Transforming Hearing Health: Amptify’s Virtual Clinic and Aural Rehabilitation Program

amptify dtx virtual clinic
July 17, 2023

This week, Amyn Amlani sits down with Chris Cardinal and Dr. Anne Michelle Puglisi from Amptify. They discuss Amptify’s innovative digital aural rehabilitation program and the introduction of their new virtual clinic.

The aural rehab program includes auditory brain training games, a curriculum, coaching, and group support. The virtual clinic enables patients to schedule remote appointments with audiologists and allows for remote monitoring of their progress. Additionally, Amptify offers partnerships with manufacturers and an ecommerce store generator, expanding access to hearing healthcare products.

Overall, Amptify aims to provide convenient and comprehensive solutions for individuals seeking hearing healthcare.

Full Episode Transcript

Welcome. My name is Amyn Amlani, and today I am joined by members of the leadership team from Amptify. Chris Cardinal and Anne. Michelle Puglisi. That’s right. Hello. Welcome, welcome. Really excited to have you all here from Amtpify. And Michelle, if you wouldn’t mind letting the viewers know a little bit about yourself, please. Sure. I am VP of Audiology at Amplify. I come to the company with over 25 years of clinical practice experience in a hospital and private practice setting. But really my passion throughout my career originating from my time at Gallaudet for my masters has always been aural rehab and I’ve incorporated into the positions that I have held through the years. So I’m just living my dream right now. Wonderful. Yes. A little bit about yourself, please. My name is Chris Cardinal, and I’m the president and chief executive officer of Amptify. My background really stems from I’m using digital tools in order to drive engagement. I am a veteran from the digital health space, and I’ve been leveraging that to bring best practices in creation of digital and virtual tools into the hearing healthcare industry. And what a better time than now to use those digital tools as we expand into these different generations that are more tech savvy, right. So before we dive into that and some of the new things that you all are doing. Which is why we’re here. Would you both talk a little bit about who and what Amptify is for those viewers? I’ll start it real quick here. Amptify is a spin out of the prestigious audiovisual and speech perception laboratory at Washington University School of Medicine and founded by by Professor Nancy Tye-Murray and Dr. Brent Spehar. And really, when we started out as a company, we were focused on development of auditory brain training video games, and that’s still really a good piece of our core IP. And something that we are always focused on is creating a better experience for auditory training. We soon realized that it was essential for the auditory training to be successful, that we build around the. Those tools in a similar way that you would build a program around someone who was managing their diabetes. And so we took those best practices from those type of behavior change and chronic disease management tools and built that into what is a digital aural rehabilitation program, which most of the listeners here would be very familiar with the components of that. And I’ll actually let Michelle speak to that a little bit. And that’s really what Amptify is best known for, is that digital aural rehabilitation program, also termed the Amptify DTx or Digital Therapeutic. Anne Michelle, you want to talk a little bit about what that program is? Sure, that’s right. So Amptify, as a total program, does take the auditory brain training games that were developed and incorporates a curriculum we currently have. Our most popular curriculum is twelve weeks long, and it includes all. All the major topics that audiologists who might be listening would find familiar. There’s much talk about communication strategies, of maximizing visual cues, of incorporating assistive devices into their use, whether they’re using hearing aids, cochlear implants, or other devices. And so the curriculum is really a way to engage the members in, like, a proactive approach. We talk about assertiveness training, a proactive approach to improving the quality of their lives, their everyday lives, to support the games and the reading of the curriculum. We have a coach that sort of guides them through the whole process. It helps them establish what their specific goals are and then helps tailor the curriculum to their needs, really, with an emphasis on what? Audiologists would know as person centered care. And then we have a group, a group of members who go through the journey together intended for peer support. And we really look to the literature and what we know works about group AR in person, and we incorporate as much of that as possible into our digital offering. So it’s really those four components games, curriculum, coach, and group. Wow, that’s wonderful. And just real quick for the audience, how does somebody subscribe to Amptify? Yeah, there are a couple of different ways, and I think this is a very good segue. When we first released the Amptify DTx, we did so, um, directly into the clinics and positioned the DTx as a way for them to outsource their. Patients. Clients are rehabilitation and as positioned Amptify really an extension of their clinic. And that’s truly how we see ourselves, how our team all see ourselves as an extension of the clinics that we work with. And when we did that, we bundled together the redistributable licenses for that digital rehabilitation program and sold them into the clinics at a discount so that they could either give them away to their patients who could go through the rehabilitation program or could sell them to their patients if they wish to do so. Very quickly we found out that it was necessary actually for the clinics to actually sell or put a value onto the price of that rehabilitation program because the patients who were given it for free were not being adherent to the program, whereas the clinics who were charging for the rehabilitation actually saw a markedly increased adherence to the full scope of the program. That’s the primary channel to which individuals who want to access the Amtpify DTx can. However, if they do want to get into the program, them themselves on their own accord, they can go to download the Amptify app on iOS or Android or go to and they can sign up directly as a consumer if they wish to do so. Wonderful. Yeah, people, we always go back to the literature, right? You have a stake in the game and you’re more likely to participate. When you don’t have a stake in the game really doesn’t matter. So that’s a great point. The big announcement that you guys had last week is really intriguing to me and. Really excited to get into this conversation. What’s this thing about a virtual clinic? Well, pretty quickly as well. When we started assigning these licenses out to the audiologists, we began getting pulled into developing a suite, ultimately of virtual care solutions, as they were recommending and referring their patients into the Digital AR program, the Amptify DTx. The providers were saying, we want to remotely monitor our patients, right? We want to be able to track their activity as they go through this program, track their adherence, track their speech in noise, because we are doing monthly speech and noise tests, monthly word discrimination tests, monthly quality of life tests. And that first step alone in the remote patient monitoring was something that was actually fairly novel and creating and generating and capturing. That longitudinal data about an individual’s journey as they go through their hearing loss and hearing challenges. Rehabilitation program was a novel concept. And then from there, it was really the next step was ultimately creating and closing the loop and creating a way to where those patients who were in their homes and those providers who are ultimately, traditionally practicing in their clinics were wanting a way to be able to better connect with one another. We had really two sides of the coin built out at that point, right? We had both this portal through which the audiologist and the provider could go and log in and remotely monitor their patients. And then we had the mobile application which the patients had in their pockets. And so it was a very, you know. It was a very easy next step to take to be able to connect that. And so what we did then is build out a virtual visit system in which the participants who are in the mobile application can easily schedule with that same application an appointment with their audiologist. Now, this isn’t rolled out publicly yet. Actually, I’ll say that by the time this is published it probably will be public at that point to all of the listeners here. So go log into your Amptify portal and take a look. And there were a few other features as well. I kind of jumped right into the virtual clinic, but there’s also the ecommerce Store generator. Again, we were kind of pulled into this to where the audiologists and the providers were wanting to be able to capture the potential leads that are generated from the sale of these OTC devices and to be able to compete at a local level. With the larger retail stores like the best Buys of the world. And so we again closed a loop there, right. We created a very simple way for them. We have literally, we internally call it a magic button that you can go and click on this magic button and you upload your logo, you pick a couple of colors, and all of a sudden you have a store where you able to sell a range of hearing, healthcare related products. And we have formed relationships with manufacturers and distributors, and we have made it as easy as possible to be able to start selling products on your own branded store that matches you or your company. And we handle the back end, we handle the fulfillment, and then just directly deposit the proceeds from this sales into your bank account. I would say last but not least is Laila, which is an AI. assistant so or an AI audiology assistant. And so the concept here as we realize is that as these devices and products were as we were forming these relationships there was a lot of education that was needed to be happening with the audiologist and then even more so, there is a very granular distribution of data around devices, around the software that the audiologist uses. And so we had thought kind of long and hard we weren’t necessarily pulled into this one about how we could better improve the provider’s experience with the actual care and seeking of information that they go through on a daily basis. And so that’s where Laila comes in. And so we have trained, basically created a database of provider facing materials and. We are also internally working with Laila at this point and testing out Laila so that we can then roll it out to some of our clinics in the future. Now, this isn’t something we’re taking this one slow, I’ll put it that way. We don’t want to release this too quickly because we want to make sure that there’s no hallucinations and we want to make sure that it’s really not going to hamper the workflow of the audiologist. And so, again, I’ll kind of fall back to Anne Michelle here. She can go into more details because she’s been using this stuff as well. Yeah, I think I want to preface my statement by saying the development of these new features, it’s really been a collaborative process between developers and digital people and professionals, clinicians who have been in the trenches. So with every feature that we see arises a need for we discuss how to implement. It, but then also what the day to day needs of clinicians will be. So, for instance, with Leila, at one of the meetings, I was like, it’s got to have repair forms and ear mold forms. Like, you have to be able to just very quickly and easily find whatever custom ear mold product any company have, because that’s what I know takes my time up when I’m in the clinic. We also looked at it from the perspective of what new patients need versus what existing patients need and what clinicians need themselves to administer to those two separate groups. So, for instance, in the virtual visits component, we have created visit types that can be initial consultations for new patients who just happen to find. The clinic on the website and decide they want to schedule an initial remote visit to talk about their hearing problem. And it’s really organized by problems, so hearing, tinnitus, communication issues, that sort of thing. So initial consults there. But then also we created visits for existing members. Every audiologist has desperate people about to go on vacation whose hearing aids just broke. And so to be able to just have that quick triage appointment available from right within the portal through the app or on the computer at, it really is intended to make the clinics ah processes run more smoothly and easily. Michelle, just a point of clarification. Are we running diagnostics through this virtual clinic We are not. We are not. Though we have big plans, but nothing immediate, we have one step at a time, really. This is intended to sort of expand the reach of an initial consult with the intention of because the people who the people who have those consultations, if they need inpatient care, will be directed to audiologists in their state locally. So it’s really almost like a stepping stone. Our press release had a really nifty image of how we envision the digital, the virtual and the in person care working together. And the idea really is that through those initial consults, it can be like the first step in creating a person centered. Treatment plan that I assume, if we’re going to dive deeply enough, will include in person diagnostics. Yeah. So it almost sounds like and I love this concept it almost sounds like you’re opening up a pathway for these folks to get into that funnel exactly. And rack them bouncing around and not knowing where to go and being lost. You are aiding them on this journey and essentially and it’ll be interesting to see in time, or maybe you have this data whether or not that treatment is now being shortened, because it’s a lengthy period right now. Right. Depending on who you read in the literature, anywhere from a few years up until a decade or so. Are we going to be able to shorten that, given that this pathway is now opening up for them? Right. I feel like we’re just in this state of evolution and it’s speeding up so quickly. I think OTCs and the internet and the younger demographic, it’s all leading to a different way of approaching access to hearing healthcare. And this is intended, you know, to catch the person who, you know, doesn’t want to have to take time off from work and go sit in a waiting room and make it a big deal. Maybe they just want a quick 15-20 minutes consult to talk about the kinds of issues that they’re experiencing, to decide what the next step is. And that really does expand access, and they are potential leads for the clinic as well. Right. We always try to keep in mind that the provider, the hearing healthcare professional is really the lifeblood of industry and the lifeblood of the care that is going to be received by those patients. And so nothing that we. Ever do is meant to replace or displace it’s. We always approach it from the perspective of expanding care to make sure that those who need it are able to get it when and where they want it. And I think that that is the modern approach that we bring to the table, is the expansion of that care, that paradigm beyond that in person care, and into the digital and the virtual realms, which are the three ways that anybody receives care for anything digital, virtual and in person. Right. I consider it I’m sorry to jump in, but I consider it really like we are the facilitator so that audiologists and other hearing health professionals can do their thing. Yeah, no, I was actually going to use the word concierge. It almost sounds like you’re taking these people provide. Them with a white glove service to make sure they get where they need to go in the manner that they want to go in. And one of the things that I’ve been working on recently is the generational differences. And as an example, I’ve got a young son at home, a young adult. He prefers the telehealth visits. And I’m the opposite. Being a little bit older, I want to go in and actually have a conversation with my provider. You’re now able to streamline those visits based on that person’s preference, given the tool that you’ve now created, correct? Yeah. That’s really cool. As I’m looking at some of these notes here, you have some strategic partnerships with some well known entity teams in our space here. Can you talk a little bit about those partnerships? Yeah, I think that. Kind of back to the same theme that we’re on. We really try to not pick winners and losers. We really try to not do much more than to facilitate, correct? And so in that same light, with this platform that we’re building, we are creating a marketplace for both providers and patients to be able to find not only the service that they desire, but also the products that they desire. And so with the partnerships that we’ve formed so it’s currently with WS Audiology and through Sony, as well as with Soundwave Hearing and with Eargo, these partners currently, we do definitely have more in the works that will be coming and. They’re all, I would say nontraditional or I’d say nontraditional players within the industry. And so I don’t want to speak too too much out of turn, but I would say that what we’re able to do is help facilitate, if you will, a relationship between those manufacturers and the audiologists as well. So that the devices that they provide and the types of services that they provide are able to get into the clients and the patient’s hands. And that provider, once again, is not someone that is kept out of that loop. In fact, what we do is create a platform through which they’re able to leverage those brands and leverage those partnerships in order to create stronger relationships with the patients and clients. that they see We also have some other partners that we actually cannot name that are able to supply us with some of the other products as well, that are on the store, again, kind of coming back to those existing patients versus potentially new patients. But we try to act as that digital infrastructure, right, that kind of ties together all of these, these disparate players. And, and so, in the future, and I could say this publicly, we have had some internal conversations about whether or not we want to strongly vet these products as they’re going through and be a gatekeeper, if you will. And that’s not our plan, right? Ultimately, at the end of the day, the provider who spins up those ecommerce stores for their clinic, they have the choice of whether or not to turn on or off those products that are there, but they’re available to them if they want to participate and they want to sell. Those products, any of them at all. They also have the ability for some of them to be able to change pricing on those products as well. Now, naturally, there are some restrictions on that, but still, we’re just creating an environment to where there is a free flowing marketplace, right? And we’re using the technology and the platform that we’re building in order to try to create liquidity within that marketplace, no matter who the players are. Really interesting. So if I were in a practice today, and I was interested in this conversation here today, how do I get more information, how do I get onboarded, and how do I then become a provider using this virtual clinic that’s soon to be available? I will say go to That’s and click on Get. Started and choose I am a provider. And you can fill out the create an account form. And as soon as you do so, you will have a link there that basically allows you to schedule a time with one of our teammates who will work with you to get started with the Amptify Virtual Clinic and the solutions that we provide. And again, we see ourselves an extension of the clinic and we do everything that we can to empower those providers that are leveraging the platform that we’re building. And we’re always trying to learn as well. Like, give us your feedback. Be harsh. Actually, I think it’s Anonymous. Leave us a nice or not nice note if you feel like doing so, but all I ask is that you be honest. It’s okay if you’re brutal. We appreciate that type of stuff because we ourselves are trying. Grow. And we ourselves are trying to learn as we keep on building for the future. And the audiologists who are part of the team have really tried to keep the development team realistic about the audiologist time that they can commit to something like this. So we really have put effort into, um, into making it as simple as possible. You don’t have to be like super tech savvy to do it. And if you do need assistance that we have the support staff available to just help you through it. Yeah, so you’ve lessened the barriers to someone not adopting or not wanting to adopt or quitting, if you will, at the end of this thing. And I love that because if you think about some of the tools that we’ve had in the profession and some of them have been around for a while. The tools are phenomenal, but the onboarding and the education that goes with them sometimes becomes a barrier because the individual doesn’t know when to use them, how to use them, and so forth and so on. And so they kind of fall by the wayside. So I really like what you guys have done here. We are doing our best to address those same issues, right? And that’s the ever present hurdle, is making sure that we can help those who are coming in to be successful. And the unfortunate part is that this isn’t Netflix, right? Providers can’t come in and they can’t sign up and press play. There is a little bit of spin up that needs to happen and every clinic is slightly different. So there’s not a step by step instruction book that we can send out either. And so we do our best to make it easy, but at the same time we know that it’s going to necessitate a human interaction. So we have humans around to help out. Not just videos and not just voice. Really cool. And last question that I have being a little bit of a data nerd here is I’m assuming on the back end that there’s data being collected so that you can then use for future integrations and future build outs. But also in some ways, maybe to look to see how the professional is behaving as it relates to set of patients or patient characteristics or however you guys are quantifying that. Am I correct in that I can speak to the Digital AR program? We are collecting data on adherence and we are happy to report that we see we certainly see trends that beat out traditional. Auditory training percentages. For those people that actually get started, we have a certain percentage of people who never get started because of whatever reason but who sign up and then just don’t ever do it. But for those people that get started we have upwards of between 50 and 70% adherence at least partially completing a couple of hours or more of auditory training and the majority of lessons. So I can speak to the auditory training and the digital aural rehab program as a whole that we are collecting data but I think Chris can speak otherwise to your question. There is natural data that we are collecting that is necessary to collect in order for the system to operate, right? We are not collecting. Anything beyond that in order to run any type of experimentation at this point. However, it will not be difficult with the data that we are collecting in order for the operation of the system to be able to generate insights on how the system is being utilized and, for example, the number of visits per provider. We are collecting things like the number of referred patients to the acceptance rates, which has been very impressive. I think we’re sitting at about 75%. So 75% of the participants who are referred into the AR program go into it, and we do work on that as well. And then I think that our adherence rate is sitting at about 66% still for participants that come to the program. And again, how you define that can be cut up a little bit too. Where is that cut off? Do you count six, seven weeks. Do you count them? Completing all the auditory training but not completing the curriculum and not reading all the curriculum. Like, where is that actual number? Right. But again, so 75% who are referred come in. About 66% are adherent to. And that we think that’s really impressive. And I think that that comes down to, ultimately the fact that we are using a progressive application that is, again, on all devices, on all platforms that the patients and the clients are on. Rather than having to people bend into what we would want to be most convenient, we are making it convenient for that end user so that they can live our confident and happy life, which is ultimately our mission. Absolutely, is there Anything else either of you would like to add? Because I don’t have any more. Questions at this point? I don’t believe so. Thank you very much, Amyn. Yes. Thank you for having us. It’s my pleasure. And we look forward to having you guys back on down the road. I think it was two years ago, Chris, that we had you and Nancy on, and you guys have moved this ball continually forward. And we look forward to having you guys on down the road, and we’ll see where that ball continues to bounce. Thank you. Thank you.

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About the Panel

Chris Cardinal, President and CEO of Amptify. Mr. Cardinal is an accomplished digital health entrepreneur with a successful history of driving corporate strategy through effective product and process management.


Anne Michele Puglisi, AuD, VP of Audiology at Amptify. She brings decades of aural rehabilitation, clinical audiology and supervision experience to her position as she leads the Hearing Health Coach program.


 Amyn M. Amlani, PhD, is President of Otolithic, LLC, a consulting firm that provides competitive market analysis and support strategy, economic and financial assessments, segment targeting strategies and tactics, professional development, and consumer insights. Dr. Amlani has been in hearing care for 25+ years, with extensive professional experience in the independent and medical audiology practice channels, as an academic and scholar, and in industry. Dr. Amlani also serves as section editor of Hearing Economics for Hearing Health Technology Matters (HHTM).

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