Position Papers
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 seven (7) 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