PHONAK TARGET 11 (01) PDF Document

PHONAK TARGET 11 is a standalone fitting software intended to be used by qualified hearing care professionals (HCPs) to configure, program, and fit hearing aids to the intended person’s specific requirements.

The fitting software is intended for qualified hearing care professionals.

The PHONAK TARGET 11 fitting software is intended for patients with unilateral and bilateral, mild to profound hearing loss or in combination with chronic tinnitus, who require the fitting of a hearing aid. The Tinnitus Balance feature is intended for patients from 18 years of age and above.

General clinical indications for the use of hearing aids and Tinnitus Balance are:

• Presence of a hearing loss

• Unilateral or bilateral

• Conductive, sensorineural or mixed

• Mild to profound

• Presence of chronic tinnitus (only for hearing aids which offer Tinnitus Balance)

General clinical contraindications for the use of hearing aids and Tinnitus Balance are:

• Acute tinnitus

• Deformity of the ear (i.e. closed ear canal, absence of the auricle)

• Neural hearing loss (retro-cochlear pathologies such as absent/non-viable auditory nerve)

The primary criteria for the referral of a patient for a medical or other specialist opinion and/or treatment are as follows:

• Visible congenital or traumatic deformity of the ear

• History of active drainage from the ear in the previous 90 days

• History of sudden or rapidly progressive hearing loss in one or both ears within the previous 90 days

• Acute or chronic dizziness

• Audiometric air-bone gap equal to or greater than 15 dB at 500 Hz, 1000 Hz and 2000 Hz

• Visible evidence of significant cerumen accumulation or a foreign body in the ear canal

• Pain or discomfort in the ear

• Abnormal appearance of the eardrum and ear canal such as inflammation of the external auditory canal or a perforated eardrum

• Other abnormalities which the HCP believes are of medical concern

PHONAK TARGET 11 usage is limited to fitting and adjusting compatible devices. The software is not intended for any diagnostic purpose.

Physiological side effects are not derived from the fitting software, but from compatible hearing aids. These effects, such as tinnitus, dizziness, cerumen build up, too much pressure, sweating or moisture, blisters, itching and/or rashes, plugged or fullness and their consequences like headache and/or ear pain, may be resolved or reduced by your hearing care professional. Conventional hearing aids have the potential to expose patients to higher levels of sound exposure, which might result in threshold shifts in the frequency range affected by acoustic trauma.

The PHONAK TARGET 11 software uses three main tabs for navigation and status information:

• [Client]: All patient information, such as personal information, DataLogging consent, audiogram, RECD, and REUG are found here.

• [Instruments]: Hearing aids, acoustic parameters, and accessories are found in this section.

• [Fitting]: All hearing aid adjustments and fine tuning can be done within this tab.

You can also hover over icons in the dashboard to see key information such as the creation date of the audiogram, serial numbers of the hearing aids, fitting formula, feedback test status, Bluetooth® side, and more.

iCube II or Noahlink Wireless™ (NLW/NLW2): No cables are needed. Insert the battery and turn on the hearing aid or CROS by closing the battery compartment. For rechargeable devices, turn on the hearing aid or CROS.

NOAHlink™ or HI-PRO®: Connect the programming cables to the hearing aid or CROS and the fitting device. Please use Phonak labeled cables.

Phonak Trial™ hearing aids: These are offered as BTE and RIC hearing aids with direct connectivity. In the bottom black menu bar, click [Trial & tools]. Select [Trial hearing aids] and [Configure]. Select the desired performance level and press [Continue]. Once the process is complete, the devices are ready to be fit in a fitting session.

Depending on the age of the child, Junior mode in PHONAK TARGET 11 offers age-specific DSL or NAL defaults and hearing aid configurations optimized to meet the needs of children and their families. Entering the date of birth for children between the ages of 0-18 years will automatically trigger a Junior mode fitting prompt.

Junior Mode includes four age ranges:

• 0-3 years

• 4-8 years

• 9-12 years

• 13-18 years

PHONAK TARGET 11 lets you transfer settings from a fitting session to a new selection of hearing aids. The transfer fitting tool can be found within the [Fitting] drop down menu, located in the top black menu bar. During the transfer process, the software will prompt you about which settings can or cannot be transferred. Transferring a fitting is not possible to or from a bimodal fitting.

Step 1. Within the patient’s fitting session, confirm that the correct fitting device is shown. To change the fitting device, use the pull-down arrow next to the fitting device in the dashboard.

Step 2. Click [Connect] to start the fitting. The connected hearing aids will appear in the dashboard. Devices available for pairing will automatically appear.

Step 3. If a device is not found, open/close the battery door or turn off/on the rechargeable hearing aids to initiate pairing mode.

Step 4. Press the multifunction button on the hearing aid to highlight it in the list when multiple devices are available or to confirm the side to assign to a patient.

In [Instruments] > [Acoustic parameters], enter or confirm the correct coupling information. If the patient has a custom earpiece manufactured by Phonak, the six-digit acoustic code on the earpiece can be entered. The attached receiver fitted onto the hearing aid is automatically checked against what is selected in the software when hearing aids are connected. This check can also be done by clicking [Check] in the acoustic parameters screen.

Accessories can be manually selected in [Instruments] > [Accessories]. Click [Compatible] to only see the list of accessories that are compatible with the selected hearing aids.

Click on [Fitting] to access [Feedback & real ear test]. The feedback test can be run in both ears, or one ear at a time. Click [R] / [Start both measurements] / [L] to start the test.

AudiogramDirect is an in-situ hearing test within PHONAK TARGET 11. You can test patients’ hearing directly through their hearing aids. AudiogramDirect does not replace diagnostic audiological assessments. To use it, click [AudiogramDirect] > [Start] to test air conduction (AC) hearing thresholds and uncomfortable loudness levels (UCLs) using the connected hearing aids. UCL measurements are optional and are disabled during a Phonak Remote Support session.

Go to [Global tuning] > [Initial fitting] if adjustments to the gain level, occlusion compensation, or compression are required. Depending on the connected hearing aids, additional tools such as [Tinnitus Balance] and [CROS Balance] can be accessed via the tab in the lower part of the screen.

To automatically acclimatize a patient to a higher overall gain level, select [Auto acclimatization] in the gain level menu in the [Initial fitting] tab. Specify the start level, the end level, and the duration in which the gain of the hearing aid automatically increases to the set end level.

TargetMatch is an automated guidance system for real ear measurements. It guides you through a step-by-step workflow of probe tube placement, obtaining real ear measurements, and automatic target matching. TargetMatch is available when using PHONAK TARGET 11 within Noah. Click [R] / [Start both] / [L] to start TargetMatch.

When performing verification outside of TargetMatch, the Verification assistant can be enabled to turn off adaptive features for a streamlined verification process. The assistant can be accessed via [Fine tuning] > [Gain & MPO] > [Verification assistant] and will guide you through a series of steps.

Fine tuning gives access to more specific fitting functionalities such as adjusting gain and MPO, as well as hearing performance and sound cleaning features. The left side of the screen is used for handling programs, where the startup program, program structure, and streaming programs can be customized. You can click [All programs] to adjust all programs simultaneously or click a single program to modify it. The [+] icon allows you to add an additional manual program.

In audibility fine tuning, selectable sound samples and the related gain are shown in the curve display. The sound samples can be played to simulate a specific listening environment. The gain values are displayed for soft, moderate, and loud input sounds. Adjustments affect only gain levels and frequencies that are relevant to enhance the audibility of the selected stimuli.

This is a situation-based fine tuning tool. The available adjustments are dependent on the patient’s evaluation of the sound situation. Depending on the selected program, a recommended sound sample is pre-selected. The sound samples can be played to simulate the listening environment.

Program options can be adjusted from the default settings. The features can be activated, deactivated, or changed in strength for each program individually. For direct connectivity hearing aids, the default switching behavior to access streaming can be modified for the TV Connector, Roger™, and PartnerMic™.

SoundRecover2 is a frequency compression system with adaptive behavior. It is on by default for flat or sloping hearing losses where the 8kHz threshold is 45 dB HL or poorer, and off by default for reverse sloping losses (8 kHz ≥ 30 dB better than 3 kHz). To disable SoundRecover2, click on [Fine tuning] > [SoundRecover2] and uncheck the [Enable SoundRecover2] checkbox.

To fine tune SoundRecover2, click on [Fine Tuning] > [SoundRecover2].

• Slide toward [Audibility] to increase the ability to detect an /s/ and /sh/.

• Slide toward [Distinction] to increase the ability to distinguish the difference between /s/ and /sh/.

• Slide toward [Comfort] to increase the naturalness of sounds, such as male voices, own voice, or music.

The noise generator can be enabled or disabled in [Fitting] > [Global tuning] > [Tinnitus Balance]. When enabled, the shape of the generated noise is shown in green, and the curve display must be set to [Output]. The default characteristics are calculated based on the patient’s audiogram. Within the drop-down menu of [Tinnitus Balance shape], the default, [Set to hearing loss], can be changed to [Set to white noise] or [Set to pink noise].

The maximum output level of the Tinnitus Balance noise generator is limited to 85 dB(A). In accordance with common noise exposure recommendations, a warning message will be shown when the noise generator level exceeds 80 dB(A). If this occurs, the recommended maximum wearing time per day will appear below the maximum noise level.

DataLogging can provide information about the listening environments the patient has been in and for how long. To access DataLogging information, go to [Fitting] > [DataLogging].

By clicking [Device options] you can configure hearing aid options such as manual controls, signals and alerts, and startup behavior. When the hearing aid is connected, each configuration can be demonstrated on the hearing aid in [Signals & alerts]. With Phonak direct connectivity hearing aids, additional settings such as configuring the Bluetooth name, side and managing pairings can be found by clicking on [Bluetooth].

A bimodal fitting can be performed with specific compatible hearing aids and sound processors. To perform the fitting:

Step 1. Open the fitting session and confirm that the Noahlink Wireless is shown.

Step 2. Connect both the hearing aid and the sound processor to start the fitting. Devices available for pairing will automatically appear.

Step 3. Following connection of both devices, PHONAK TARGET 11 will automatically align the program structure and device options of the hearing aid to match the sound processor.

Step 4. Proceed with using the software as you would in a standard fitting session to complete the fitting. The sound processor is in read-only mode, and no changes can be saved to it.

The requirements for Phonak Remote Support are:

• Latest PHONAK TARGET 11 software version available for optimal experience.

• Most current myPhonak app version installed on the patient’s mobile phone.

• An initial hearing aid fitting must be performed in the clinic.

• Computer with an integrated webcam or microphone or an external webcam and microphone connected to the computer. For better sound quality, use headphones with a microphone connection.

• Stable internet connection (Wi-Fi, LAN or 4G) with at least 5 Mbit/s of data transfer connection for uploads and downloads.

Step 1. Select the patient for Remote Support. If there is more than one clinic site available, select the clinic where the remote session will take place.

Step 2. An initial hearing aid fitting must be performed in the clinic. Upon clicking [Save & close session], Remote Support is enabled. To activate Remote Support in compatible hearing aids for an existing patient, the hearing aids must be connected to PHONAK TARGET 11 in the clinic. Upon saving the session, remote fitting is activated.

Step 3. The patient must download the myPhonak app onto their smartphone and pair the hearing aids to the app before a Remote Support session can take place.

It is recommended that the patient has new batteries in their hearing aids or sufficient charge in their rechargeable hearing aids before connecting.

Step 1. Click on [Start Remote Support]. You and your patient will be connected to the video call.

Step 2. Once connected, you will see and hear your patient. Make sure the video and microphone on your computer is enabled. Switching between an integrated or external microphone or webcam can be performed before or during a session.

Step 3. As soon as the patient enters the Remote Support session and has accepted the camera and microphone requests on their smartphone, both videos are displayed on the screen.

To activate this setup, click [Setup] > [Remote Support & Internet] > [Remote Support] and check the tick box. Return back to the [Client & sessions] screen and click [without Audio/Video]. Once your patient enters the Remote Support section and starts a session, they will see a 2-digit authorization code. You will need to enter this 2-digit code in PHONAK TARGET 11 to have access to the patient’s fitting session. This feature is only available if the patient has the latest version of the myPhonak app.

You can close the session at any time by clicking [Save & close session] in the top right corner of the screen. Select the items to save. The save dialog will confirm the successful save of the hearing aids and accessories. After the save, PHONAK TARGET 11 will guide you to the start screen.

Patient data is private and its protection is important:

• Make sure your operating system is up-to-date.

• Make sure your installed PHONAK TARGET 11 software version is up to date.

• Have the Windows user login activated, use strong passwords and keep credentials secret.

• Use adequate and up-to-date malware and antivirus protection.

• Depending on national laws, you might be required to encrypt all patient data. You can use drive encryption (e.g. the free Microsoft BitLocker) to protect all data on your PC.

• When transferring data through unsafe channels, either send anonymous data or encrypt it.

• Protect data backups not only from data loss but also from theft.

• Remove all data from data medium which are no longer used or will be disposed.

The fitting software informs about restrictions in the following cases:

• MPO: MPO exceeds 132 dB.

• Fitting Session: Before a measurement/testing is performed, when the acoustic parameters are selected, and before test signals are produced.

• Tinnitus: The output level of the Tinnitus masker is above 80 dB(A) or the Tinnitus Balance is selected for a patient below age of 18.

• Sound Pressure Level: MPO exceeds 100dB SPL while using AudiogramDirect.

• Data Transmission: Fitting data are transferred to the hearing instrument.

• Intended patient population: Device is fitted to patient population ≤36 months.