Hearing Health & Technology Matters is pleased to announce the launch of a new weekly video series: This Week in Hearing. The new series will offer a candid, insightful, and engaging weekly exploration of the latest trends, technologies and developments in the world of hearing.
For the inaugural episode, Dave Kemp interviews interviews Brent Edwards, Ph.D, Director of National Acoustic Labs, and Andy Bellavia, Director of Market Development for Knowles Corp. They discuss the blurring line between consumer audio and traditional hearing aids, and the potential impact on the overall hearing health industry.
Please enjoy the episode! We encourage your feedback and comments, and hope you’ll share with your friends and colleagues.
Dave Kemp 0:10 All right, so here we are welcome to This Week in Hearing. This is a weekly show where we are going to be breaking down any number of things that are happening that pertain to the worlds of hearing health, hearing aids durables, consumer audio, really anything that falls on this spectrum. It’s going to be moderated through a number of different hosts. It won’t just be me, but we’ll have lots of different panelists lots of different topics that we’re going to be discussion. And you know, for today, we’re going to be talking with Andy Bellavia of Knowles Corp and Brent Edwards of the National Acoustics Lab. Before I introduce what were we talking about? Why don’t I introduce our guests a little bit, let them tell us who they are and what they do start with you, Andy. Andy Bellavia 0:52 Thanks, Dave. And I appreciate being part of this inaugural broadcast on the the new podcast much success to you with this new one. I’m the Director of Market Development for Knowles in the hearing health tech division. I’m actually responsible for everything but hearing aids. So in your monitors for musicians, radio communications, earpieces and hearable devices, which of course dovetails into this conversation, have been working at Knowles for almost nine years, I’ve been a hearing aid wearer for about three years. And I probably should have had a hearing aid or some device five years previously to that the poster child for a person who waits too long, but I’m also on the younger end of hearing aid wares, and I’ve been digitally connected since it was possible to do so. So I think I’m a bit of a bellwether for what future people with hearing impairment are going to be looking for and in a lifestyle enhancement device. Dave Kemp 1:44 Awesome. Brent. Brent Edwards 1:47 Yeah, and thank you as well for the invitation to be on this inaugural podcast. I’m really looking forward to the discussion today. So I’ve been in the hearing space for 26 years. I had research and technology at resound and at Starkey, and then also headed technology at a couple hearing startups in Silicon Valley. One of them interestingly, back in the year 2000 Sound ID where we created what you’d now call the first hearable. So the timing wasn’t right back then. So I’m really excited to see how things are evolving today. And again, looking forward to the discussion. Dave Kemp 2:23 That’s awesome. I didn’t I didn’t know that you were with Sound ID back in the day. But like you said, the first hirable. And so that’s so appropriate for what we’re going to be talking about today. Because the reason I wanted these two one was that we’re going to be talking about basically this whole notion of there being a lot of momentum around kind of like what I consider to be the hearing aid hearables convergence. You know, you look at five big pieces of news that have transpired over the last call it a month, you know whether it be Bose introducing a hearing aid gn resound with Jabra their consumer brand, you know now Jabra is going to be a hearing aid brand that they’re introducing initially into Costco, Sonova bought sennheisers audio division, which I think that many that aren’t involved in this industry would think that Sennheiser is bigger than the hearing aid brand. But you know, for us that are in this industry, we know that synovus quite a bit bigger than them, you then have everything that’s going on with Qualcomm and you Jacoti, one of the most interesting things that really feels like it’s flying under the radar a bit with their partnership, where basically with the Qualcomm qc 5100 chip, they’re now going to be embedding chip Jacoti technology in there, and they’ve created this OTC ready licensing capability so that for any OEM manufacturer of these devices, they’ll basically be able to just kind of white label that into their device and have that functionality available. And then last but not least, we have the 800 pound gorilla with Apple. And you know, they just continue to make air pods and AirPods pro more and more like a you know, basically like a personal sound amplifier with what they’re doing with the conversational boost is being the most recent one where basically converting your AirPods pro into directional microphones and having an element of beamforming there. So lots of really, really interesting things that are happening. And ultimately, I think it kind of boils down to the same thing, which is, you know, we’re really seeing a lot of momentum around this mild to moderate part of the market. And I think that I’m excited that Brent’s here, because he with the MarkeTrak 10 piece wrote in 2020 he really segmented out the market into sort of five different categories of different patients, if you will, you know, ranging from those that have no hearing loss, no hearing difficulty all the way to hearing loss and hearing difficulty and everything that falls in between. And I think that this sort of presents, you know, with these new solutions, we finally are going to start to see I think a solution set that is catering to this portion of the market. That’s never really been Brent Edwards 4:59 cater to before, by and large. Yes, we’ve had personal sound amplification devices, we’ve had these sort of, you know, introductory level devices, but for a number of different reasons they’ve never really caught on en masse. And when you sort of look at what’s happening with these big name brands, these consumer facing products, it seems to me that we might actually be at sort of this inflection point where this all is gonna start to culminate to something that will start to really appeal to maybe the younger population, the more mild end of the spectrum. And so I want to start things off with you, Brian, to just kind of get your overall perspective of, you know, kind of your take on these big five announcements. And then more broadly speaking, how you’re interpreting what’s happening right now, sort of in the absence of the OTC legislation really being implemented. A lot of this seems to be skirting that, so why don’t we just start there? Sure. So just really quickly on what the big five are doing, you know, they’re realizing the consumer opportunity, and I think making some moves in order to address it. I think Demant did this a couple years ago, when they partnered with Philips. And then all of a sudden you see Philips hearing aids and Costco. And, you know, if you think about OTC, you walk into a Walgreens, what are you going to buy a an oticon hearing aid or Philips hearing it? Same with phone? Are you going to buy a phonic hearing aid or a Sennheiser hearing aid. So you have these really trusted consumer brands that are going to be important for direct to consumer. So that’s kind of how I interpret what’s going on there. But more broadly, in the field, what I’m really excited about is we’re seeing ways of addressing all these different segments of people who have hearing needs that were left kind of out in the cold, except for a very specific group who were willing to go to see an audiologist pay a lot of money and get a traditional hearing aid. Now we’re seeing innovation in different kinds of technology, different kinds of services and different kinds of distribution channels. And because of that, I think we’re seeing these segments that weren’t being served, are now getting solutions that are more tailored to them. So I don’t see this as a cannibalization of all traditional hearing aid wares will now migrate over to direct to consumer or hearables, I think there have been millions of people who have been rejecting traditional service channel and devices that are now getting the kind of offerings that are meeting their unique needs. Yeah, well said. And, and honestly, I think we have one of those people that is here with us today with Andy. Andy now wears Phonak Marvels, and I think he’s a very happy customer. But as he might attest, you know, he wishes he would have been in the funnel a little bit earlier. But I don’t think that the device set that existed, say, five years ago, Andy, and correct me if I’m wrong, was such that that you were willing to take action on and I think I’m really curious to get your perspective on this. As somebody that maybe, you know, this would have, you know, with the current sort of slate of options available? What’s your take on this? You know, kind of almost from the perspective of Andy from five years ago if these had existed? Andy Bellavia 7:22 Yeah, no, that’s really true. Because now I’ve been wearing for three years and I, you know, first started noticing things about five years previously to that. I mean, I would be in the same place today regardless, I mean, I’m in severe territory now. And if I have my back turned on my spouse when she’s talking, you know, four or five feet two meters away, I have a hard time understanding or so I would be in a proper hearing aid at this point, no matter what, but if a viable, comfortable enough situational hirable device were available five or seven years ago, absolutely, I would have popped one in my ear and warn them in a loud pub or restaurant, no question about it. So I don’t think I really don’t think there’s any cannibalization when you see, all the survey data shows that people with mild to moderate hearing loss aren’t going for traditional hearing aids anyway. So the pie will be expanded. And at least my hope is, is that as people gradually work their way into Hearing Solutions, they’re comfortable with whatever is appropriate wherever they are in the journey. And I’ll actually even go one step further back, because even to go get an OTC device, you have to admit to yourself that you have hearing loss. That’s a step already. And when I look at the MarkeTrak 10 report that Brent wrote, and I see 26 million people who have hearing loss but don’t admit to having hearing difficulty even they’re not going to go for the OTC route. But what I wonder is, does the pie get even bigger when you already own air pods and you For example, put it in the conversation enhancing mode and you start to realize, Hey, this is pretty good. I like this mode, you know, so you you know, you don’t you’re still not saying you have a hearing loss. What you’re saying is this place is bloody loud, and I can’t understand anything. And this mode really helps me is that even as a precursor to OTC and perhaps even these hearing enhancement as a solution will actually cannibalize OTC, more than OTC will cannibalize hearing aids, and I’d love to hear your opinion on that brand? Brent Edwards 10:02 Oh, that’s, you know, that’s a great point. As you say, at the end of the day, OTC hearing aids are still hearing aids. And people aren’t when people go to an audiologist, they don’t go saying, boy, I really hope they recommend a hearing aid, I’ve been waiting for years, I can’t wait. Now I can finally wear a hearing aid. People don’t want to wear hearing aids, they do want to wear air pods, they want to wear other devices that enable their lives better not realizing that hearing aids actually do that right if you have hearing loss. So what I’m really interested to seeing what this conversation boosts does when it comes up the addition of beamformers, to beamforming, to AirPods. Pro, because I think right now, the air pods don’t do a whole lot for speech and noise. But with this, it might. So now you’ve got people who are buying air pods for a completely different reason, then they’re discovering that they can hear better and noise with these devices. And that’s a whole new way of addressing a need, which again, is is really exciting. Yeah, and a different way of thinking about about solutions, Dave Kemp 11:00 that that you nailed it on the head there. That’s the big thing, that’s that’s the big difference here is that we’re now talking about a set of devices that nobody’s buying them for that reason, at least initially, you know, we’re talking about a population, a device footprint of, you know, when you add both air pods and app AirPods Pro, it’s like over 100 million devices today. And, and so these are numbers that are just absolutely Titanic, and it’s going to just continue to increase. And that’s what’s so exciting to my opinion is that it’s sort of a Oh, by the way, you know, it’s a, it’s an additional feature that a lot of these people, what’s so exciting is that a lot of folks that might fit into that category that have never been exposed to it. And that’s what I think the name of the game is is exposure, is being able to provide them with that first experience of this is what it feels like to restore your sense of sound, and have the ability to hear the sounds that you’ve never, you know, you haven’t heard in years, because again, it’s this progressive hearing loss, that’s what’s so exciting is that you can literally flip on a switch on your AirPods Pro, and then they’re starting to function like that. And that’s what I think is probably the most different thing. You know, when people say, Well, we’ve kind of seen this before, we’ve seen this, you know, in some different form, this is the big difference is that we’ve never seen the kind of proliferation of these kinds of devices that have that capability that you can sort of just turn on. Andy Bellavia 12:28 Yeah, I completely agree. And I’ll and I’ll go one step further and think about the new techniques, which I like to think of is hearing v2 beamforming is, you know, a small part of that. But there’s also the machine learning based speech from noise extraction techniques, as well, I took for a first test of the chattable software, you know, in the nubile device, haven’t given her a full test yet, but I gave it a first test in a moderately loud environment. And after I twiddle the knobs into the right spot, it really worked. And, and I’m a severely hearing impaired person. And yet, when all the background noise went away, I had a much easier time understanding my spouse than I did, you know, pulling the hearing aids and pulling the air pods with the nubile attachment out and you know, you go to that base of people who don’t measure hearing loss and a single tone test. But you have hearing difficulty, you’re starting to see solutions for them to and also another route for people with measured mild hearing loss to solve that speech and noise problem without even realizing it. Because they can just simply, you know, switch on pump mode, and they can hear better. So there’s lots of different things happening in the field, both, you know, OTC amplification at mild level, and also non amplification techniques that I think really build a broad base of solutions that will work not only here, but globally, I had an error, I want to take a small transition and get brands take on this because there are many places in the world where the audiological model doesn’t even work. I’ve got an earlier who report that talks about this. And as in the countries they surveyed 18 out of 19 low income countries have less than one audiologist per million people. So how do you reach those people when the traditional model doesn’t even exist in those places? And I would like to think that when we drive OTC in United States and other Western countries that that’s going to build the economy of scale for devices that can serve the rest of the world. How do you see that playing out? Brent, do you think that’s a real possibility? Brent Edwards 14:28 Absolutely. So you know, what’s happened in the US and Europe as you’ve had a single approach to devices, to services to the distribution channel, and we’re starting to evolve and innovate and all those and come up with a whole variety of different models. Some countries, there is no established model at all. So I think historically, we’ve thought, Well, how do we replicate our model there? Well, that doesn’t work. So you have to innovate. And maybe the innovation isn’t in the device. Maybe it’s in the service, but how do you measure someone’s hearing in a remote community with no professional How do you get them the right device? You know? And is is a traditional hearing aid the right device? You know, you could answer yes or no to all those you can mix and match. But we need innovation in not just the hearing device, but in the service provision in how you get awareness of the need and the solution to them, which is the distribution of those solutions. So, you know, I think it’s the innovation in all these areas, and we need to stop thinking of that single model that has existed in our world for decades. And again, that’s what’s exciting for me, we’re seeing, we’re seeing all these different approaches for different segments of customers that have different needs. Andy Bellavia 15:39 Yeah, okay. No, I really like it. And of course, there’s a lot of intractable problems and trying to deliver Hearing Services in places like rural Honduras, where I’ve gone on multiple occasions, and we stay in the little town of a few 1000 people, but there is a clinic in that town. So you start to think about the possibility of, you know, an app based hearing test. And there’s some, you know, professional grade tests that are available in an environment and an inexpensive and easy to use device that could be fitted, it would be a you know, you think of it as a cell fitted device, however, it would actually be the coalition helping you fit it so that you can send somebody off with a simple device that’s easy to work with, and really gives them a completely different quality of life. If you’re a student, it’s hard to attend school and get a good education. If you can hear well, if you’re an adult, you’re frozen out of a lot of jobs, because you can hear well, and in those environments, even a 70% solution is way better than a 100% solution. And so it looks like all the tools are being put in place, we need a little bit of the will to make this happen. But in the end, and this is Jacoti says the same thing. I mean, they they state their global mission very directly on their website, I really hope that between new thinking of the service model and the advancement of device tech that we can actually get there now. Brent Edwards 16:57 So I like that idea of a 70% solution is still a good solution for someone, again, with the single lens that we’ve looked at hearing healthcare for so long, we’ve become to think that boy, if you don’t hit target, if you don’t hit the NL to target, then you’re doing a disservice. Or if you don’t do a real ear measure to confirm that then how do you know people are benefiting? You know, maybe that’s the gold standard, but people could do really well with the silver standard. Right? Better Hearing is better hearing. Dave Kemp 17:22 Yeah, I think that’s so well said. And that’s what’s so exciting. I like what you said, Brent, where it’s like, there’s a lot of innovation that’s happening from the device level. But there’s also a lot of innovation that’s happening from this service delivery model. You know, honestly, I think that might be the most exciting thing that’s happening with we live in a world today and 2021, where the global population by and large, you know, the majority of people have some semblance of a cell phone and a smartphone. And so you can start to layer these solutions onto the app economy. And so when we talk about like the cell fit devices, I think you’re exactly right, where in the US, it’s easy to frame things in the gold standard sort of parameters. But when we’re talking about portions of the world that like Andy said, you only have one provider per 1 million people, you need something that’s way more scalable than that. And that seems to be like, what’s really exciting about what’s happening right now is that you have the ability to diagnose through an app to some semblance of where that person fits on the spectrum. And then you can also then sort of give them something that’s almost self programmable. And so that’s what’s so exciting to me is that where we are today is that as the economies of scale continue to increase, this is all sort of a byproduct of the smartphone proliferation, and the byproduct of all that and all the different components that go inside it that have just become so much dramatically more cost effective. So I just think that we’re at this point in time where you do have to look at it from more of a global standpoint, rather than just sheerly a US OTC you know, regulation, because really, what we’re looking at is that previously, a lot of the limitations that existed where you couldn’t have these sort of column entry level devices that needed no involvement of the practitioner, they now exist, and they’re pretty good, and they seem to be getting better. And I think that’s really exciting. Brent Edwards 19:15 And, you know, part again, part of what excites me is a new definition of who needs care. So, in that paper I wrote last year, I think there’s something like 25 million people in the US who need hearing help, but if they walked into a clinic, they would show a normal audiogram what we call a normal audiogram. And they be told you don’t need any hearing help, or there’s nothing we can do for you. Well, I think there’s this movement now to get beyond the audiogram as the measure of need. So Suma dar has published a paper recently saying it’s rather an arbitrary way of categorizing hearing need by a pure tone average. And so what is he Well, people know what their needs are. And so if we let people define for themselves, then the audiogram just becomes, say for example, what you use to determine a target So at nl we just finished a study where we tested the benefit of traditional hearing aids on people with normal audiograms. But who have said they have abnormal difficulty and noise. Now, no one in their right mind probably would fit someone with a five dB of hearing loss with a high end hearing aid, a guess what the majority of them really like their hearing aids. And at the end of the study, when we asked would you want to continue to wear them? The majority of them said yes, but in a different way, maybe only situationally, so they’re not going to wear it all day long, they don’t have that need. And they probably don’t need that sort of, you know, neural habituation to adjust to amplification. But in situations, they benefited from noise reduction, beamforming directional microphones, and so again, it’s it’s new technologies, it’s new consumers, it’s new need, if you look at Facebook, what they’re publicly talking about on their efforts to develop a hearing device, I think they call it something like superhuman hearing. So they’re not even framing it. As you know, you have hearing difficulties or saying why just live with normal hearing, give yourself superhuman hearing. I think that’s great. Dave Kemp 21:07 I yeah. And you mentioned something there, too, that I think is really interesting. It’s this idea of you know, so if the pure tone audiometry isn’t really like the whole picture, and there’s a lot more information. And that’s part of where the focus is right now, you know, when we think about this, as you outlined in the market trek study, it’s like, there’s all kinds of these people that probably do warrant the services of the practitioner. And the most telling thing I thought of the whole study that you had was that I think it was like, there was an N of 3000 people who had been surveyed. And they said that, you know, they had all sort of already gone through the process of going and meeting with a practitioner and experiencing the audiological sort of value, if you will. And I think it was 88% of them had indicated that, you know, had they’ve been given that option, again, knowing what they know, they would go that same route, they said they would definitely do that. Or they would likely do that relative to like the OTC route. And so again, this tells me that there’s basically it’s like, that’s actually extremely encouraging, from the standpoint that we know that the value resonates. But the challenge is, how do you actually expose people to that value. And to your point, I think that, you know, when we talk about making sure that you’re properly assessing people early on, that might be what the role of the practitioner is, in this mild end of the market, because at the end of the day, they might not be candidates to buy the kinds of things that you sell, like hearing aids, but that doesn’t necessarily mean that they’re not like candidates for your actual service. And so I think that begs the question, how do you actually then incorporate yourself and embed yourself into that process early on to establish that as the value proposition of Let me help to just make sure you know exactly where you fall onto the spectrum? Andy Bellavia 23:05 Yeah, that’s I guess that’s my question for Brent, is that how do you get people to engage earlier in their journey, so that they don’t wait too long before they have that first conversation about their hearing? And if you think on a worldwide basis, is there a difference between countries where your primary medical physician addresses hearing and countries where they will not end? Do you see people engaging in different ways depending on when they first have that conversation with any medical professional? Brent Edwards 23:34 Well, you know, the way I’ve tried to think about this is there’s something called the COMB model, which is looking at capability, opportunity and motivation, that explains why why people behave in a certain way. So why are people behaving in a certain way towards their hearing health? Well, because they have different capabilities, opportunities and motivations. You know, why does someone choose not to go to see a professional? Well, they might have certain biases against that they may want to do it themselves. They may be you know, what, it’s as too much of a hassle. There’s all kinds of reasons why and so can professionals still engage with them? Yes, but don’t pretend that all of your clients are going to be people with gray hair, and who are older, and who have a moderate or worse hearing loss, you know, provide a variety of services. So there’s a variety of different solutions. Not everyone needs eight appointments, to get their hearing aid right. Now, everyone wants that. Not everyone, everyone even wants to come and sit in your waiting room and book an appointment. So we need to start to adjust, you know, the services and the delivery and the solutions that we provide and the opportunity there is great. So if professionals adapt, you know, I think the opportunity is there to expand the reach and expand the services but we can’t be stuck thinking about things the way we did 20 years ago. That is The road to to catastrophe. Dave Kemp 25:03 Right? I completely agree. So as we sort of come to the close here, I mean, I think that this is a really interesting way to frame it. I like what you said there brand where you can’t just sort of have this legacy mindset of this is how we’ve always done things, because we know that, you know, what we’re really looking at is an expansion in the market, we’re looking at an entirely new population of people that have never sought these services before. And so in order to, I think, capture this in warrant, you know, them to come and see you and incorporate you into their whole overall process, you have to find a way that that appeals to them. And by just saying, you know, I’m the person that fit you with hearing aids, is not going to resonate with them. And so I think that it’s being more holistic, it’s coming up with a way that is, like you said, you know, gathering all of this information to be able to provide a robust assessment. I’m just curious, like, you know, with everything that’s sort of on the table now, and then, in addition to what we know, will be coming here soon, when in the US, OTC really does start to take effect probably in 2022. Who knows, you know, what do you two think will be the sort of next three years ish, three to five years in terms of really catering to this portion of the market where it is much more on the more mild end of the market, or even the hidden hearing loss? situational difficulty? Just curious to kind of get some closing thoughts on, you know, like, how this takes shape over the next few years. And what your hope is, in terms of, you know, the way that this ultimately kind of, you know, I guess manifests? Andy Bellavia 26:39 Yeah, you beat you beat me to it, because I wanted to ask Brent, that question. I mean, my closer is to get Brent’s feedback. When I look at the chart, just in the US, there’s the 50 million people who have hearing loss or hearing difficulty with no hearing loss. And we all know when you look at different surveys that do enter the adoption rate of hearing devices amongst people with a hearing difficulty of some kind is very, very low. How long do you actually think it will be Brent in do you feel? or reverse the question? Do you feel we’re at the point now, where we can really move the needle on the low adoption rates? And how long do you think it will take before there’s noticeable improvement? So Brent Edwards 27:19 what I think is, we still got a ways to go to really dramatically grow the market. And we can look at history and ask ourselves, why did companies like Sound Hawk, which was an evolution of Sound ID? Why did it fail? It was one of the early hearables, great product out of business, why did Doppler Labs fail? Why did Bragi fail. So just having consumer form factor with some good audio processing is insufficient. As I said, People aren’t clamoring for hearing aids, you know, waiting, just hoping that for the day when they get a hearing aid, so putting out on the shelf at Walgreens isn’t necessarily going to dramatically grow the market either. But we’re seeing a lot of companies really innovate in a variety of different. And when you really get a true consumer product that people want for other reasons, they’re they’re addressing certain unmet needs that are attractive to people where people going, Wow, that’s really cool. I want it that also helps with hearing difficulty. That’s where I think we’re gonna see real dramatic increase in the use of this technology. So color me a little bit skeptical on how much the market is going to grow just by putting a consumer friendly brand on a hearing aid on the shelf. And also call me a little bit skeptical on all of the horrible companies that are coming out there. Because, you know, there’s the lesson in the failures of past companies there. And we need to understand that in order to continue to provide better solutions that are going to be more accepted. Dave Kemp 28:46 Well said, I agree with you. I think that there’s a lot of hype. But I do think that what’s encouraging is that we’re seeing things that are definitely novel to the market than we’ve seen before, namely air pods, and just this sheer proliferation of devices that look like them. And the cultural shift that’s really taking place, I think, over the last few years where it’s becoming very much normalized to where things like that. And at a certain point, I know as you outlined in the MarkeTrak 10 piece, it’s like, it’s gonna be really hard to even tell what you know, who’s wearing a hearing aid and who’s wearing a hearable. And that’s probably going to be very advantageous from a shear reduction of stigma standpoint. So I think there’s a lot to be optimistic about on the horizon. But I agree with you that it’s probably going to be a little bit more of a slow burn than just some sharp uptake to the right. So this has been fantastic. Thank you too, so much for joining me on this inaugural debut episode of this week in hearing. Thanks for everybody who tuned in here and we will chat with you next time. Transcribed by https://otter.ai