Last week’s Hearables post highlighted some emerging ear-level devices and left three rhetorical questions dangling:
- What groups decide which are medical devices and which are consumer devices?
- Who gets final say on who sells them and how they are sold?
- Will hearing aids morph into consumer electronic gadgets?
Current thinking on that last question brings up thoughts that were previously unthinkable–at least to most audiologists. How could this have happened?
How Did It Ever Get to This?
Quickly. Veeery quickly. Less than a year.
- Entrepreneur magazine dubbed 2015 the Year of the Hearable. Yet Hearables, at least by that name, didn’t even exist until around April of 2014.
- Mother Nature Network’s (mnn.com) “Green Tech” column anointed Hearables as the “Boomer’s answer to the hearing aid” in November 2014.
- The same mnn.com article relegated hearing aids to history in one harsh sentence:1
“Hearables… the devices formerly known as hearing aids.”
What Happened in 2014?
CES Looked at the Ear and Found It Good
Back when Audiologists and others were heatedly arguing the merits and definitions of PSAPs versus hearing aids, electronic innovations were afoot in places unfamiliar to many clinicians, like the International Consumer Electronics Show. There, in January 2014, Hearables burst forth as the “Game Changer.” High-resolution audio content and technologies were put forth as benefits to be enjoyed not only by audiophiles but by anyone with hearing loss or listening/understanding difficulties in near- and far-field situations in which background noise might interfere with speech intelligibility. (ital added.)
The shift from hearing aid to consumer electronic device was stated plainly in the coverage of the show, even though the name “hearable” had yet to be uttered:
“Any device, or combination of innovative devices and software that helps someone hear better would benefit consumers.”
In August 2014, a report by Nick Hunn2 seconded the CES motion and nominated ear-level smart wearables as the breakout technology. He predicted a global market of $50B globally by 2018 and named them “hearables.”
Meanwhile, Back at the PSAP Ranch
That same month saw publication of the Consumer Electronics Association’s (CEA) comprehensive survey report on PSAPs. The report reinforced the intuition of the January CES show, concluding that PSAPs were a viable, simple, cost-effective, and acceptable solution for many consumers. The report reached two important economic conclusions:
- The PSAP market is highly fragmented (no supplier has market power), and
- Consumers want the right to purchase directly. (Fig 1)
Fig 1. The market has spoken. Bring on the Hearables.
Thus, as 2014 wound down, the stage was set for Hearables to become a disruptive innovation, starting with PSAPs for the masses and jumping forward from there as fast as technological innovation allowed. As one CEA reviewer saw it:
PSAPs are an important class of device for anyone who needs a hearing boost. … [likely to be sold everywhere, first online and then at retail outlets like Verizon and Apple Stores, and Walgreens and CVS. Audiologists will probably recommend them as well. Longer term, they herald yet another step towards bionics — improving human performance beyond its natural limitations. My hunch is that PSAPs are getting a toe-hold into a new market, and tomorrow they’ll disrupt the world of hearing aids as we know them. (itals added.)3
The Thrill of Bionic Hearables
The bionic angle excited the general media, which quickly jumped over PSAPs onto the Hearable bandwagon. Soon after the January 2014 CES, NPR’s All Tech Considered blog was already anticipating and extolling the virtues of Hearable-assisted future social networking:
As you say her name, a little device in your ear picks it up. The device does a search, and microseconds later it feeds you the info it has found on the Web: the college she attended, her current company, that she has two kids and is an avid runner.
The same NPR article was one of the first to enumerate Hearable attributes which are now so familiar that they seem self-evident:
- Unobtrusive
- Enable, sometimes encourage, face-to-face communication. (No more looking down at a visual display or through Google Glass.)
- Integrate easily into our daily lives
Where Will It All End?
Items 1-3 above are likely to leave Audiologists and manufacturers puzzled. Together, they form the core of good hearing aid design. Current BLE hearing aids achieve those goals and more. No doubt, premium hearing aids could and will monitor health and fitness without breaking a sweat. They will stream content if the manufacturers decide that’s a profitable road to travel. Hearing aids have the real estate and technology to do it all. But when and if they do, the devices formerly known as hearing aids will likely join the ranks of Hearables. When/if that happens, wholesale and retail suppliers will face formidable pricing and distribution challenges that we’ve only glimpsed with PSAPs.
Future posts will circle back to the economic conclusions of the PSAP study. Those conclusions forecast a fragmented distribution landscape for Hearables in which consumers’ strong preference for direct purchase at low cost forces audiologists and the Big 6 to consider changes, even as new suppliers of all sizes fight for market share.
Change could be good. If the Artist-formerly-known-as-Prince can resume recording after 18 years, there’s no reason to think that hearing aids-by-any-name and the audiologists-that-fit-them will disappear from the market. Like Prince, we just need to figure out a way to make it work. Economic analyses and measured thinking such as Harvey Abrams is doing in his monthly Peeling the Onion series can help us make it work in the end.
This is the 4th post in the Hearable series. Click here for post 1, post 2, or post 3.
References
1If you doubt the street cred of MNN, consider that it was launched by one of the Rolling Stones and has CNN and Discovery Channel as equity partners, according to Wikipedia.
2Hunn made a draft of his report available to some in April 2014 in which the Hearable concept was named and described.
3Robin Raskin, founder of Living in Digital Times,
Feature image courtesy of @hearables.
It does not matter whether it is Hearing Aids, PSAP’s, or Hearables. Retail is all about the numbers. Audiologists are all about the patient. Only when Audiologists form a single large powerful Group Purchasing Organization (GPO) that meets federal guidelines where margins must be reported above 3% can true market pricing discovery occur based on a bidding process similiar to the VA “Industry days” process. That process must be transparent and ethical to be sustainable. It must mirror the GPO’s used by 98% of the USA Hospital Industry to provide a business model and environment suitable to a Health Care Provider Industry such as Audiology. This process is initiated by signing a pledge and waiting until sufficient purchasing power is accumulated. ALL Audiologists should sign a pledge that focuses their purchasing power similiar to the way Audiologists purchase hearing aids when employed by the VA or a large retail establishment such as Costco thereby earning the same considerations from suppliers in pricing pariety.
My opinion is “Bring it on”, because when licensed audiologists are allowed to function in the traditional venues of private practice, medical offices, Universities and Hospitals at pricing pariety; they will serve the patient better, provide superior diagnostics and counseling, provide superior access at more convient locations, out satisfy and out perform in every way the new retail settings and at the same consumer price! Sign a pledge!
This is exactly the evolutions I’ve been writing about for the past two years.
It is past time we recognized that what we’ve thought of as hearing aids, and how they were fit, used and sold is a thing of the past.
No amount of ‘price parity’, or hiding behind licenses, or perceived educational advantage will stop the evolution of ‘hearables’, nor the public’s desire for something other than a hearing aid, and it’s current ‘best practices’ delivery system.
It is long past time that we recognized that it is the consumer, and marketplace that dictate ‘best practices’ when it comes to the future of hearables, and not academia, or any regulatory board.
Welcome to the age of consumer, and applications driven hearing care.
The message for those within our profession is clear, adapt, or find another way to make a living.
But, dispensing as we have known it, is going the way of lamplighters, and buggy whip makers.
We either attract the consumer and demonstrate real value through our goods and services, or the consumer will simply go elsewhere, regardless of what rules, regulations and proscriptions those seeking to hold back the tides of change seek to erect.
All I am saying is that if a product passes through the hands of a licensed audiologist as part of their professional evaluation and treatment process they should not be penalized because of where they perform their services. No one can control the consumer.