How ALEX Brings Hearing Aid Technology to Life for Patients and Clinicians

Speaker 1: Welcome to This Week in Hearing. Hello, I’m Bob Traynor, your host for this session, where we’re going to discuss some educational issues in audiology. And my guest today is Rob Koch, founder and CEO of AHead Simulations out of Toronto, Canada. Thanks for being with us today, Rob. And we very much appreciate your time, energy, and effort that goes into this type of a session.

Speaker 2: Very happy to be here.

Speaker 1: So I’m… We’ve worked together before here at This Week in Hearing on, on the CARL project and some other kinds of discussions. But my guess is, that was two, three years ago and I, and I’m not sure that anybody remembers that one too well. So, how about if we talk… Start at the beginning and look at your background and why you founded AHead Simulations?

Speaker 2: Definitely. So I have a… More of a technical background, so I came up as an electrical engineer. And early on in my education, I was lucky enough to get connected to the audiology faculty at Western University in London, Ontario, Canada, just down the road from us. And from a engineering technical perspective, the way that sound and hearing works was absolutely fascinating. So, I sort of doubled down into that discipline, and I ended up taking on a project which was incorporating more simulation into audiology. And so, at the time, you know, still students were poking and prodding each other’s ears, learning how to do various procedures. And down across the street, at Western, nursing and med schools had all these big, fancy simulation centers and products. And so, I was really tasked to be able to develop something like that for audiology that results, good feedback at the very beginning, and we ended up both validating it and having some meaningful research that’s published right now on the benefits of simulation in audiology. And we found that the results of people implementing simulation was, was very incredible to see as well. So back in 2018, we incorporated AHead Simulations and we introduced CARL the mannequin for training within audiology, and it’s been really, you know, quite an amazing handful of years because it started out simulating training for real ear measurement in particular, and as we got into the field, it was, “Oh, wait. We can also use this for impressions and wax removal and audiometry,” and so the use cases really expanded. And then we also saw, it wasn’t only the educational institutions that had a need for training, but, you know, hearing aid manufacturers, the hearing clinics themselves. There was really, you know, more of an importance for, for training in the field in general, whether it was at the beginning of your career or during your career, so it’s been really incredible to see that evolve and now, you know, the next step in what we’re looking at is, how do we take what we’ve learned, from training and best practices to introducing clinicians to these new concepts? How do we then apply it down the chain a little bit more to, to patients and the public, which I’m sure we’ll get into.

Speaker 1: You know, that’s just how things happen. When we, when we… In audiology in particular, when we bring in people that aren’t like us, that are engineering people or, or medical people or this or that, things seem to move forward, and I know our topic today is gonna be more, better education in hearing care for professionals and patients, but also the general public in the kinds of things that you guys can simulate that… You know, and I remember as a… As a professor at Colorado State for many years, you know, this would have been a fabulous adjunct to what we were doing in class, because we had to go hustle a couple of patients or hustle a couple of other students from somewhere to come in and, and put up with us messing around in their ears and all those kinds of things, and

Speaker 2: Yeah.

Speaker 1: they can do it on CARL first, and and so maybe you could tell us a little bit about what CARL is, who he is how did we… How do we get to know him, and, and maybe a little bit about the expansion of CARL and, and into university programs.

Speaker 2: Yeah. Yeah. So CARL is a simulated mannequin, a simulated hearing loss patient that can help simulate the majority of the clinical workflow. So think of a, you know, typical clinical workflow going from initial otoscopy, looking in the ear, potentially removing some wax, doing a hearing test, masking may be required, potentially doing an impression for a custom, and then actually fitting the hearing aid through the manufacturer’s software as well as with REM as well. All of that can be done on, on CARL now, and so, you know, instead of being able to in clinic in particular, be able to practice all of this and kind of learn on the job with, with patients. Instead, you could plop our simulated mannequin, CARL, right in the chair instead, go through the whole process, get feedback about whether you’re doing it correctly or not, and the hope is that, you know, people will be able to be far more confident and that the quality of patient care will, will really succeed, and, you know, what we really encourage, particularly in the audiology programs that you mentioned is just-… how hands-on our field is. It’s very person-centered. You are working directly on people, and so we shouldn’t wait to give those kind of experiences until you’re already, you know, a year or two into your education or until you get to clinic. We have many different programs that, you know, in the first week of classes, it’s, “Let’s get a hands-on with hearing aids. Let’s look at all the different styles of hearing aids. Let’s put the hearing aids on the mannequin’s ear. Let’s just remove a lot of the barriers and the intimidation to working in hearing care.” And, you know, the results have been really fantastic. And, you know, we see clinicians that are out there that have either recently graduated or that were training on CARL and, you know, they come to us and they say, “Oh, we love CARL. We love CARL,” because it gives them a lot more confidence in moving forward with this, you know, profession and knowing that when they’re working with actual, you know, people and patients in front of them, that they know what they should be doing like the back of their hand. And instead of worrying about, “How do I do this process? How do I fit this hearing aid?” they already know all of that and they can purely focus on, on the patient and, and the counseling that’s required.

Speaker 1: You know, that’s something that we have we wanted to do with the AuD programs. We wanted people to hit the ground running whenever they started, and one of the criticisms of the AuD programs is, yeah, okay, now you have a doctorate, but you still don’t know a whole lot more than you did when you had your master’s degree. And and this kind of an approach will allow people to be able to hit the ground running whenever they finish school, which has really been our goal since the inception of the AuD back in the ’90s. So

Speaker 2: Exactly, yeah. And I think you know, a lot of the time as well, we think of education as something that you do, you know, when you’re in school and then you go out into the field and, you know, you, you do your clinical practice and that’s kind of it. But as we’ve seen, you know, technologies evolve, processes evolve. So to be able to have tools where you can continually experiment and learn in a more safe environment as opposed to having to, you know, make mistakes on patients it really does extend to, you know, professional development and continuing to, you know, be a better clinician basically every day.

Speaker 1: And so that’s kinda how things have been changing over the last five to 10 years or so. And, and again I, I remember when we had this first discussion Rob, it was like, “Oh, wow, that sounds so cool,” just because of having to try to work with students over the years, you know, sitting there in the sound room and watching them make mistakes on real … just wasn’t really the best way to do that. So have hearing clinics and so on adjusted to these changes pretty well?

Speaker 2: Yeah, I think, you know, as you mentioned audiology and a lot of this baseline education is, is, really the foundation for a lot of clinical practice and what we think of when we think of training clinicians. And thankfully with, you know, the implementation of CARL, there’s been a lot of more hands-on training there. The other side of it is, is the hearing clinics and the dispenser side of things as well. And so, you know, a few key trends that we’ve seen in the last handful of years is you know, a shortage of clinicians. Talked to many different clinic owners where it’s hard to find the right people, the right talent to fit within their team. The AuD degree is, is very expensive for a lot of people as well. And so that’s a big debate that’s, that’s ongoing for quite a while. So that helps fill that gap. And then on the, you know, the clinic owner perspective too margins are being challenged more and more. And so the economics of a hearing clinic is changing quite a bit. And so all of this has really led to what we’ve seen more often of hearing clinics taking more ownership of the training, taking more ownership of the hiring. And at the end of the day, I always say, no matter, no matter what industry you’re in, the company with the best team, they’re gonna be the ones who are able to outlive challenges, are going to, you know, be able to excel no matter the environment through all the ups and downs. And that is, you know, of course the soft skills and, and the team that you generate and that you hire, but a lot of that is, you know, if you’re able to find the right person that fits within the team and then train them yourself and there’s the tools to do so that can be huge for, for practice. And so that’s a big trend more in that last handful of years to be able to, to fill those gaps.

Speaker 1: That’s always been a concern. You know, in my practice it was always people can come in and they say they have this and this and this, but when you get them they might have those things, but they only may be concepts and not necessarily the way you think that they need to join up with the team to

Speaker 2: Yeah.

Speaker 1: a movement forward. So

Speaker 2: And especially when you’re, you know, a, a, a clinician or, or a clinic owner you know, you’ve built your business from the ground up in a lot of times. You have developed a certain kind of reputation in the community and with your clinic and doing things a certain way, and when you start to grow or when you start to add locations, all of that gets challenged because it might not be you in front of the, the patients anymore. So

Speaker 1: true.

Speaker 2: ………………………. is such an important aspect of a clinic’s strategy, being able to make sure that the value proposition that you began with and you’re able to start with in the early days can be replicated across these locations. a big part of that is proper onboarding, training, and making sure the, the clinical care is, you know, meeting the standards that you, that you wish it to.

Speaker 1: Well, some, some of the some… Even though audiologists in some respects are hard to find in some places you can get into other places where there’s not one on every corner, but maybe every other corner.

Speaker 2: Yeah.

Speaker 1: And, and so, it, this could be quite a differentiation of one practice versus another practice and and so well… But how does this trickle down to patients and families and the general public and, and their interaction with hearing care?

Speaker 2: Yeah. So I, I would bucket this into two different categories, one of which is the clinical education that we’ve talked about, which is, you know, most of our conversation thus far. I think that’s the easy answer, which is, you know, better clinical education translates to better clinical care and, you know, patients being able to succeed more with their hearing aids. The other big side of it, which we’re starting to look at more and more, is more of the product training side of things. And so, so often in the industry, you know, there’s a discussion of what the public’s general interpretation of hearing aids are and you’ll see outdated hearing aids in, you know, big mainstream press articles.

Speaker 1: That great big thing with the guy on the phone

Speaker 2: Yeah.

Speaker 1: … all a big thing on his ear. I

Speaker 2: Exactly.

Speaker 1: … it’s the thing with the guys at Starkey, the head guy at Starkey bought that once and he said, “Yeah, we’re working on that.” And

Speaker 2: Yeah.

Speaker 1: this could really help with some of those perceptions, for sure.

Speaker 2: And so it’s that, yeah, that product training piece where, you know, these manufacturers are creating incredible technologies year after year and it’s how much are these technologies really trickling down all the way to patients and the public and how much is that being characterized? So, you know, breaking that up a little bit, there’s a part of the manufacturers passing on these product features and the value to the clinicians, which is a part of it, and then there’s the clinicians being able to pass that on directly to the patients and the public through community events and everything. And there’s not really a fantastic way that that happens right now. And unfortunately, what we see is that these incredible technologies, they’re not seen from the everyday person as, you know, the incredible kit that they are. They’re just thrown inside of this bucket of hearing aids. And so what we’ve done is really try to look at what we’ve seen and learned from CARL in implementing best practice educational products and initiatives within the clinical education side of things. How can we then facilitate the product training side of things that can make sure these technologies get out into, you know, the patient’s awareness and the public’s awareness as best as possible?

Speaker 1: Great. Well now, I know that AHead Simulations has been around this kind of a discussion for quite some time. What specific things are you guys doing to move this, these, you know, this whole effort forward?

Speaker 2: Yeah. So on the foundation of the, you know, the clinical training that we have with CARL, we just announced our whole new product name, ALEX. And ALEX is for Hearing Aid Demonstrations and Technology And so if you think of, you know, a new hearing aid comes out and a lot of the time, you might be talking about the different features there might be a particular launch event that you can listen to the features. Our goal with ALLEX is so that this kind of experiencing of the hearing aids and experiencing of the different features can occur all throughout the industry. So whether it is better hearing aid demonstrations from a manufacturer to the clinic so that the clinic gets a really good grasp on what this new hearing aid is capable of or, which is really the, the incredible part of this, is being able to provide tools to the clinic and the clinicians to better showcase and demonstrate features of the hearing aids to end users. So whether that is during the actual consult when you can provide a sound demonstration to the patient and their family member and the clinician can listen at the same time, you can compare different kinds of hearing aids, you can compare different brands to see what might interest you the most. You could be, you know, at an open house, you could be at a community event where you wanna showcase a bunch of the public what these hearing aids are capable of. It really tries to lower the barrier to getting people to listen to hearing aids. And through a lot of our testing, one of my favorite reactions was someone who was completely unaware of hearing aids, they’re not in the industry. I set up a little demo so that they could listen to some hearing aids and their first reaction was, “Oh, those don’t sound that weird.” And so clearly, they had some kind of a preconceived notion of what hearing aids were and what they look like. And so the more that we can just get, you know, patients, family members and the general public to just listen to these things and not be scared of them and realize how much amazing technology and features are included with them, I think will do wonders for, you know, a broader, a broader acceptance.

Speaker 1: Well, absolutely. About the time that guy has that big, the phone thing in his ear and, and people look and they say, “Man, I don’t want any of that stuff.”

Speaker 2: Yeah.

Speaker 1: and, you know, and so now then it looks like AHead Simulations has twins. You have CARL and you have ALEX, and CARL’s more the academic side, it sounds like. And ALEX is more the product-oriented side. And,

Speaker 2: Yeah.

Speaker 1: know, and, and I would encourage manufacturers to jump on this heavily just because of the fact of having been the clinician sitting in the room, listening to the PowerPoint talk about how cool a particular product was. And, and yes, it might be cool, but you never really know much about what it’s gonna do and what it’s gonna really sound like or work with and what it’s gonna interact with-… until you fit four, five patients.

Speaker 2: Yeah.

Speaker 1: And here, we can actually decide whether this is a product we wanna jump on or not rather rapidly. And

Speaker 2: Yeah.

Speaker 1: this should be, manufacturers should be knocking on your door rather, rather hard

Speaker 2: Yeah. And, and two, two anecdotes that, that we’ve seen as well in the past is, you know, talking to clinicians and realizing that, you know, they are dispensing these hearing aids every day, and yet at the same time, they may not have listened to what these devices sound like themselves.

Speaker 1: Oh, absolutely. Yeah. Sure.

Speaker 2: And just being able to have that, you know, empathy piece and as well as the, you know, more technology-driven feature side of things knowing, you know, what these different features sound like in the real world, not what the spec sheet says, but just qualitatively what is the patient’s experience gonna be when they plop these in for the first time. You know, obviously we can’t simulate the physical fit and everything like that, but kinda like we do on the clinical education side, let’s just get them experimenting and experiencing these hearing aids as soon as possible. And so that will, again, make it easier and easier to go to the next step and go to the next step within the patient journey. The other side of things is talking to other clinicians that they said their clinical process really doesn’t change much when a new technology comes out or when new technology comes year after year. They’re still having the same conversations with the patients. And so that means these manufacturers and these hearing aids, all of these technologies and these features that are being passed onto the clinician, they’re not actually making it down to the patient because they’re still having the conversation of open versus closed fit and what kinda style. And all of those are really important, but somewhere in that process to be able to demonstrate and inject a bit of a experiential, you know, point of the journey where let’s just get you familiar with what these devices are. And, you know, throughout our process building this, even in the last few months when we’ve been trialing it quite actively in the field I feel like I’ve learned more about hearing aids in the last three months actually listening to all different brands and all different technologies than I have in the five years before that reading online about it. So, I think that really tells wonders, and I hope that this can really start a, a, a change and a conversation about how can we, you know, reduce the barriers to just experiencing and

Speaker 1: Mm-hmm.

Speaker 2: … these hearing aids.

Speaker 1: You know, I did a I had the opportunity to work with some, some colleagues in, in a, in a This Week in Hearing session on stigma. And, you know, stigma was when we, when I, when I started in audiology in the ’70s, it was you had to be half dead, 95 years old, and and can’t hear, can’t hear a thunder to be able to think that “Maybe I better get a hearing aid.”

Speaker 2: Yep.

Speaker 1: Now things are a whole lot better than it used to be. I mean, people are, are using products. They’re they’re not quite as antsy about that, but the stigma issue is still there.

Speaker 2: Yep.

Speaker 1: And with this kind of an approach, maybe we can reduce that stigma thing just a little bit more.

Speaker 2: Yeah. And, and there’s, you know, pressure such as the, you know, AirPods Pro having hearing aid functionality. If, if traditional hearing aids, if we don’t give a broader access and don’t allow people to experience them and they’re kind of hidden behind a extensive clinical process, then I worry that those technologies you know, there’s, there, people are going to not go the extra mile to look at these, you know, prescription hearing aids, if you wanna call it that.

Speaker 1: Right.

Speaker 2: It’s just a little bit more friction to get there. And so being able to, you know, even directly compare what do the AirPods sound like directly next to hearing aids, what are the additional values that they provide, those conversations are gonna be had whether it’s in the clinic or whether it’s at home. And so let’s facilitate that and ultimately position a lot of these technologies to, you know, be the better and the, and the superior solution if we can manage it.

Speaker 1: Great. Well, this has been a great conversation, Rob, and it’s really great to to see the kinds of things that you and AHead Simulations have conducted. And again, it’s a total issue of bringing people into audiology that come from other areas with different backgrounds to help us begin to make the products that are really gonna be beneficial to our patients. And on my side, it’s been very nice to meet the AHead CARL and ALEX both. And so anyway thanks so much for being with us today here at This Week in Hearing. My guest has been Rob Koch founder and CEO of AHead Simulations that, that are now beginning to move into making life better with a better understanding of the products that can assist people with their interactions with families and the community and other things. Again, thanks so much, Rob, for being with us today.

Speaker 2: Thanks, Bob. That was great.