 2017
Fabry D, Groth J. “Teleaudiology: Friend or Foe in the Consumerism of Hearing Healthcare?” Hearing Review. 2017;24(4):16-19.
IHS Board of Governors. “International Hearing Society Policy Statement on the Use of Telepractice in the Delivery of Hearing Healthcare”, April 2018
National Initiative for Telehealth Guidelines. (2003). National Initiative for Telehealth (NIFTE). Ottawa
Association of Hearing Instrument Practitioners of Ontario
Responsible Use of Artificial Intelligence in Hearing Health Care
Statement of Purposes
The Association of Hearing Instrument Practitioners of Ontario (AHIP) recognizes that Artificial Intelligence (AI) can be a valuable tool when used appropriately. However, AI requires careful consideration and is intended to support professional practice, not replace the knowledge, clinical judgement, experience, or accountability of a hearing instrument practitioner. Safe and effective patient care must always remain the primary consideration.
The purposes of this Position Statement are to outline AHIP’s principles for the responsible use of AI in hearing health care, and to provide guidance to Hearing Instrument Specialists (H.I.S.) and Hearing Instrument Dispensers (H.I.D.) about considering whether the use of AI is in the best interest of the patient and, if it is, about AI’s use.
For the purposes of this Position Statement, Hearing Instrument Specialists (H.I.S.) and Hearing Instrument Dispensers (H.I.D.) are collectively referred to as practitioners.
The principles presented in this document are intended to complement existing legislation, provincial requirements, and AHIP’s Standards of Practice. They do not establish new professional obligations or replace the requirements of practitioners, the Personal Health Information Protection Act (PHIPA) and/or other legislation applicable to the activities of practitioners. Rather, this Position Statement reflects AHIP’s commitment to the promotion of innovation and to the maintenance by practitioners of the highest standards of patient care, privacy, professionalism, and public trust.
As AI technologies continue to advance, AHIP will encourage ongoing education, thoughtful adoption, and continuous evaluation to help ensure these tools are implemented in ways that benefit both practitioners and the patients they serve.
Transparency and Informed Consent
Practitioners have a responsibility to foster trust and confidence with patients through transparent communication. When considering the use of AI within hearing health care, practitioners should ensure that patients are provided with appropriate information to understand how AI may be incorporated into their care.
When AI is used in hearing health care, practitioners should be prepared to explain, in general terms:
- what AI tool is being used;
- why it is being used;
- how it supports patient care;
- what information it processes; and
- any known limitations or risks associated with its use.
The use of AI does not remove the importance of the professional relationship between the patient and the practitioner. Patients should continue to receive care that reflects their individual needs, preferences, and circumstances, with the practitioner maintaining responsibility for communication, recommendations, and clinical judgement.
In accordance with the principles of patient autonomy and informed choice, patients should be given full information and should be allowed to ask questions and be able to agree to or decline AI being used in their care.
For full information on consent requirements, please refer to AHIP’s Guidance Document on Consent.
Privacy and Security
Practitioners use of AI must comply with all applicable privacy legislation and professional obligations relating to the protection of personal health information. Before implementing AI technologies, practitioners should understand how patient information is collected, stored, used, retained, and protected by the AI system.
For example, identifiable patient information should not be entered into AI systems unless practitioners are satisfied that robust cybersecurity safeguards are in place and are regularly monitored to prevent misuse.
The Information and Privacy Commissioner of Ontario (IPC) oversees compliance with Ontario’s privacy legislation, including PHIPA, and provides guidance on privacy, security, and emerging technologies such as AI. When evaluating AI technologies for use within their practice Practitioners are encouraged to consult IPC resources, including:
(i) the document titled ‘Principles for the Responsible Use of Artificial Intelligence’ (2026-01-AI-principles-acc (1).pdf) issued jointly by the IPC and the Ontario Human Rights Commission (OHRC); and
(ii) the IPC’s Privacy Impact Assessment Guide.
Responsibility and Accountability
The use of AI within hearing health care does not replace the professional responsibilities of practitioners. Practitioners remain responsible for the care they provide, including the decisions made, recommendations given, and information communicated to patients.
AI tools may assist with administrative, clinical, or communication-related tasks; however, practitioners should maintain appropriate oversight of any AI-generated information or recommendations used within their practice. AI systems may produce information that is incomplete, inaccurate, outdated, or inconsistent with the individual needs of a patient. Practitioners should critically review AI-generated content and use their professional knowledge and judgement when determining whether such information is appropriate for use.
The integration of AI into practice should complement and enhance, rather than diminish, the professional relationship between the patient and the practitioner. The expertise, experience, communication, and human connection provided by practitioners remain essential components of effective hearing health care.
Practitioners should consider the limitations of AI technologies, including the potential for errors, unintended outcomes, or biased results. AI systems are developed using data sets that may not fully represent every patient population or individual circumstance. Practitioners should remain aware of these limitations and ensure that AI use does not negatively impact the quality, accessibility, or fairness of patient care and the equitable treatment of all individuals.
Ultimately, accountability for the use of AI in patient care remains with the practitioner. Responsible adoption requires thoughtful consideration of how AI is implemented and ongoing evaluation to ensure that its use continues to support patient safety, professional integrity, and public trust.
AI-related Documentation
Accurate and complete documentation is an essential component of safe and effective hearing health care. The use of AI to assist with documentation does not change the responsibility of practitioners to ensure that patient records are accurate, complete, relevant, and reflective of the care provided.
AI-generated documentation should always be reviewed before being incorporated into the patient record. Practitioners remain responsible for ensuring that documentation meets all applicable professional, legal, and privacy requirements.
In addition, practitioners should maintain for review by patients detailed, plain-language documentation regarding AI systems which they use, including describing data sources, intended purposes, and potential impacts of the use of the relevant AI.
Clinical Decision-Making
Clinical decision-making within patient care requires the knowledge, skills, experience, and professional judgement of practitioners. While AI may provide information, assist with analysis, or support aspects of care, it does not replace the practitioner’s responsibility to assess each patient’s individual needs and determine appropriate recommendations.
Decisions related to patient care should continue to be based on professional knowledge, clinical observations, evidence-informed practice, and the individual patient’s goals, preferences, and circumstances, while remaining consistent with AHIP’s By-laws, Code of Professional Conduct, and Standards of Practice. AI should support clinical reasoning, not replace the professional judgement required to provide individualized hearing health care.
Ultimately, responsibility for clinical decisions remains with the practitioner. AI should be considered a supportive tool that complements professional expertise while maintaining the standards of care expected within the profession.
Understanding AI Technologies
AI technologies continue to evolve rapidly, and practitioners should remain informed about changes in AI capabilities, limitations, privacy considerations, and emerging best practices. Understanding how an AI system functions, the information it uses, and how its outputs are generated can help practitioners make informed decisions about whether a tool is appropriate for their practice.
Practitioners should maintain knowledge and skills related to:
- the purpose, capabilities, and limitations of AI tools being used;
- recognizing that AI-generated information may be incomplete, inaccurate, or influenced by bias;
- understanding how patient information is collected, stored, protected, and used by AI systems;
- evaluating whether an AI tool is appropriate for its intended purpose and aligns with patient care needs;
- considering the accuracy and consistency of relevant AI outputs;
- ensuring that there is a “human in the loop” when AI is used, with clear accountability for AI decisions and outcomes;
- maintaining appropriate human oversight by reviewing AI-generated information before relying upon it; and
- participating in ongoing education and training related to the responsible use of AI.
Practitioners should also consider the broader impacts of AI implementation, including whether the use of a technology provides meaningful benefit to patients and supports the delivery of quality hearing health care.
Professional Competency and Use of AI
Practitioners should only use AI in areas where they possess the knowledge, skills, and professional judgement necessary to evaluate and oversee its use. AI is not a substitute for clinical education, experience, or professional development. Practitioners should not rely on AI to provide care or make decisions beyond their own knowledge, skills, or scope of practice outlined in AHIP’s By-Laws, Code of Professional Conduct and Standards of Practice.
Overreliance on AI may impact professional judgement and reduce meaningful engagement in the patient care process. Practitioners should remain actively involved in assessment, recommendations, counselling, and follow-up care to ensure that patient needs continue to guide clinical decisions.
Patients trust practitioners to provide knowledgeable, compassionate, and individualized care. The appropriate use of AI requires the maintenance of balance between embracing innovation and preserving the professional expertise and human connection that are central to effective hearing health care.
Resources and References
AHIP acknowledges the work of health regulatory organizations, privacy authorities, and other health care stakeholders who have contributed to the ongoing discussion surrounding the responsible integration of AI into hearing health care.
Practitioners are encouraged to consult current and reliable resources when considering the implementation or use of AI within their practice. These resources should be considered alongside applicable legislation, AHIP’s governing documents, and professional judgement.
Resources considered in the development of this Position Statement and available to support practitioners include:
- Code of Professional Conduct.
- Guidance Document on Consent.
- Standards of Practice.
- College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO). Practice Advice: Principles for Ethical Use of Artificial Intelligence.
- IPC and Ontario Human Rights Commission (OHRC) Principles for the Responsible Use of Artificial Intelligence (2026-01-AI-principles-acc (1).pdf).
- Resources related to privacy protection, artificial intelligence, and emerging technologies.
- Privacy Impact Assessment Guide.
- Office of the Privacy Commissioner of Canada. Resources related to artificial intelligence, privacy, and responsible information management.
- Personal Health Information Protection Act, 2004, S.O. 2004, c. 3, Sch. A.
- AI technology providers’ privacy, security, and governance documentation
- Other applicable legislation, standards, and evidence-informed guidance related to AI and hearing health care.
Practitioners are encouraged to evaluate AI resources critically and consider whether information provided is current, evidence-informed, and applicable to their practice environment.
AI has the potential to enhance hearing health care when implemented responsibly. AHIP supports the thoughtful adoption of AI technologies that improve patient care while preserving professional judgement, protecting patient privacy, and maintaining public trust.
This Position Statement will be reviewed periodically to reflect evolving technology, legislation, and best practices.