How AI is Transforming OTC Hearing Aid Support: Inside Tuned’s Innovative Approach

Thank you all for joining me for this episode of This Week in Hearing. I’m here on the show floor at EUHA with the folks from Tuned. Please give a brief introduction to yourself. Definitely. Omri Gavish, CEO and co founder of Tuned. Ron Ganot, co founder and CBO of Tuned. Delaine Wright, Board Advisor to Tuned. Thank you very much. So you had a recent press release talking about 6 months experience with JVC and new hearing aid models coming out. Now it so happens that a month ago at the Academy of Doctors of Audiology conference, I led a panel, a keynote panel talking about trends in hearing care and AI was one of the hot topics. So we had a lot of conversation about the various roles AI play throughout the hearing care ecosystem. And so this is a really good time to talk about what you’re doing and the progress you’ve made over the last six months. So first I want to break down the devices and then talk about the heart of all this, which is the caremodel that’s AI based. Okay, so in your press release you mentioned the partnership with JVC and that there are new models coming out. Can you briefly describe them? Yeah, sure. So first the new model coming out is a joint venture with Novidan, which are the Lexi powered by Bose hearing aids. So we actually have our first hearing aids already here at the show and those are top of the line of course, hearing devices. It has capabilities that the previous model by JVC did not have such a streaming rechargeability, very long battery Life of about 20, 21 hours. So it’s a huge leap in terms of the technology that we are presenting with this one. Regardless of the new model, the previous model was quite successful. So as you saw in the press release, we have very small return rates, if I remember correctly, 13.5% or something around that area. We showed that basically even with the previous model hardware you can still be very successful in terms of the satisfactions of our users. Okay, so in terms of devices, you’ve now gone to what I would consider a modern hearing aid. In other words, it has streaming capability, it has rechargeability. When you think about the OTC space, you’re tending to access a younger population. That’s a population that going to want those things. Yeah, right. And so now you’re there. Okay, but the heart of it really then is the software component. So I’d like to break down exactly what you’re doing here and the results you’ve seen so far. Can you give me an outline of how your system works. Definitely the competition over the hardware starting to be very difficult. The hardware, I mean, the hearing aids themselves, all of them, has most advanced hearing capabilities. But customers forget the hearing journey that the customer needs to go through. And in the OTC market, we tried to take the professionals out of the equation, but we forgot we need to fulfill it with something else. This is exactly where Tuned comes in. We introduced our AI capabilities to replace the men or help the customers do the rehabilitation process. Working with an AI. And we see what we have seen in the market is companies that just sell perfect hearing aids. They’re selling the hearing aids, but they don’t give any support to the customer. And this is exactly where Tuned come in. We give a wide support through AI to the customers to walk them end by end through the process of getting acclimatized to their hearing aids. Okay. And so let’s explore that in a little bit more detail. All right. I’m a new hearing aid user, and we’ve seen that one of the reasons for high return rates is a misconception about hearing in general. And that is, it’s not like glasses. You put them on, you see better, that there’s actually a rehabilitation process. You actually have to get used to it. I can talk from my own experience. When I first got fitted I had worn them for a minute, and my audiologist says, I’m going to print out your paperwork. And I jumped out of my chair when the printer went off, like, oh, right. She says, let me take it back down a little bit. You get used to it. A couple weeks later, you come back and I’ll put them where they belong. And we had this conversation about wearing them all the time and getting used to them and learning. Let your brain learn new sounds and so on. So with OTC, if you just order them out of the box, put them in, you don’t get any of that backup. Right. You don’t understand. It’s uncomfortable. You don’t like it, you send it back. Is that a fair statement? So what’s different when you use the Tuned system, how does the onboarding work? Yeah, you know, I mean go back a little bit before we talk about that. You know, there’s been a lot of criticism about OTC. And while we all thought this was a great way to reach new people, a year later, everybody’s saying, wow, we haven’t done it. It’s been not as successful as we hoped. And a lot of that is because for OTC, to be successful it’s going to take everything. You got to have all the right ingredients to make a good cake. We’ve got to have the first of all, of course the right product. We’ve got to have the right engaging software, the best follow up software. You got to find the right channel and then you got to educate the consumer to understand what it is they’re buying. But, but until we get this software or a software, and you know why I’ve been so enthusiastic about Tuned is because I think they are the leaders in this kind of user engagement software. I think no one begins that journey by bringing them on, taking them through, educating them and then the follow up where you go through the efficient chat function where you can make modifications to the hearing aid without the human involvement. And then if you need to, you bring in a remote care you’re a live agent to help. But that’s the efficiency we need to make the OTC successful. Okay, it’s got to be a whole. Solution, it makes perfect sense. But actually lead me through it now, okay, I’m a new user, I get it. The box arrives in the mail first. You made a right decision taking those devices. So the first thing you, when you do in the unboxing is you get a quick startup guide saying download the Tuned app. So please don’t take any further step, don’t try to determine nothing, just download the Tuned app. Once you download the Tuned app, the onboarding really takes you in both those baby steps exactly what needs to be done. So we have chosen to go with video tutorials. We think it’s the most intuitive easiest way to follow those onboarding process. Because most people, OTC users are new users for hearing aids, they never had previous experience with hearing aids. You really need to cut down those explanation to bits and pieces. So video tutorials are divided into episodes. Each of them are six to eight seconds long. So very fast, very easy to follow. You just take them out of the box and you follow exactly what you see in those video tutorials. It ends up with our hearing diagnostics part which is extremely very accurate. FDA cleared as you probably know. And again we are giving those very simple to follow explanation of every step. So for example, the hearing diagnostics start with a practice step just for the users to be able to try and see how it goes until they figure out okay, this is my threshold and this is what I should do now in the next frequencies to follow. Once we are done with the onboarding then you have that first fit and Then you have that and what you felt at the first fit that you got. So people are sometimes confused, sometimes could be too loud for them. And what we do is we introduce them. Not device control, which is where our competitors usually go to the next step of the onboarding. This is device control. Now figure it out yourself. We are actually starting by introducing the hearing journey. Our hearing journey is divided into two. It’s a daily goal and a daily lesson. Daily lesson is the part where we keep our users educated about different parts of the app, of the hardware, and of course about hearing loss in general. And what’s the meaning of untreated hearing loss, for example, and how can it affect your life and your loved ones? The daily goal is, for example, the first few days is how long you should wear them. We know that first time users usually will not start with a 16 hours full day use. So we take it down and break it down into steps so they can easily be achievable. The first lesson just to for an example is just setting the expectation correctly. So it’s a three minutes movie about giving our users that first experience of new sounds. So in that video we have different sounds. It’s majority of them already forget like singing birds or laughing children, et cetera. And we break it down to them explaining that this is a process you have to go through. It’s challenging at first, but over time it will get better and better. And this is where we fill in that audiologists. When you take the audiologists out of the equation, there is a vacuum. And this is how we try to fill that vacuum with those lessons. Okay, and how long does that last? How long does the initial journey last with these daily goals and daily lessons? So we focus on the first 60 days we found them, the most important ones. First 60 days, it’s the time for acclimatization to the hearing aids. As you said, it’s not like glasses that you wear them. And that’s it, you can see you need your brain to adjust to this. And we have four protocols, AI protocols of what the user should be doing and what the proactive approach Tuned should take. If we don’t see the user does this. So if we see the user as a search and behavior, we might proactively approach him via different channels and encourage him to use the hearing aids and getting back to the application and play auditory games. Or if we identify he has any problem, then send him to our AI audiologist. It’s a system chatbot like which was trained by our team of audiologists with thousands of cases that you can report in natural language any problem you have, and we will solve it for the customer. We might even tune his devices to fit the certain problem he has, give him explanation, give him movies, and we focus on those 60 days of acclimatization. Okay, so let me, let me make sure I understand this. Let’s say I have a problem. If I can describe that problem. So, for example, I went to a loud restaurant and I had a hard time hearing people at the table. What would happen if I said that. To your app If you go to a restaurant? So first of all, we start with explanation. We explain to you where to sit in the restaurant after this we identify the right program for you. We listen to the background noise environment and we set the right program for you. We even sometimes people going to a restaurant and they still on a program that is omnidirectional. We will focus you on the speaker that is in front of you. We will reduce the background noises. We will do all the things that if you have audiologists in the palm for your hand would do and explain to you when you are in the restaurant. So you can imagine you have an audiologist in your palm for your hand wherever you go. So I can do this in real time. I’m in the restaurant. I say I’m having trouble. You see, I’m in the omnidirectional mode. You explain I should use the restaurant mode and it switches it to the restaurant mode. Yes, and we also give you explanation. We have to sit in the restaurant as. Someone that is out of hearing, we will explain to him exactly where to sit in there. We give him explanation, and we also set the expectations with this customer. Okay, so then you can actually do all the hearing aid adjustments remotely with the AI chatbot who’s listening to what I say. Is that correct? That’s correct. Okay, and then what happens if I go a couple of rounds with the AI chat bot and it’s not working right? What happens next? So the AI, of course, is not perfect, and it’s quite interesting to look at how it evolves over time, because that’s actually a machine learning so. Exactly. As a young audiologist, he won’t have the answers to all of the questions at the first few years of his profession, but he will get better over time. And it’s the same with our AI. If the AI doesn’t have an answer, he’s educated to escalate and offer you a live agent so you can have a hearing care professional help you solve that issue. Now, that conversation could seamlessly transform from an AI chatbot into a human that answers and interacts with you through the chatbot. But we also have a full remote support capabilities, which means that you can have a video call with that caregiver and you can have them control the device remotely, exactly the same way they would have if you were sending them face to face in a clinic surrounding. So that remote capability really solved 99% of the problems that the AI was unable to solve. According to the statistic we have, only 9% of our users need to escalate into a live agent. So you’re saying that roughly 90% of the interactions take place with the chatbot, and only the last 10% go to a live audiologist. But the chatbot will hand me off if the chatbot can’t handle the problem, right? Exactly. And when I log into the system as an audiologist, before I give that service to that customer, I have a full overview of the problem that customer said he has. I can see the interaction, I can see previous settings that he tried to maybe fine tune by himself using the equalizer or the chatbot. I can of course reverse. And then when I start the call, I already well informed about the situation that this customer is complaining about. So on average our remote support session is only four and a half minutes. It’s enough to solve that problem. So four and a half minutes with the chatbot typically does the job. No, no. Four and a half minutes with the remote support agent is enough to solve the problem, so only that 10% of users that actually escalate to that service. We can solve those problems in an average four and a half minutes of a remote session. And is the chatbot learning? In other words, right now you’ve got 10% of the people who get kicked out of the chat bot, or I shouldn’t say kicked out. The chatbot recognizes that this problem is something the chatbot can’t solve. Hands you off 10% of the time. Is the chatbot learning so that you can further refine the interactions? Yes, the chatbot is not learning only by himself. We have full visibility because all the logs are being uploaded to our cloud services and we have team of audiologists that looks themselves on questions that were asked, problems that were reported and they know to solve it and they know to train the audiologist so we have full visibility to see all the complaints of the customer. Imagine to yourself that any of the Big 5 knew all the complaints of their customers, how they could improve their product. You can see any complaints, every problem and training. I would like to double click the point that Ron just said. The times that solve problem remotely in Tuned systems take 4.5 minutes. This is based on real data from Hearing Help Express, one of our partners. They have this report. But why? Because when a customer representative comes to the calls, you see the full map of this customer, he has amazing reports that shows everything on the customer and he can tune his devices as if the customer was inside in a clinic and he doesn’t. He can play with all the parameters he wants but on top of this we save him a lot of time because we have pre cooked solutions. So if he knows this is the problem, he can press on one button, all the parameters will be changed. He doesn’t have to play with this manually. Okay. So that you’re learning both on device level. In other words, if there’s a shortcoming in a device that’s showing up in repeated complaints, that’s good feedback for the next generation device. But you’re also learning about the kinds of things customers are asking for. So in other words, if you’re repeating, you’re often getting requests for a different tuning in a different situation you can feed that back in and either provide that in the first place or like in the case where that’s a situation where you get handed off to a live person, you’re going to learn so that the chatbot then gets better at handling that situation. Is that correct? Absolutely. And you know the success in keeping the hearing aid on the patient is about engagement. And that’s why our industry has done this. And this is why we’ve not been able to move from the existing prescription model. It’s about those touches. And the audiologist and the hearing care professional has learned that over the years. What we’re trying to do is say, wow, here’s a way we can maintain those touches at engagement with the patient only. We can do it in a more efficient way. We’ve all moved to other things, online banking, online, other healthcare. Why in the world wouldn’t we use this part of a more efficient touch in this space as well? And my opinion on the big opportunity for this software, but also for OTC we haven’t even gotten there yet. You know, we really haven’t moved these products into the areas of, you know, managed care. You know, we’ve done it, we did it the easy way. You know, the FDA came out and gave us this new way we can go and we threw them on pegs in pharmacies, which was kind of a new idea only because we had new legislation. But in the past there had been products there. But the big opportunities probably lie in how do we, we go into different channels. And the big one is managed care. Yeah. And, you know, how do you present to a patient or a member. Here’s an alternative that may be much better cost. You have to take some ownership. You got to get engaged yourself. But boy, it could have a lot of benefits. So, yeah, let’s explore those benefits. Right. I mean, we know the typical return rate for OTC is 30-40%, roughly speaking. Right? So you’ve had six months of experience. What’s your return policy and what return rate have you been seeing? So if you look at one of our partners, which is JVC, I think it’s a great. Yeah. And I should, I guess I should clarify. Right. This is really up to the device manufacturer, not you. Right. So use JVC as an example. So JVC, what we see in the US is as mentioned in the press release, 13.5% return rate, which is I think market lowest publicly known figure for return rate. So very high satisfaction rate. And we also see, by the way, because we keep track of the user’s progress for different customers, whether JVC or whether in Israel we have a partnership with local HMOs, we see very high retention in terms of the users keep engaging with the app in that 60 days crucial window of getting used to. So 75% of users keeps using the app in those 60 days. So we know that that’s one of the reason they keep the device with them, they are happy, they are enjoying, interact with the app itself. In Israel, the system that we have is a little bit different. It’s a hybrid solution which means that they actually go and see an audiologist as the first step. They do the diagnostic, the hearing tests in those special clinics and then they upload the audiogram into the Tuned system and send the customer with the Tuned solution there we actually see a lower return rate, it’s just around that 10%. So even slightly better once you put on the audiologist as a first step. Okay, so that opens up a really interesting question. You’re doing this primarily with OTC, but you just described a hybrid model. Is there any reason why this couldn’t be used in conjunction with prescription hearing aids where I get professionally fitted in the beginning and then all of the onboarding and the chatbot functionality including hearing aid adjustments and all of that. Is there any reason why that couldn’t be done with a prescription model? It can be done with the prescription model. This is the answer, this is the short answer. Yes, it is not always it can be done, it could be, it should. be and we have to get there because we’ve got to engage the professional. And yeah, sorry, it saves but I couldn’t resist that. I agree with you. So what we see. Before I just answer this one, let me just double click one thing there. Most of the returns we say certain percent but what we, what we’ve seen is with the previous model of JVC which was non rechargeable device, so out of those 13%, 7%, like 7% return the devices because it wasn’t rechargeable. So with the next model we expect to be around 5% return rates because it will be rechargeable. Now regarding your question. We know that our software, and we proved it based on real data can save a lot of chair time for, for clinics. They don’t have to deal with the low level issues. I have this problem how to clean. We give a lot of data to the customer that they will be able to maintain the hearing aids themselves. They will be able, they will be educated themselves, they will use auditory training. We can save a lot of time, a lot of chair time to the clinics. So instead of, I don’t know, five repeating meeting, let’s say they will have only one, if at all. Imagine to yourself what they can do with all this spare time. They can sell more devices they have time to sell and sell more devices. We can save a lot of chair. Time for, or even more important, it can serve more patients because we know there’s a shortage of audiologists. And so you’re not trying to replace audiologists. What you would do is let audiologists practice at the top of their scope and offload all the lower level things through your software system and the ability then if you really need a live person, you can access a live person. Do I understand that correctly? So Tuned, from my point of view, I’m an audiologist in Israel. I had been doing hearing aid for the past 15 years. Tuned is our co pilot. So he just there to help me with those low level issues that, let’s be honest, it’s a waste of time for audiologists. So for audiologists to do troubleshooting or maintenance or wax removal, that’s just a waste of time. They are a clinician, they should do the most sophisticated cases, rehabilitation, etc. So Tuned is really a copilot that really saves that time, make that audiologist time more valuable and more directed at where it should be. Okay, terrific. It’s a fascinating system. We’re really looking forward to following your journey as you continue to go forward. Any of you have anything else to add? I’m looking forward to a world where we can recognize the value of OTC, use all the best tools, also engage the professional and make it seamless for the patient, which is really how we help more people. Well, thank you all. I appreciate you spending some time in the midst of this busy EUHA. Thank you. Thank you very much. You’re welcome. Nice to see you guys too.