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Auto-REM

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Hello All… 😁

I am hearing on the grapevine of a new type of delivery of , called “Auto- REM”, I am assuming this will be for Phonak hearing aids, UK Audiologists are awaiting a full 1 day training course before its rolled out? I have no idea how this works or indeed what equipment is required, if any? Anybody heard anything? Cheers Kev😉👍

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I wonder if it is like this - though it seems several years old...

In reply to @kevels55

AutoREM isn't anything new. It was first introduced in the early 2000s with the Siemens Unity system. It has become more widespread following the introduction of ICM2 in 2017 which has standardized communication between hardware. The verifit autoREM cited in the linked article doesn't use ICM2 but a proprietary standard that ICM2 was meant to avoid. Fewer hearing aid manufacturers support verifit AutoREM than the ICM2 standard.

Any good audiologist should be able to perform autoREM without additional training. AutoREM accuracy depends on many factors and for many manufacturers isn't as accurate as manual . A lot depends on the interaction between the hardware and the manufacturer's autoREM workflow as well as the acoustics of the fitting. Phonak has the best workflow but Unitron's hasn't been anywhere near as good so it really is manufacturer and equipment specific.

AutoREM is designed to try and remove barriers to clinicians performing REMs because manufacturers know that they are very helpful. I haven't seen evidence that this has actually improved REM adoption anywhere.

I hear about an Audiologist who would use the AutoREM and then would do a again to verify how well the AutoREM actually matched the prescriptive targets. She might repeat the AutoREM more than once to "sneak" up on the targets. As a retired engineer (not an acoustic specialist by any means), this approach seems to be sound with any sort of automatic adjustment system.

@Lour said:

I hear about an Audiologist who would use the AutoREM and then would do a REM again to verify how well the AutoREM actually matched the prescriptive targets.

AutoREM displays what is happening on the screen, so I'm unsure why she would need to repeat manual , unless she couldn't understand what the autoREM graphs mean.

Whenever I've run AutoREM I've always needed to manually adjust things because it isn't as accurate as what I can do manually and often doesn't include the full range of measurements that you need for a successful hearing aid fitting, even when configured correctly.

In reply to @kevels55

Your post brought back old memories.

I joined this forum in 2009 to learn about hearing aids that led to self fitting aids. A new revision of Phonak Target came out about then with Direct insitu fitting. It worked like a dream for me, a huge money saver over the years. Self fitting back then was totally different than it is now. It was like a black art back then. :thinking:

Yes. Here's an answer because it can answer faster than I can.

Required Equipment & Software

  • Real-Ear Measurement () Hardware: You must have a compatible physical REM system (such as the Inventis Trumpet, Interacoustics Affinity/Callisto, or MedRx Avant). This hardware includes probe microphones that are inserted safely into the patient's ear canal to measure exact sound levels. [1, 2, 3]
  • Compatible Fitting Software: The feature must be supported by the manufacturer's programming software, such as ReSound Smart Fit, Starkey Inspire, or Oticon Genie 2.
  • Noah Software Module: Most setups require a core audiology database framework (typically Noah Version 4.8 or higher) utilizing the Inter Module Communication protocol (IMC2) so the fitting software and the hardware can "talk" to each other automatically.

In reply to @Raudrive

Yeah Rick, twas basically the blind leading the blind, but also exciting to learn something new, my first go with self programming was with Phonak Spice, I want to say around 2013? Fun times, and a lot of water under the bridge since those days… I believe, I am going to give the new Phonak Eon Sphere Cros a trial, if my agrees, I am desperate to try out the Spheres, in the fond hope I may get a little bit more clarity? But in the absence of a Naida Sphere appearing anywhere on the horizon, the Cros might be my best option? As always, we chase our tail, in the hope we reach some better hearing outcomes, perfection can’t be found, but a little more clarity would suffice! Take care, cheers Kev 😉

In reply to @Hearing_Potential

So all this equipment is still required to do Auto-? I had the feeling this was a corner cutting exercise, to actually save money, but perhaps it’s an exercise to save on training time, and ultimately money? Maybe, some of these companies, see Auto-REM as a valid alternative, than actually training all their ’s in manual REM? Cheers Kev 😉

@kevels55 said:

Maybe, some of these companies, see Auto-REM as a valid alternative, than actually training all their AuD’s in manual REM?

I suspect insitu fittings have always fallen into this. There seems to be so many hearing aid fitting failures in the industry that the hearing industry came up with something to help fit aids.

I do know it has made a big difference for so many on this forum over the years.

In reply to @kevels55

@kevels55 said:

I believe, I am going to give the new Phonak Eon Sphere Cros a trial, if my AuD agrees

There's no Eon Sphere , the Eon CROS is compatible only with Eon R, but I don't recommend to trade off Spheric feature...

You can try with deep fitted cShells with UP and no vents. However, IIRC weren't Infinio Sphere too weak for you?

I hope that with introduction of new Advanced Bionics sound processor there will be new Naida Link Sphere, so maybe ordinary Naida Infinio/Eon Sphere also....

I am if you don’t mind.

However, if you believe we are drifting off-topic, please feel free to send me a PM or we can start a new topic. I will follow your guidance on this.

@OcramSagev said:

I am if you don’t mind.

I don't believe @kevels55 will mind. He is someone who will remember what I do and maybe add something to it.

Back when I started this forum had a very small hidden sub-forum for the DIY members. Seems there were about 15-20 people that participated. The mods did not allow this topic in the main forum.

As far as programming aids there was no wireless programming. Each manufacturer had it's own proprietary programming cables and connectors that connected to the Noah Link communicator which tied into the computer. This made it very difficult to get your hands on these devices. You just couldn't put your hands on any of this equipment easily. The software was another difficult thing to get your hands on. One of the old members PVC was the guru for software. Most of those members from that time are gone now.

To add some expertise to all this we were very lucky to have @Um_bongo that would slip little hints of knowledge our way when we learned enough to ask a decent question. There were no tutorials for the general public. Those that wanted to do DIY had to be savvy troubleshooters and willing to spend the time to learn on their own. Dumb questions did not get answered.

DIY is flat easy now. It's open and talked about. Tutorials are easily available. Wireless programming has changed DIY big time. The software has gotten much easier to follow and understand. It's intuitive now.

The short version.

I didn't like auto when it first started out and so I went a few years without, but lately I have found that as long as the acoustic coupling is correct the oticon auto REM has been quite accurate. It is often not faster than me although it does allow me to leave the patient and write notes while it's running, but it is often faster then some of my early practice colleagues. Because we use the verifit, I haven't been able to use auto REM with phonak yet because it hasn't been compatible.

In reply to @Neville

@Neville said:

I have found that as long as the acoustic coupling is correct the oticon auto has been quite accurate.

Good to know it's accurate with the Verifit. I wasn't impressed with how it worked with the Aurical Freefit. Phonak works really well with the Freefit, but I prefer to not verify open fittings with AutoREM as clients move too much and there is a lot of recalibration of the reference mics involved at the best of times.

In reply to @Raudrive

@Raudrive said:

I don't believe @kevels55 will mind. He is someone who will remember what I do and maybe add something to it.

No Rick, you are 100% correct… I always find most threads take on a life of their own, threads tend to meander, sometimes they morph into something else, but they usually find their way back…

As most ’s in the UK don’t actually use or indeed Auto-REM, Apart from Costco and perhaps a few independent practices, the NHS AuD’s are probably the exception to this rule, they definitely use REM, but much depends on where you live! Then it is little wonder that most laypeople haven’t heard of “Auto-REM”, but it is very interesting that Phonak are now adapting this here in the UK, and no doubt around the world! IMO, this will lead to better hearing outcomes… Cheers Kev😉👍

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