This week, Laurel Christensen, Chief Audiology Officer at GN Hearing, joins host Andrew Bellavia for a deep dive into the company’s latest hearing technology: ReSound Nexia. They discuss the evolution of hearing aid technology over the past decade and how GN’s latest devices are equipped with latest technology, including Bluetooth® Low Energy Audio (LE Audio) and seamless compatibility with Auracast™.
They also examine the crucial role of low latency in audio streaming and the potential for Auracast™ to enable the direct streaming of public broadcasts to hearing devices and wireless earbuds.
- Andy’s presentation from VCCA 2023 on Auracast, mentioned in the interview, can be viewed here
Hello, everyone, and welcome to This Week in Hearing. In 2014, GN Resound launched the first Made for iPhone hearing aids. Impressively, that’s actually a year before the first true wireless earbuds began shipping and meant to address the short comings of Bluetooth classic that made it unacceptable in the hearing aid application. The ability to direct stream to hearing aids was a game changer I can personally attest to because of our increasingly connected world. But the resultant proliferation of proprietary connection schemes created its own problems for both hearing care professionals and end users. The hearing aid manufacturers were not happy with this situation either, and as a result, they urged a Bluetooth Special Interest Group, or SIG, to develop a new version of Bluetooth that would work with hearing aids and earbuds alike. The result was LE Audio and Auracast. It may seem like forever, but the rollout of LE Audio has now begun in earnest, including with GN ReSound’s recent launch of their Nexia hearing aid platform. Here to tell us more about Nexia and the advantages that LE Audio and Auracast will bring to hearing aid users is Laura Christensen, chief Audiology Officer at GN Hearing. Laura, welcome to the show. Please tell everyone a little bit about your background and your role at GN. Well, first I’ll say thank you. Thank you for having me. And I loved your introduction. Been a part of all of those things that you introduced there. So I’ve been at GN for almost 21 years now, going on 21 years, and I’ve been in various roles. When I first started, I started as the head of research in the United States when we were just creating a research division in the United States. And several years later, I took over Audiology, both in Glenview, Illinois, where we have about a third of our R&D, and in Copenhagen. And so I’ve had Audiology then kind of the rest of the time been in and out of doing the audiology and marketing. Right now I run training and education, but what I’ve always done is been audiology. Or ran the audiology team in R and D. So doing clinical trials, all of our regulatory work, being part of product development, that has always been my passion is to actually be in product development. So my background, I got my PhD from Indiana University, and then my first job was at LSU Medical Center in New Orleans. So I had the great opportunity to work with the like. Of Linda Hood and Chuck Berlin and be part of Kreske, and I stayed there until I was a tenured professor, and then I got an opportunity to work with Mead Killion at Etymotic Research. And it was those days at Etymotic that made me know I really want to be in product development. I don’t want to be in the university looking at hearing aids after they’re launched. I want to be there when they’re, when they’re being launched and when they’re being tested and defined. And so I stayed at Etymotic for about five years, but I came to GN again 21 years ago and haven’t looked back. Love being part of hearing aid development teams. It’s quite the background, and I remain amazed. I met Mead Killion when I first started working with my now former employer, Knowles, and I am still amazed at how many people he’s touched over the years. It is truly amazing. I learned so much about product development from ya know over the years that I was think, you know, you could do a whole segment on mentors, but I think I had some of the best mentors there is. Larry Humes was my mentor at Indiana University, so started out very well, and then Chuck Berlin, Linda Hood, bob Turner at LSU Medical Center, and then ultimately Mead, Killion, and then I’ve had great business mentors even in GN here. So, yeah, I’ve been lucky. I think, having the opportunity to learn from other people and to surround yourself with people who are better than you are at things and to learn from them. That’s always been how I think about hiring people. When I hire people, I want to hire people that will challenge me, who are better than I am, who can know more. You hire some of these young kids and it’s like these guys are passioned and charged up and they want to go and they want to know everything, and that’s how you keep sharp. Well, that’s a terrific background, and I really appreciate you sharing it with me and with everybody listening. So let’s get to the Nexia. The announcement really highlighted the platform’s LE audio and Auracast capabilities. Now that piqued my interest as both an industry professional and a hearing aid wearer who’s been living a connected lifestyle, really for most of my adult life. So I think a great place to start would be to share how GN sees the value of connectivity in general that made it worth investing significant resources over the last ten years or more. Well, you started the podcast by introducing the value of connectivity that we’ve seen for a long time. We were the first company that put 2.4 GHz. Into a hearing aid and got a lot of criticism for it. Oh, you won’t be able to do it, you won’t be able to do ear to ear, you won’t be able to do the things you need to do. But we have some incredible engineers that are still with the company today that said, this is the future you’ve got to be on 2.4GHz I think. You point out that this connected world is incredibly important. At that time, you had something around your neck, and you had to stream with that around your neck, and people just weren’t going to do that. Connectivity has been really important, but it’s been a little chaotic, I think, as you look at how it’s progressed. Because you had companies like ours that came out with proprietary 2.4 GHz protocols, and then you had Apple come out with an MFi type of audio protocol, and then you saw ASHA come out, which is Android streaming for hearing aids. And you have, of course, Bluetooth, the regular standard Bluetooth that was introduced to the market, I think, around 1999, and only one hearing aid company chose to put Bluetooth in their hearing aids. And the reason for that is that all of the rest of the companies, every company not just all of the rest, but every company was already starting to think we needed to do something together. And we needed to do something that everybody would be on the same wireless protocol and frequency, because being able to be helped by assistive devices. Tele-loops are very popular, and people who use them swear by them, because they do make a huge difference in public situations. And to have everybody on one frequency has always been this kind of dream that you could put one transmitter in a public space and everyone could connect to that transmitter. And so the importance of connectivity has always been in the back of all of this, all of the engineers minds. EHIMA the European Hearing Aid Association was really the charge to make it all happen. In 2013, they approached Bluetooth SIG, which is the Bluetooth special Interest group, and asked for a hearing aid protocol. They asked for a protocol that would be low energy, really high quality, even for a low latency, which is what we need. So we needed low power, low latency, high quality, and something that would do public broadcasting. And so it’s been ten years since that request, and I think ultimately the request was accepted and. And as your listeners will hear, it’s going to impact everyone’s lives, not just the hearing impaired person’s life. So it’s a huge deal. We expected it to be out a little bit earlier, but it had delays and then the pandemic hit. But we’re on the forefront of all of the Bluetooth low energy audio and auracast hitting the market as we speak. Okay, okay, thanks for that background. And I will add as a person, I’ve only been wearing about five years, but I introduced internet meetings to my then company in the 90s. So been doing this for a long time and I’ve come to appreciate the value of being able to hear well. Even before I was hearing impaired, I made sure I had a good system so I could hear clearly when having an Internet meeting and so on. And I think that’s sometimes understated how important it is that if you’re doing a lot of internet meetings or otherwise listening connected, the fatigue factor that goes without being able to hear properly really has an effect on your well being and it can have an effect on your career as well. And so for that reason, connectivity has always been, I seen one of the actually almost as key as the core functions of hearing aids. For a person who spends half their work life on Internet meetings and half their work life in person, then the ability to hear well in both situations is equally important. But you actually brought up something you alluded to it the problems with Bluetooth Classic versus LE Audio. We’ll leave Auracast aside for the moment and just talk about LE Audio and why LE Audio is necessary for the best connectivity experience in hearing well. So, you know, LE Audio, what they’ve done is be able to make a really high quality audio and even if it is compressed or even if it’s compressed to send it faster, the sound quality stays incredibly good. If you compressed Bluetooth before, the sound quality would just really degrade and we had to do those kinds of things because it takes too long to send if you don’t do those. So now we’re going to have very fast latencies with no degradation in sound quality whatsoever. So it sounds really good. I was going to pick up on something you said you can’t have a conversation about hearing aids, it seems like, without talking a little bit about MarkeTrak, but MarkeTrak 22 listed the hearing aid features that are most important to use. And what is pretty interesting in that list is that being able to control an. App and stream, I think, were number three and four only after like a volume control, and I can’t remember what the other one was, but it had to be speech and noise. It wasn’t actually, it was something more tangible. It was something more that people could see in terms of a feature, because I think MarkeTrak was asking about features, but I thought it was incredibly interesting. And a colleague of mine, well, two colleagues of mine, Jennifer Groth and Dan McCoy, they actually sent out surveys to 25,000 hearing aid users and got responses back from 10,000 and looked at streaming and how do you see the sound quality? Streaming? And it was surprisingly high. More than 90% felt their streaming sound quality was good. And when you looked at that, even by how they were fit, even open fittings, thought their sound quality was good, but when you looked at it, by what they were using their streaming for, it made complete sense. I mean, the vast majority of people were streaming conversations like this, or direct phone conversations, FaceTime calls, those kinds of things. The typical hearing aid user is not streaming music all day, and I think sometimes we get a little backed up and maybe the sound quality could be better, but the sound quality hasn’t been too bad and we’re even going to make a big jump, like you say, in sound quality. So I think that that’s fantastic. And it’s just part of this new Bluetooth low energy audio. Yeah. And so there’s two things about LE audio or low energy audio, which I think are worth pointing out. One is the low energy part, simply because Bluetooth Classic is pretty power hungry, which means you pay a penalty in hearing aid size, especially in rechargeables, to support all day battery life. But the other is the latency. And I think actually, for the audience, it’s probably worth explaining what latency is and why having as little latency as possible is important. Go ahead. No, I’m the one who asked the questions here. How do you see it? I think you’re probably a great person to do it. Okay, well, fine. I was actually quite willing to hear how you view it from the standpoint of one of the major hearing aid manufacturers. But for me as a user, it’s really all about the synchronization with lip movements for people who are, for example, watching movies and rely on lip reading cues as part of their comprehension and understanding. So if you’re just streaming spoken word audio, and I completely agree with you, I listen to podcasts through my hearing aids all the time. Spoken word audio. The audibility is brilliant music. Now, if I’m listening to music I pop in my earbuds with some equalization dialed in. They account for my hearing loss. But spoken word audio is perfect, even listening. If I do occasionally listen to music, you don’t care about latency because there’s no video to go with it. But if you’re watching a movie you want the audio to be synchronized as closely as possible with the lip movements. So you get that combination of lip reading cues and audio at the same time. It’s important also for the exact same reason for open hearing aids. If you’re streaming and have something coming into your ears at the same time, you want these things to happen quickly and you want to be able to get things there quickly. And unfortunately, to do that with standard Bluetooth, we’ve had to compress it. And compressing it actually will decrease the sound quality dramatically. And now with the new codec, which is really just the new software, the new streaming software from Bluetooth, you can compress and have a really fast transmission with no degradation in sound quality whatsoever. And so that’s huge for us as hearing aid companies we have in our app as we come out with this Nexia device you’ll be able to change latencies and things in your app so that you can sync up voice and audio or lip sync and audio. So we have a TV streamer coming out with this and you’ll be able to control all of that because it is very annoying. Any normal hearing person will tell you it’s incredibly annoying when it somehow gets unsynced by the TV or by the channel and hearing impaired people have had to deal with that a lot more. And so the ability to control it is something but the ability to have it come quick enough that you don’t have any problems and don’t have any distortion is just incredible. With this new Bluetooth standard there’s so much to unpack there. Actually that’s part of the user experience with hearing aids. A key one is actually that mixed reality audio because for example, when I watch TV and use the TV streamer I’m going about 50% TV and 50% ambient. So that way I can still get the benefit of the TV audio being corrected in my hearing aids but I can talk to the people in the room with me. And if you do that, the latency has to be very low or else it’s going to sound way too echoey or reverberate. And the same thing is true if you use a remote microphone. The latency has to be very low because you’re going to get half real audio and half remote microphone audio. You cannot have a lot of deviation there. And the adjustable latency is a very interesting thing because I don’t know how many people think about this, but sound is slow. And so, for example, if I’m watching in my living room, I’m about, say, 3 meters away from the television set, if I remember right, that’s about ten milliseconds of audio delay me right there. If you’re farther away, like in a public place, the speakers in the auditorium, the sound from them are going to get to you with a fair amount of delay. So if you actually have it’s actually interesting doing this. We went to a concert in Wrigley Field in Chicago, Bruce Springsteen, and the concert is in the outfield, and we’re behind home plate, so we’re something like 100 meters away from the speakers, and you could actually see, looking at the big screen and the audio coming a sizable fraction of a second delay. And so if you’re going to be in an auditorium using Auracast, which we’ll get to, you have to be able to manage that delay just to account for the natural delay of the speaker audio getting to your ears. It’s actually the opposite, where the latency might be too low. So the fact that you’re building a latency adjustment in the app is brilliant. Yeah, and we’ve had end users ask for something like that for some time with Auracast, it’s something we can do. It’ll be in there now and it’ll be nice for people to control. With the app, you mentioned the power, and I was just going to go back to that. I think you have to be really smart. Everything you put in a hearing aid takes a certain amount of power. A lot of hearing aid companies made the decision to stay away from Standard Bluetooth, because ultimately so much of your power was going to be used in streaming that you’re compromising what you’re doing in the hearing aid as well. Your battery life goes down so much, but you even have to compromise what algorithms you’re going to use and how you’re going to use them, just because you’ve got to look at power across the whole hearing aid, and you want the streaming to be good, but you also want the hearing aid to be exceptional. And I think that’s why many hearing aid companies took the decision that, hey, we’re going to wait for Bluetooth low energy audio, because that’s the right amount of power we should be spending and leave the rest of the power to the hearing aid and such. So a lot of us waited and had to wait a long time, so it’s really exciting to have it coming out. I was in California last week at the California Academy of Audiology and I gave a talk there to a really large crowd on the order of probably 300 people. And I asked how many of you have heard of Bluetooth Low Energy Audio in Auracast? And about five hands went up. So there is a ton of education to do. People are like, what is this bluetooth low energy audio? Why do we have it? What is it going to replace? I think the vast majority of audiologists out there don’t know it’s coming, don’t know it’s on the horizon. And I think that it’s something obviously your podcast will help with there. But I think more and more people are going to need to get the whole education like you’re giving them today about what is this Bluetooth Low Energy Audio and what is it going to be used for? No, I completely agree and because of it, I’ve actually been called upon a few times to help explain it as well. Shameless plug for the ten minute presentation I did for the Computational Audiology Conference a couple of months ago, which is now on their website. I’ll put links into the show note where I gave a brief description of both LE Audio and Auracast and what it means for hearing impaired people. And I’ll actually be doing a longer version of that at the Academy of Doctors of Audiology Audacity Conference coming up next month. And that one will be interesting because there have been so many announcements, including Nexia’s, but also from people like Intel and Samsung, that even though it seems like we’ve been talking about know forever, things are now starting to happen. And LE Audio I think makes sense. Lower power, lower latency. It’s a version of Bluetooth. I think one of the key advantages will also be there for hearing care professionals who don’t have to navigate all the proprietary systems anymore. And it will also open up innovation because if somebody does something invents a better mousetrap and remote microphones, they will work with all the hearing aid brands once all hearing aids are supporting LE Audio and Auricast. So let’s actually go to Auracast. I think we’ve been talking around Auracast, but I think it’s worth describing what Auracast actually is. Please. How do you see Auracast from your point of view? Describe it. So Auracast is part of this Bluetooth Low Energy Audio release, but it’s a public broadcast, so you’ll be able to identify a transmission with an assistant And to make this really easy, just like you would go into, let’s say, Starbucks and look for their Wi Fi network, you will be able to go into public spaces with your phone and you’ll be able to look for Auracast networks and. So you’ll find your Auracast network and you connect to that. And as long as you have anything in your ears that is Bluetooth low energy audio, you will be able to stream directly that Auracast network. So this is not just for hearing aid users, it’s not just for cochlear implant users. This is for anyone who’s using headphones or earbuds. Anything that you have in your ears, you’ll be able to identify these public streams, these public Auracast streams and have them come directly to your hearing aids. That’s of course what we cared most about, but it’s also going to be used for people with normal hearing. And I find that to be incredible because think about that. This little hearing industry, and we are very small, approached the Bluetooth Special Interest Group, which is a mammoth, and said, hey, we would really like this just for our industry, just for hearing impaired people, because this is incredibly important. And now it is becoming a new Bluetooth standard for all. So everyone will be able to do about think about some of the situations. I have a daughter who’s at the University of Colorado right now and it’s really fun to watch CU football with Deion Sanders these days. It has become the biggest thing. So I was in Nashville the other day because I have another child at Belmont University in Nashville and I was there for parents weekend, but I wanted to watch the CU football game. So I go to a bar, everybody is screaming, it is loud, the CU football game is on, but I can’t hear the audio of it. And you will be able to have an Auracast network coming from that TV right to your Jabra Enhance, your AirPods, whatever you’re wearing, you will have something that will stream right to you. So in that situation, think about exercising in a gym where you might have ten different TVs on different channels. You can go up with a QR code and just scan it with a QR code and you’ll be directly streaming that Auracast stream to your hearing aids or to your earphones. So it is amazing what it will do for public. You put it in a church, you put it in a courtroom, wherever you want to go. It is very small, these transmitters. The one we’re putting out is absolutely tiny. It’s smaller than the post it note. So you’ll have these transmitters that are very small and they can transmit. Think about how you do WiFi in your house. You might have a main WiFi network and then you might have some ancillary ones to make sure that the WiFi is everywhere very strong. You’ll be able to do this in public places. Airports will have Auracast. Everyone will be able to do this, not just people with hearing loss. So this is game changing for everyone. And I think that that’s just remarkable, given that it started with the hearing industry. And one thing I would also just mention goes back just a little bit more, but we’ve had problems with different phones. So you had to have MFi. You even alluded to this, you had to have MFi for one, and you have to have ASHA for Android phones. As soon as you have phones with Bluetooth low energy audio and hearing aids with Bluetooth low energy audio, then everything’s hand free. Every single phone. Doesn’t matter which Android phone. Right now we have lists of phones that are compatible and lists of phones that aren’t compatible. As the phones now have Bluetooth low energy audio, you’ll have that. And there’s actually the Samsung S 23 already has low energy audio. The Samsung Flip, I think it’s called. I don’t know, Z Five or something like that. And Z Four, that has low energy audio. The latest Pixel phone from Google has low energy audio. So it’s not well advertised because there are not a lot of devices that pick up low energy audio today, and there are no assistance. So in the phone where you would pick up your Wi Fi network, where you’d pick up your Auracast network that doesn’t exist in a phone today. So we’re just waiting for those things to come, and they’re coming very quickly. We’ll see some demonstrations at the European Hearing Congress in Germany (EUHA) next month of how all of this will work. And we need to all be ready for the future and be future proofed with these hearing aids. Yeah, well, and future proof is a question I had in mind because if I understand correctly, actually, I should back up a little bit because one thing about Auracast, which is different than hearing loops, is that you can have multiple channels running at the same time. You can only have one hearing loop in a facility. Fine for, say, a house of worship, not so good for a sports bar. When you have ten TVs going, you could only have a loop for one of them. And so the multichannel nature of Auracast makes it really interesting. And yes, it was very much the tail wagging, the dog. What, 20 million hearing aids being shipped annually, so 10 million people being served. Well, there are between three and 400 million true wireless earbuds shipped every year. And yet the hearing aid industry drove this. But because everybody will be able to use it, I think you’ll see many, many more installations of Auracast than you ever would see with hearing loops because of all the other applications that can now be served. But by that same token, just as you use the sports bar example, I think the first Auracast transmissions, and tell me if you agree the first Auracast transmissions are going to be in mass consumer locations. In other words, a house of worship is not going to rip out their loop and put an Auracast tomorrow, but sports bars may start broadcasting it tomorrow. And because there’s a lot more value when you can tell every patron of the bar. My advantage over the other one down the street is you can listen to all the games, but that implies a very long transition period where both hearing loops and Auracast will exist side by side and in fact, hearing loops even today. I would tell somebody if they’re considering putting in a hearing loop in a public place, single channel public place, like a theater house of worship, by all means do it. You’re going to serve your clientele with hearing impairment for a long, long time. So then when it comes to the hearing aids, I was digging into the Nexia. It looks like you have a model that will have both a telecoil and Auracast. Is that correct? That is correct. And I do agree with you that these things will coexist and can easily coexist. You could put the Auracast in a house of worship and have a loop so these things can coexist together easily. We do have in the Nexia, we’ll have a receiver in the ear model that does have it’s a size 13 battery with a telecoil in it. But our spouse mic has a telecoil in it. So as long as you have a spouse mic, our multi mic, you always have a telecoil. So it doesn’t matter what hearing aid you have, you would always have a telecoil. So we’ve always believed that get the smallest hearing aid you want. Don’t worry about having the telecoil in there, just make sure you have your multi mic with you and you always have a telecoil. We believe that it will coexist, just like you say. I think. I believe it’s going to happen a little bit faster than you know. I think we’re already seeing it from a GN perspective faster than we thought with Samsung already telling recent TV buyers that they will get a firmware update to update their TVs to Auracast and then they’re starting to sell everything that will have Auracast. I’ve seen some statistics, believe them or not, but 3 billion Auracast devices or Auracast transmitters out there by 2030, and by 2027, two and a half billion LE audio devices out there. So you already are going to start seeing a shift. The new Apple AirPods are low energy audio. So you already have earbuds coming out with them. And I think you’ve got phones coming out with them. And you’re just going to see more as the rest of this year goes on. And as you get six months into 2024, most people are going to know what Auracast is, most people are going to know what Bluetooth Low energy audio is. It’s just going to be. I think a very quick pickup. And then I think people are going to go, wow, I need my stuff to be equipped with low energy audio. And people will be looking for that. So I do think it’s going to happen pretty quickly. Obviously, we’re excited to be here in this situation. We put out Omnia not that long ago. We put out Omnia and Omnia was the culmination of the 15 years of work that we had done in hearing and noise. And we even took some choices around there. Do you really kind of finish all this hearing and noise and wait on Auracast? And we did. We went ahead and put Omnia out and then really focused with Nexia to get Auracast and Bluetooth Low Energy equipped in there and a few other things we’ll talk about in Nexia as well. But we wanted to make sure that we had done both of those things. I have a lot of customers right now saying, geez, you just launched Omnia. Well, we just feel like it’s really important to have Bluetooth Low Energy audio in the market as fast as possible so that people aren’t buying hearing aids that won’t have well, in fact, I could see that the Nexia carries over the Omnia speech and noise system because it’s only last year, which makes perfect sense. And then you add Auracast and LE audio to it. But what else is different between the Nexia and the you know, there’s a few know size and hearing aid continues to matter. And so one of the things that we have worked on is a new micro receiver in the ear. If you look at our current receiver in the ear line, we have a standard product and then we have a mini product, and then we have this new micro product. The new micro product is 25% less size than the standard product and even 16% less size than our Micro than our mini product. So this Micro is tiny, but it even has the same battery in it and it’s got the same sound processing and a few new things in the hardware. So we have an accelerometer in there today, so you’ll be able to just kind of tap twice. You can do it by your hearing aid or right on your hearing aid, and you will be able to answer your phone using the accelerometer. So that’s new in there as well. But it has all of the sound processing that we had before. Plus we’re adding a CROS hearing aid. Resound has not GN in general, has not had a cros hearing aid. And so we’re adding one. We’re very proud of this one. It will be the smallest and has a really low noise floor. So it’s a really nice cros hearing aid with 16 hours of streaming with that battery. So. It’s a really nice cros hearing aid we’ll add, and then we’re also adding in terms of signal processing, new onboarding prescriptive method. So it’s called first time user onboarding. And it’s just another way to get new users comfortable with hearing aids as they start out. We’ve been a company that gives a little bit more high frequency gain or so we turn up the high frequency a little bit more for first time users than some other companies. And sometimes first time users comment they don’t really like that tinny sound quality and such like that, even though they need it. That’s what you have to have to hear a noise is ultimately get those consonant sounds heard. But it is nice to start in a place where you can get used to that sound and then gradually be increased into what you need for good speech understanding. So anyway, there’s a lot with Nexia, a lot. In addition to that Bluetooth low energy audio and Auracast, you actually forgot one, and that’s the waterproof design with IP 68 rating. And it’s funny because there are things you don’t think they’re important until you try it. Because I’m wearing IP 68 hearing aids, I’ve had them for about a year and a half, and I literally had them for a week, maybe two, when my spouse and I went down to Florida beach vacation. And of course I’m going to go wear them out in the Gulf of Mexico. And I’m out there talking to her, talking to other people, standing around me, and I could hear what they said. It was actually hard when you had to take your hearing aids out to go in the water. Not to mention, I mean, the usual things like getting caught out in the rain. If you wear running, you get caught out in the rain, that sort of thing, which I’ve done like a million times. But there are times when you’re going to be around moisture of one kind or another and you want to hear well. So I think that’s actually an understated feature that I’m glad to see coming to more and more hearing aids. Yeah, we actually have been IP 68 for a couple of hearing aids now. And it’s fun because you’ll go into training audiologist and you take a hearing aid that’s working and just dump it in a glass of water for the whole training and then, okay, let’s see if my hearing aid still works, and pull it out, put it in a new battery, works just fine. These coatings, these nanocoatings, really, I think, changed a lot of things, including something that I love to do is backpack and be outside and hiking and those things. It completely changed that industry as well. For sports and being out in inclement weather, hearing aids have benefited from those kind of coatings. So they really have been game changers for many things for people. Yeah, absolutely. So you have all these features of the omnia and Nexia and yet they’re smaller. And you’ve. Added LE Audio and a couple of other things as well. And the battery life I saw was listed as being 20 hours when streaming half the time. Yeah, and even more if you’re streaming less. That’s actually pretty impressive. It also implies that you’ve got some headroom to further raise the bar on the performance level. In what direction do you actually see those improvements coming? You can take advantage of the small size and the longer than necessary battery life for all day wear. What performance improvements do you put that back into? Yeah, anytime. We want those kinds of battery life so that we can run a chip with a lot of processing power and do the kind of signal processing that we want. I think as we look toward the future, what we and every hearing aid company wants is smaller rechargeable batteries. We have rechargeable custom hearing aids on the market today, and they’re larger than most people would want. We can’t really make a true ITC a true in the canal unless you have a larger canal size. So we’re still making maybe bigger custom products than a lot of people would like. And we would like to get those down and have rechargeable in the ear products. We look at those, but I think you look at the signal processing going back to that. You want your hearing aid to be able to run a very high performance chip that’s doing all of the processing that we want to do. I’ll go to our hearing and noise. It’s something that I was around when the whole story started in research. So at that point, I was the head of research in North America, and I have just a wonderful colleague named Andrew Dipper. He came from University of Iowa. He was a grad with Ruth Bentler. He and Todd Ricketts graduated, I think, together. And Todd, of course, has become quite a good hearing aid researcher, well known at Vanderbilt. But Andy came into our research team at GN, and I can remember where I was standing when Andy came up to me and said, you know, Laurel, we really need to do monovision in hearing aids. And I looked at him and go, what the heck is monovision? And he goes, that’s that deal where you put a contact lens in for vision for Far, and you put another one in for vision for close up, and your brain just adapts to it, and you feel like you are looking in the distance with both eyes and up close with both eyes. And he goes, I think we need an Omnidirectional hearing aid on full time for people to hear around, and we need a directional hearing aid on full time for people to hear in noise. And I kind of did look at him. And I’m coming from Etymotic research at this point, and I was developing directional microphones Etymotic research, and I felt like we had climbed this mountain to get audiologists to even fit directional microphones at that time. And I’m like, oh, and now we’re going to go tell people, you only need one in one ear. And Andy was like, you only do need one in one ear. Laurel and and this started just a plethora of research. Brian Walden, who was at Walter Reed Army Medical Hospital at the time, was probably the person who grabbed onto it the most and said, this is the right thing to do. And he was doing hearing aid fittings with veterans, and he sent them out with all these counterbalanced memories, but ultimately had them test whether or not they liked hearing aids that were both hearing aids directional, both hearing aids Omni, or this asymmetric fitting with one directional and one Omni. And he actually had them journal, and yet the data was all of these journals, and they would have to write down where they were, what they were listening to, and which of those programs that they liked. They had no idea what was in those programs. And what he found was that they liked the asymmetric fitting. They loved that ability to get out some of the noise, but they liked the ability to hear around them. And then you saw labs like Ruth Bentler’s lab and Ben Hornsby, who was in Todd Rickett’s labs, start to look at, does the signal to noise ratio improvement degradate if you only put one on versus two on? And the answer to that question was no. You only needed one hearing aid set directional in order to have the same signal to noise ratio improvement. And the only place that wasn’t the case was when 100% of the noise was in the back and 100% of the speech was in the front. Thus comes this asymmetric hearing. And we put it out in a product called Azure. I mean, we’re talking decade more than 15-16 years ago, and we didn’t even have ear to ear processing at that time. We had one was Omni and one was directional. Through the years, we have a very sophisticated system now where using ear to ear, you as the hearing aid user in a quiet environment, you’d be in Omnidirectional. And then if you get into noise and we can detect some speech in the background, we will turn on the directional microphone on the side with the most noise, and that starts to take out that noise. If the noise changes and it goes to the other side, we’ll turn on that one, and we’ll put the other one on Omni, and then we will turn on both hearing aids to directional. when we can detect the speech in the front and noise in the back, which happens maybe 4% of the time, it’s very little. And so on the hearing aid and in the app, you can actually turn both of them on yourself if you want that just little extra added boost. And you know what our hearing is to the front. And really this has revolutionized how people listen in noise and now you’re seeing other manufacturers do this. You’re seeing other manufacturers advertise that you can hear around and you can hear around while hearing a noise. And we’ve definitely been the pioneer at the point where we are today with Nexia. We are using all four microphones on the two hearing aids to create a really narrow beam on the directional side, so incredibly good directionality. And our engineers, they’ve learned to really sample what the noise looks like in a better way so we have a higher resolution when we cancel noise. And the higher resolution has ultimately brought us to almost 9dB signal to noise ratio improvement in Nexia. So it’s astounding and it’s been a journey that we’ve been on for many years. We’ve had to have a different chip. We had to have chips that did different things, different microphone inputs and ear to ear. And so over the years, we’ve kind of just built on this until the culmination of the hearing in noise system that we have today. So really, when I think about Nexia, I guess the way I would summarize it is that you’re ticking the box in the real world by providing the best speech and noise enhancement you know how to do and continuing to develop along that line and also the best virtual experience now through LE audio and Auracast connectivity. So I really appreciate you coming on to explain all that as we wrap it up. Any other last you know, I would mention one thing that’s kind of in the back of my mind. We actually in a product a couple products ago, put out a new receiver called M&RIE, and it’s microphone and receiver. in the ear is what M&RIE stands for. But the M&RIE receiver is just a new receiver that has a microphone in the ear. So it’s hard to develop because the receiver and the microphone are right next to each other causing feedback. But we’ve done a very good job with the fitting range for this. You got to stick to the fitting range of the M&RIE receiver. But the M&RIE receiver for the right people actually gives great sound quality because have the acoustics of your own ear when you speak, because you’re listening. With the microphone in the ear in all omnidirectional settings. In directional, we turn off the microphone in the ear and we use the microphones on top of the hearing aid. So it’s a really unique way to hear. Sound quality is even better, especially for new users. They don’t get that weird feeling because we’ve always had to build an acoustic pinna, your pinna acoustics back into the microphones up on the top. And we don’t have to do that when you’re listening with your own ear. So, great sound quality, the microphone’s inside the ear. So you have really good wind noise reduction. We found that you talked about listening effort earlier. We found that listening effort is less with people when they’re listening to this microphone. So this M&RIE receiver has really been well received. And NAL, the National Acoustics Laboratory in Australia just did a series of studies on this receiver and actually just put it out publicly. It was on Australian TV today. So it was kind of a great day to talk about it, but really talk about the benefits to this receiver. And so I’d be remiss if I didn’t say, hey, Nexia also takes that receiver. So you can have that receiver with the microphone in the ear along with a standard receiver. And not everyone is a candidate for this M&RIE receiver. But it’s also one thing that I should mention that is part of Nexia. So for all the people listening now, the next hour of this podcast will be about the head related transfer function and what it takes to replicate that in a hearing aid or an earbud. And you completely get this, Andrew, because that is exactly what it took and exactly why we decided that we wanted to have that in there. And, you know, with the extended bandwidth and having the microphone in the ear like that, patients that don’t have too much high frequency hearing loss actually do hear the sound where it originates, which is not common with the hearing aid fitting. Most people with hearing aid fittings hear the sound kind of in front of them. And if you’re wearing the M&RIE, I’ve had patients just look at me and go, oh my gosh, I hear you where you are instead of in my head. So it’s amazing what you can do with technology if you also know how the normal ear works. And we’ve got some incredible researchers and technology people who can make these things happen. So it’s fun. I mean, I told you at the beginning I wanted to be in the development part of it. It’s not me developing these things. There are 400 engineers and researchers who do these, but I’m lucky to be a part of it. Well, that’s really terrific. And like I said in the beginning, your very background, I’m sure, a lot to GN in the sense that you can serve as the voice of the customer. Between end users, hearing care professionals and the development community. I suspect there are going to be people who want to reach you about aspects of this conversation. How would they do that? If they would like to? Yeah. So I’m easy to reach at LChristensen. And it’s T-E-N-S-E-N. So it’s that [email protected]. Terrific. Well, thanks for joining me today. I look forward to seeing you in person at EUHA in a couple of weeks, too. That was good. I look forward to it as well. And thanks for everyone for watching or listening to this edition of This Week in Hearing.
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About the Panel
Laurel A. Christensen, Ph.D. is the Chief Audiology Officer at GN Hearing. In this role she leads a global team of audiologists that are responsible for all aspects of audiology for the company including new product trials, audiology input to marketing, and global audiology relations which encompasses training and product support to subsidiaries world-wide. Prior to joining GN ReSound, she was a researcher and Director of Sales and Marketing at Etymotic Research in Elk Grove Village, IL. While at Etymotic, she was part of the development team for the D-MIC, the Digi-K, and the ERO-SCAN (otoacoustic emissions test system). Prior to this position, she was a tenured Associate Professor on the faculty at Louisiana State University Medical Center and part of the Kresge Hearing Research Laboratory in New Orleans, LA. During this time at LSUMC, she had multiple grants and contracts to do research including hearing aid regulatory research. In addition to her position at GN ReSound, she holds adjunct faculty appointments at Northwestern and Rush Universities. She served as an Associate Editor for both Trends in Amplification and the Journal of Speech and Hearing Research. Currently, she is on the board of the American Auditory Society and is a member of the advisory board for the Au.D. program at Rush University. Christensen received her Master’s degree in clinical audiology in 1989 and her Ph.D. in audiology in 1992, both from Indiana University.
Andrew Bellavia is the Founder of AuraFuturity. He has experience in international sales, marketing, product management, and general management. Audio has been both of abiding interest and a market he served professionally in these roles. Andrew has been deeply embedded in the hearables space since the beginning and is recognized as a thought leader in the convergence of hearables and hearing health. He has been a strong advocate for hearing care innovation and accessibility, work made more personal when he faced his own hearing loss and sought treatment All these skills and experiences are brought to bear at AuraFuturity, providing go-to-market, branding, and content services to the dynamic and growing hearables and hearing health spaces.