Reaching More People with Hearing Loss: Interview with Soundwave’s Anthony Florek and Chris Boven

Bob Traynor 0:10
Welcome to another episode of This Week in Hearing. Hi, I’m Bob Traynor, your host for this week’s episode. And I have a really interesting discussion this week with a couple of colleagues that are building a very unique device. The device is called Sontro. And you may have seen this in a announcement by Karl Strom in Hearing Review. A few weeks ago, these guys are actually the the winner of a honorable mention award from the annual Hearing Technolog Innovator Awards. Now there we have had like 15,000 people voting. And these guys came very close to winning from what I understand. They’re also the winner of Big Innovation Award for 2022. offered by the Business Intelligence Group. You know, they’re one of 81 brand new products across the whole globe, for innovation, and so on, these are judged by execs and leaders across the world. So it’s my pleasure today to introduce to you, Anthony Florek, who’s the president of Soundwave hearing. And his colleague, Christopher Boven, who is the Chief Technology Officer for Soundwave. Again, this is just a unique device that we thought was really worth the time and energy for our colleagues to at least think about, as an OTC product in their clinics. So let’s begin with with Tony. Welcome, guys to This Week in Hearing. And, and Tony, can you give us a little bit of an idea of how you came to the industry and an orientation to Soundwave Hearing?

Anthony Florek 2:18
You bet. Thanks, Bob, thanks to also Hearing Health & Technology Matters and This Week in Hearing – exciting to be here in Soundwave’s honored to be in a discussion with you all this week. So I’ll give you 30 years in less than three minutes. So I’ve been in medical devices for about that 30 plus years. First half of that was in ophthalmology with cataract implants and commulsivication equipment and LASIK equipment that I often joke with people that I’m working my way down the body and I got into to hearing I spent about 11 years with with Beltone as their VP sales and training and worked with the managed care departments and business development sales administration, the dealer network and the surely their corporate stores. And after that I ventured out on my own and ventured into a technology incubator called Matter in Chicago and met Chris Boven, who was working for a company called Resonance Medical. And he was developing a hearing test for an app and they didn’t have a hardware yet in OTC was bubbling. This was before we signed into law in 2017. I spent about a year and a half, helping them commercialize the software, looking for hardware partners and eventually went out on my own in 2018. And started Soundwave Hearing. My first partner Joe is the brains behind all the hardware and then Joe and I turned around and bought Resonance Medical and the app, and the software and the patents and all the technology and Chris became our third partner and that’s that’s the foundation for Soundwave Hearing and we just commercially launched our product, the Sontro hearing aid model AI this past January.

Bob Traynor 4:14
Great. So So Chris, what’s your story, I know that you studied with some of the famous audiology researchers in our field, such as particularly John Allen at the University of Illinois. But tell us a little bit about your journey into into the, into the physics and so on and software and all the things that go into an innovative kind of product.

Christopher Boven 4:40
Yeah, both. Thanks, Bob, for having us on. Yeah, I got my start with hearing about 10 years ago, doing a PhD at the University of Illinois, trying to analyze the signals in the auditory system. And so I was presenting some research from that. From that time in 2016, I met a team of people in San Diego at this conference and they were building a product to optimize cochlear implants at home. So patients wouldn’t necessarily have to go to the audiology clinic to improve how those cochlear implants sound. So I ended up joining that team, we pivoted pretty quickly to hearing aids just because there was a much larger commercial opportunity there. And as Tony said, eventually, that turned into Soundwave Hearing. And here we are building our own hearing aids, developing the software, which allows users to optimize their devices in the comfort of their own home.

Bob Traynor 5:44
My understanding is that, that the Sontro device uses a unique kind of AI and machine learning as well as some some techniques that are involved in in the hearing evaluation component. Maybe Chris, you can kind of help us a little bit with understand that better.

Christopher Boven 6:12
Yeah, sure, Bob, you’re an audiologist. So I’m sure you’ve administered many an audiogram. So audiograms work by playing pure tones to the patient

Bob Traynor 6:24
somewhere around 50,000 or so.. Right? Just like many of my colleagues that do this every day.

Christopher Boven 6:32
Right? Exactly. So with with a conventional audiogram, you know, you play pure tones to the patient, the patient indicates whether they heard the response or not, you go through half a dozen frequencies or so one at a time, on the left, and right here, you go up and down in intensity to sort of zero in on that threshold for that given frequency. So our approach is similar in the sense that we play pure tones to the user, the user indicates whether they heard the tone or not. But we use Probability Theory to decide which tones to play. And the way that we do that is we recognize that pure tones exist on a two dimensional space of intensity in frequency, same as an audiogram. So what we do is we compute a special function over the space that represents our uncertainty about any possible tone, we could play given the previous responses of the user. So our algorithm recommends a tone to play that we’re most uncertain about, or equivalently, the tone that will provide us the most information, we play that tone, we get the response from the user, that’s a new data point, we recompute this uncertainty estimate, and then we get a new recommendation for which tone to play. And we do this over and over iteratively, until in a similar way, we can zero in on the hearing threshold curve. And because we’re doing this in a statistically rigorous way, an optimized way, we’re able to get a result in about 3 minutes versus 5 to 10 minutes for an audiogram. In addition, our estimate is a nice continuous assessment of the threshold rather than just discrete points that you get with the audiogram. So that’s that’s basically how the algorithm works. And then this is a in-situ test. So that just means that we’re using the hearing aids themselves to play the tones, administer the test. And it’s they’re talking with the app, which is it contains all the intelligence that I just described.

Bob Traynor 8:37
Now, I understand too, that the the evaluation itself has some pretty good test, re-test kind of reliability, relative, in other words, the test I do at the clinic, how close is that to the test that you guys might do to facilitate the use of the device?

Christopher Boven 9:00
Right? Yeah, we were very interested in that question as well. So that’s why we did an experiment at Northwestern University and their audiology clinic. We had patients take a conventional hearing tests in a sound booth with an audiologist and compare those results with our in situ self guided hearing tests. And we found that the average difference between the thresholds was only a few dB. So we think this really indicates that using this method to program the amplification of our devices will give us a decent first fit.

Bob Traynor 9:38
Well, I think that and all of us know from from all of our lives, in audiology that the test retest reliability is like 5 dB. My understanding yours is even just a little better than that. From what from what we were talking about the other day

Christopher Boven 9:55
Yeah, that wasn’t a part of the study, but we have tested internally and yes, our test retest reliability is absolutely comparable to what you get with a conventional audiogram.

Bob Traynor 10:08
So, so if so how do do patients actually go through the fitting process and, and that kind of thing in terms of your particular system?

Christopher Boven 10:22
Well, so we get the threshold curve, which again, is just the same as an audiogram. And then we use a prescriptive fitting equation, then to adjust the compressive gain parameters of our of our hearing aids. So we do it in the same way as an audiologist.

Bob Traynor 10:41
Well, and yet the other question I would have for you to Chris is, you know, everybody, and their, and their brother and their mother and their brother in law and so on, are all talking about AI. What really is kind of the AI concept, and how have you incorporated it into the processor and into the, into the fitting parameters and those kinds of things.

Christopher Boven 11:09
What I just described earlier about the this uncertainty estimate, and using probability theory, that really is the machine learning I was talking about, machine learning is sort of just a buzzword, really what it is, is just statistics. So that’s how we’re using machine learning to improve how we get this hearing threshold curve. But I would say that, you know, it takes a fair bit of computation to do these things. And one of our major accomplishments was getting that to run on a mobile processor. So we had have to use highly optimized math libraries that can do things like linear algebra, in an efficient way on on your device, because in between each trial, each presentation of the tone, we have to make a decision, right, what’s the next one, we should play, and that has to be done in a fraction of a second. So again, that’s something that where the intelligence is really all made possible, because we all have smartphones, now we have this pretty powerful computer in our pocket.

Bob Traynor 12:16
And so I’m glad there’s somebody who can compute all that linear algebra and all those fancy kinds of calculus things and so on that are necessary. Rather than having me do it, or some one of my colleagues do it. Most of us know the decibel. And we know physics and we know some of those things. But, but but some of the calculations escaped us to some degree. And so, so, Tony, as you guys looked at the marketing and so on for this device did was Was there some sort of rationale that went into having a self fitting instrument rather than just something that was a one size fits all, as many of the OTC products are

Anthony Florek 13:02
Part of our goal at Soundwave is to partner with the audiology community. And we thought this was a really effective way to do that efficient way for the patients. You know, we’re sort of positioning ourselves as a starter hearing aid. And I know from previous experience, running groups of providers that if 10, people walk into a hearing aid provider’s storefront 40% of the time, on average, nationally, they walk out with nothing so that that tested not treated patient is not, doesn’t make the business model for the provider very efficient. It makes it very inefficient. So part of our thesis is, hey, can we capture those tested, not treated patients? Because I think every provider knows if they leave the office, they don’t come back, they go down the street, they go online, they go to Costco or they do nothing. And that’s that’s what we’re trying to capture. And that’s that’s why we want to partner with the audiology community as a started hearing aid, and that’s the opportunity I saw with the software with the self fitting technology, we had to come up with a piece of hardware that was worthy of the audiology community and certainly to the to the patients. And I think we did that. And we partnered put them both those technologies together to come up with a robust solution for those providers.

Bob Traynor 14:32
I’ve always been a huge advocate for for practice differentiation, and practice differentiation is kind of where the ballgame is these days. How different your practice can be from another practice up the street. And the more more levels of product that you can carry in your clinic and and the more innovative each of those can be. The the better or your success will be in any particular market? I would think. And, and so.

Anthony Florek 15:08
And we agree with that. And I often joke that I’m the dumbest guy in the room. But I listened to all these providers and these folks in the audiology community. And I think that the innovative ones, the ones that are on the, the early part of the curve, are seeing OTC and all the changing regulations as an opportunity. They’re no longer threatened by this, this is a big bucket of lead generation. And I think if and when more when they learn how to embrace it and change their business model slightly. This will be a boon for the penetration of all those folks that have a mild to moderate hearing loss, but don’t seek a hearing, you know, don’t seek amplification for whatever reason, is it the stigma still, is it the pricing still, what is it but I see more and more audiologists actually selling online and getting on their own website getting into this digital marketplace in attracting more patients becoming the local experts in their community. And whether they sell a central hearing aid through that ecommerce idea, or they sell hirable, or, you know it’s there but they’re attracted to, or hearing protection device to they’re attracted a patient to their practice. And they’re getting them into their ecosystem. They’re getting into their, through that patient into their purview of care. And eventually, you know, they’ll when they fall outside of the moderate to mild indication, they’ll sell them a prescription hearing aid, and if their care is good, and most are they’ll sell them a third and a fourth set and that’s that’s the long term value of OTC is lead gen as part of this, you know, getting in this e-commerce mix and just fortifying their bottom line so they can take care of more patients.

Bob Traynor 17:04
No, I I totally agree. I’ve been an advocate of OTC for way over 20 years now because of the of the benefits I think that it will offer versus the limitations and so on so so there are lots of reasons why this would be now if we just shift gears here for a moment or so Tony, what how would What do you guys think the difference between the was a lot of OTC or I guess, more than OTC they’re more DTC direct to consumer products that are out in the marketplace currently. And, and how how do you see Sontro kind of working within that DTC market?

Anthony Florek 17:56
Right. It’s it’s sort of a Tony, Chris question. I’ll sort of set the stage.

Bob Traynor 18:00
A Tony, Chris question. Well, great. Yeah.

Anthony Florek 18:03
Or, or Tony Chris answer, or

Bob Traynor 18:06
a Tony question, maybe, who knows?

Anthony Florek 18:09
Right. But I mean, it’s, it’s a little confusing out there. And I think that’s the frustration of consumers frustration of providers. And I think OTC, though it was difficult in the beginning came along at the right time, to set clear boundaries of demarcation between PSAPs. What an OTC hearing aid is, what a cochlear implant is, what a prescription hearing aid is, and, and really strong guidelines for manufacturers like us to follow. And for the FDA to regulate. I think that that’s super important. And I think, right now, it’s a little bit of the wild west out there. And I think some of these direct to consumer companies are making claims that, you know, perhaps are unfounded. So if we have, again, a clear set of rules from the FDA, and clear boundaries, that we all can play within, I think that ultimately benefits the consumers, the providers, and gets more people involved in their hearing health. And Chris probably can talk a little bit more to the features and benefits of what’s out there. But what differentiates the Sontro from anything else out there, in our opinion has is our hearing test. And I think that’s a really nice line of demarcation. Now, getting that across to providers and to consumers is a different story. And we’re working on that. But it’s it’s fun to have a technology that you believe in that can help people and the fact that we’re partnering again with the audiology community to bring more people in the pipeline is fun and exciting

Christopher Boven 19:39
Yeah, I would say one of the issues with direct to consumer hearing aids now is that a lot of these devices are a low cost. A lot of them are low quality. And not only that they’re low customization, right, so many, there are many products that are so called picking clicked, picking quick devices which have a small number of amplification profiles to choose from. And you better hope your hearing matches one of those, otherwise, you’re out of luck. Some products allow the user to change the amplification directly themselves, which is certainly an interesting approach. We really believe that the best place to start is the hearing threshold curve, after all, has been 100 years of audiology, hearing research that’s gone into translating that measure into amplification parameters that maximize audibility, and speech intelligibility. So it seems unwise to throw that away just because a product is DTC?

Bob Traynor 20:46
Well, it’s, it really is an innovation and I think right now, the way the way the some of the other products in the marketplace have gone, your instrument is one of the one of the few left that’s a true

patient, interactive kind of device for programming. And some of those things if I, if I remember correctly.

Christopher Boven 21:14
Yeah, that’s all made possible through our app for OtoTune app, which is available on iOS or Android, it allows users to connect their hearing aids to their smartphone, they can do things like change the volume mode, adjust the equalizer noise reduction, and of course, administer the the intelligent in hearing tests that I described earlier.

Bob Traynor 21:37
Well, well, ah, you know, again, as a person who encourages colleagues in their clinics, to have to investigate all of the available OTC products that will be out there. I think that this is one that actually deserves their, their their attention to at least for investigation to see what’s going on. So Tony, if an audiologist or hearing aid dispenser are interested in just in using your products in their clinic, how do they go about getting in touch with you guys,

Anthony Florek 22:19
so they could go to our website at hearsoundwave.com there’s a professional tab and they can sign up and create a wholesale account. We’ll enter in their wholesale pricing. The MSRP for our products are $999 per set They come in two colors currently gray and beige. The the audiologist can can make 30-35% on margin on the product. If they want to have a further conversation with me I love these kinds of conversations. They can leave an email at [email protected] That email’s found at the bottom of our website and fill in their name and information and I’ll contact them and we’ll set up a call to discuss further and how Soundwave wants to partner with the audiology community.

Bob Traynor 23:12
Well, this has been an interesting discussion from the innovative OTC product. And I would encourage colleagues to begin to at least investigate the Sontro device for possible use in their clinic with their patients. And I want to thank Tony and Chris for being with us today. Here at This Week in Hearing