Hearing aids and smartphones

Trying on my new hearing aid reminded me that Steve Jobs was playing 3D chess while the rest of the technology industry were playing tiddlywinks.

My Resound Linx works with my iPhone. This means audio is streamed directly from my phone into my hearing aid using Bluetooth signal. Phone calls are great, there is no interference from noisy surroundings. Podcasts, music, movies, they all stream beautifully. Using the iOS app I can change the volume of the hearing aid, switch its mode, find out if I am moving closer to finding it, or the GPS location of where I had last left it.

Given my own hearing the most important aspect is that the phone’s bluetooth audio and the hearing aid’s microphone work simultaneously. I only have one ear with any hearing, and the hearing in that ear is very limited without the hearing aid. Previous hearing loop solutions meant I would either hear the phone exclusively, or other people. Listening to a podcast at home meant not hearing anyone from my family. Now I am productively listening to lots of podcasts, I’m finding housework enjoyable, and my wife reports increased volunteerism.

I was amazed to hear from my audiologist that Apple had started working with ReSound on this 5 years ago. Given the iPhone itself was not launched until 2007, Apple is a company with a long term vision. iOS 7 has features designed for hearing aids, including easy pairing, and easy access to controls by pressing the home button three times. Smartphones are bringing a lot of innovation to helping the disabled (ProductHunt has a great list) but Android does not have the built-in infrastructure for hearing aids. My own hearing aid does not work with Android (beyond a simple app for controlling audio levels) and Android has limited accessibility features compared with iOS. I say this as a big fan of Android, and it was a sad day when I discovered that my hearing meant I had to switch to using an iPhone.

The hearing aid industry

Denmark grows great technologists, including the founders of Zendesk (it’s worth reading Startupland), Just-Eat and 37 Signals. But did you know that 48% of global digital hearing aid sales go to just three companies in Copenhagen’s Medicon Valley: Oticon, ReSound and Widex. Elsewhere in Europe Sonova has 24% and Siemens has 17%. Starkey is the only major US player, with 9% market share.

How did Denmark get so good? In the early 1930s, acoustics was established as a research field at the Technical University of Denmark (DTU). This became the starting point for a series of highly successful companies. In 1961 Denmark became one of the first countries in the world to provide universal healthcare. Hearing aids are provided free of charge to Danish citizens. And it continues to adopt technology, with 100% electronic health record adoption amongst its clinicians, with 90% of communication between providers occurring digitally. For each of these points it is well ahead of the USA.

For those interested on our bionic future, the cochlear implants industry is worth watching. Cochlear implant technology is amazing: it involves drilling into your skull and directly connecting the audio chip to the nerves in your ear.

Cochlear, an Australian company, has 67% market share. On a personal note, in the earliest days when funding was hardest, it was inspirational to listen to the lecture series by Graeme Clark, Cochlear’s founder. He had no funding for his research, let alone for setting up a company. “All I could manage was a few hundred dollars from the occasional after dinner address at service clubs” he said in his third lecture.

Software eating hearing aids

Marc Andreessen famously said that “software eats the world”. His prediction was that, “everybody on the planet by the end of the decade is going to have a smartphone”, so “how can we reinvent it now knowing that software can basically play such an important role in everything.”

I first used a Mac at age 10, and a hearing aid at age 15. For 25 years the hearing aid industry has disappointed me in adopting consumer computer technology, even as it used increasingly sophisticated digital signal processing technology for the audio chips.

Nor is Silicon Valley bringing out fundamental innovations. Soundhawk and SoundFocus are providing disruptively priced supplements to hearing aids. But you still need a hearing aid. Embrace Hearing’s true innovation is disintermediating audiologists, producing high volumes of limited models and tuning these centrally before sending by postal mail. But the hearing aids are “engineered and produced in Germany”, their market share is low, and they have no models made for iPhone.

So will likely be Medicon Valley that brings the greatest smartphone and software innovations to the hearing aids industry. I can’t wait. In the meantime, if you have a hearing difficulty and an iPhone, talk to your audiologist.

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