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059 – De Wet Swanepoel – HearX & Healthy Hearing for Everyone, Everywhere

This week on the Future Ear Radio podcast, I’m joined by the great De Wet Swanepoel, founder of HearX Group. Along with launching HearX, De Wet is a longtime research audiologist who also teaches at the University of Pretoria, has served as the President of the International Society of Audiology, and is currently the Editor in Chief at the International Journal of Audiology.

What was so great about chatting with De Wet was his deep expertise in audiology, as well as the remote-first mindset that he has, which seems to have manifested in the HearX Group’s overall mentality. Given the vision of HearX – to service the global population and provide healthier hearing for everyone, everywhere – there’s a distinct mentality among this group with regard to its understanding of the rising demand for online tools and how to meet that demand.

Throughout the pandemic, it has become clear that there’s plenty of opportunity for companies like HearX to outfit hearing professionals all over the world, including North America, with digital services to allow for remote services. So, throughout this conversation, De Wet and I chat about what HearX is building and making available to professionals, and how these new digital options can be implemented and integrated into the hearing professional’s overall suite of services.

My Takeaways:

  • I loved the way that De Wet provided very actionable things that any provider could legitimately implement into their business in a matter of days or weeks. For example, the HearX hearing screener widget that can be embedded on any given website and would serve as a great lead generation tool.
  • Speaking of online hearing screeners… I think it’s crucial to understand how important “friction” is when we’re talking about something like determining whether one is a candidate to seek further treatment/guidance from a professional. The beauty of quick hearing screener is not just the convenience and time-savings, but the reduction in emotional friction too. A quick screener might ultimately offset people’s natural inclination to find an excuse not to take that next step. I strongly believe this very first step needs to be very quick and effortless for the patient.
  • As we discussed, it might be easier to approach building one’s digital services in a piecemeal fashion. It might be less daunting to gradually add new online capabilities and not feel like one has to do everything all at once. Maybe the first thing a practice owner tries to tackle here is adding a click-to-chat option to their website (Facebook Messenger has some really slick integration capabilities).
  • I highly recommend educating oneself on the overall adoption of remote services and telehealth that’s been transpiring the past year at a high level. Look at what market leaders like Teladoc are doing to better understand why both medical professionals and patients are adopting remote services at such a fast pace. The broad patient population’s expectations with how they want to interact with the healthcare system is changing fast.
  • De Wet’s concept of low-touch and no-touch models of audiological services is really neat. I love the graphics that help to visualize this. De Wet’s article really resonated with me when he published it at the beginning of the pandemic.
  • In my opinion, companies like HearX are going to be increasingly important to this industry and its future. We’re going to need service providers and vendors who create tools that enable professionals to extend and amplify their core value (expertise) in ways that are more conducive to the patient of the tomorrow.

-Thanks for Reading-
Dave

EPISODE TRANSCRIPT

Dave Kemp:

All right. So, here we are. We’re joined by De Wet Swanepeol. De Wet, how are you doing today?

De Wet Swanepoel:

Good. Thanks, Dave. It’s good to be with you.

Dave Kemp:

Good, good. So, tell us a little bit about who you are and what you do.

De Wet Swanepoel:

Dave. Yes. So, I am a research audiologist. My day job is as a professor of audiology at the University of Pretoria. I also wear a couple of other hats. I’m also the editor in chief of the International Journal of Audiology, and I am also a co-founder of the hearX group, a digital hearing health tech company where I serve as a scientific advisor as well.

Dave Kemp:

Very cool. Well, yes, like you said, University of Pretoria. So, I’m really excited to have you on to have this conversation today, but you’re also helping to round out my map of guests. So now I have a guest from South Africa on, which is really cool. So, the reason I wanted to have you on today is I think you have a really fascinating story about how you came into this audiology industry.

Dave Kemp:

And because I think you’re based out of South Africa particularly with hearX group, you’ve had this very remote-oriented mindset, I think, as you deal with people in the U.S and other parts of the world, obviously you’re not in person. So, I think you’ve always been hamstrung a little bit in terms of having to get creative with your ability to meet people wherever they are. And I think that’s really translated into all the work that you’re doing with hearX.

Dave Kemp:

And with this podcast, I’ve had a number of conversations on here really going back to the start of the pandemic around the rise of telehealth and remote services as a whole throughout the healthcare system. But specifically talking about this industry and I wanted to continue that conversation today with you because I do think that you’re on the forefront. So, why don’t we start with hearX group? Can you share a little bit about this company that you started, what the vision is and where you are today with this company?

De Wet Swanepoel:

Sure, Dave. That’s a long story. I can go back a long way if I really want to start right at the beginning. Look, my area of research interest has always been around accessibility of hearing care services. And you’re absolutely right, when you come from a context where there’s such a scarcity of access to services, innovation is out of necessity, right? So, you need to come up with innovative ways of trying out new models.

De Wet Swanepoel:

And very soon in my research career, I realized that really to make an impact that’s bigger than just the kind of incremental addressing of hearing loss, we do need to turn to digital health technologies. The connected world is really the influencer of change in low and middle income countries in Africa.

De Wet Swanepoel:

I think of the mobile operators. They really changed the landscape in Africa entirely in industries like banking and agriculture. And certainly it’s starting to happen in hearing care. And I just felt that it should also happen not just in health in general, but also in hearing care in particular. So, hearX is borne from the research we did over the past, 10, 15 years.

De Wet Swanepoel:

It’s a tech spun out from the University of Pretoria. We developed a couple of patterns and some IP that was then spun out into a digital tech company that was founded towards the end of 2015 and started operating with two employees in 2016.

Dave Kemp:

That’s awesome. As a side note, I just find it fascinating, particularly with emerging markets. Like you mentioned, with the dawn of mobile computing. And you look at places like Africa, India, they’re not really inundated with a lot of legacy systems. So in many ways, they can leapfrog into these new technologies.

Dave Kemp:

And you see it with, like you said, mobile banking is huge in a lot of these parts of the world. And I think that actually ties into this conversation because so much of, probably the biggest limitation to adoption is the mindset of, well, this is how we’ve always done it, both from the patient and also from the provider.

Dave Kemp:

And so, I do think it’s fascinating when you look at parts of the world where maybe that mindset didn’t really exist because it was such a raw market in a sense. And so, then you introduce the successor to the technology or the systems that exist in these more developed countries. And they’re not having to transition and deal with all the incumbent legacy systems and processes. So, I always find that really fascinating where you tend to see some of the most advanced technology being most rapidly adopted by some of these emerging markets.

De Wet Swanepoel:

You’re absolutely right, Dave. So, in a way, the leapfrogging means you’re not bound by the traditional constraints of thinking about service delivery in the old-fashioned way of doing it. And that’s typically the way in which conditions often operate. And all of us are like that, but we do things this way because it’s always been done this way. And sometimes if there’s actually no service infrastructure, it gives you the freedom to actually innovate and come up with new solutions.

De Wet Swanepoel:

And it’s just because of the mega trends have also combined at the right time. Connectivity has penetrated all areas of the world. We’re over-subscribed in terms of mobile penetration rates around the world. But at the same time, we’ve seen this digital revolution, the fourth industrial revolution taking place at the same time.

De Wet Swanepoel:

And so, there’s this convergence of technologies and connectivity that’s really exciting in terms of the solutions that are possible. And then at the same time, maybe just to sketch the bigger context. If you look at a continent like Africa with more than a billion people, and you realize there’s a prevalence rate of hearing loss around 7%. And less than 3% of people who have hearing loss actually are able to access hearing aids. You realize that existing models are not delivering the care that people need. So, it necessitates innovation.

Dave Kemp:

Yeah, no, I think that’s actually, it started out as a tangent, but I had not realized how much this will pertain to our broader conversation, because you look at somebody in Africa or India, maybe the first computer they’ve really ever interacted with might be their phone. And that’s actually a pretty profound thing to think about when you put it at scale. Because you’re opening their eyes to the possibilities that exist in there. They’re operating at that mobile first mindset.

Dave Kemp:

And so you say, well, most Android, even a $20 Android phone, it still has a semblance of connectivity. And so, for the types of hearing aids that are starting to really come on the market, they might not be up to the same caliber of the high-end hearing aids that we see here in the States, but like you said, these mega trends that are converging together are enabling, I think, they’re setting the stage for widespread accessibility finally.

Dave Kemp:

Finally, giving us the ability to serve at scale a lot of these underserved populations all around the world. And again, that’s why I think your company is really interesting because most of the conversations I’ve had have been very U.S-specific, but when we look at this as a very global problem, I’m sure there are tons of different World Health Organization stats out there that say the prevalence of hearing loss across the globe, if you apply these figures, these percentages, if it’s 10%, 15%, we’re obviously looking at billions of people.

Dave Kemp:

So, how do we make it so that this type of technology fits into these macro-level trends and can be part of that solution. And so, I think with hearX, what’s really interesting is because you’re based out of Africa, clearly you’re going to always be somewhat focused on the U.S market, but I think some of the international growth is probably really exciting to you all as well. So, how do you look at all of these different markets and both from a business perspective but also from, like you said, your core mission being accessibility-driven?

De Wet Swanepoel:

Yeah. Yeah, Dave. So, I mean, it comes back to the vision of hearX. We started early on and we realized that we need to be a vision-led company. That’s the reason we started. So, our vision is healthy hearing for everyone everywhere. It’s a big vision, but we believe with these types of technologies and being partner-centric, it really should be possible. We have everything available to us to see that vision become a reality in the next couple of decades.

De Wet Swanepoel:

So, we are impact-driven start up or scale up as well. So, we really chase impact. We want to touch people’s lives, as many as possible. And like you mentioned, we started out on the continent of Africa, but now we have products that are used by different groups and government organizations in more than 39 countries. So, it’s quickly spread.

De Wet Swanepoel:

And the interesting thing is, we developed it for the low and middle income country contexts to be accessible and affordable. But very soon you realize that these mobile solutions are actually also very relevant and needed in high income countries. So, it’s actually been a bit of a pool factor that’s pooled through the U.S market, right? And at this stage, that is one of the big markets where hearX is growing and doing some interesting things with new models, but also in line with affordability and accessibility of hearing care to individuals.

Dave Kemp:

So, let’s talk about some of these products that you alluded to there. I’ve poked around on your website and I’ve just come across some of the different things that you have. So, you have the hearing screener, let’s start there. Talk about this. Because I know that you guys just passed a pretty cool milestone with a million hearing tests. So, talk a little bit about this, because I believe this was probably one of the first products that you guys developed.

De Wet Swanepoel:

Yes, exactly, Dave. So, the way in which we want to operationalize this vision of healthy hearing for everyone everywhere is really just set ourselves the mission of providing affordable access to hearing health using digital solutions that anyone can use anywhere. So, this has been our philosophy. So, it should be extremely high-tech pieces of equipment or devices that are always connected or that at least should connect at some point in time. But they should be so simple to operate that anyone should be able to actually operate the device and facilitate the test.

De Wet Swanepoel:

So, that’s the philosophy around how we started out developing our technology. So, our first hearing screening device called the hearScreen we really started developing in 2013. And our aim was to use the least expensive or the most inexpensive Android phone at that time. There was a small little device that almost looked like just a feature phone.

De Wet Swanepoel:

And we can make pure-tone audiometry screening work on that with calibrated headphones. Then we know we could make it work on any platform. And eventually we got that right. And that was the first technology and it was called the hearScreen. And it was developed so that layout workers, teachers, nurses can operate the device, do a test in unconventional environments, primary healthcare clinics, schools, early childhood development centers.

De Wet Swanepoel:

We utilize the sensors of the device to ensure we do very good quality control. So because you have lay health workers or laypersons doing the testing with minimal training, you need to be sure if you want to rely on the results that you’re doing lots of quality control utilizing that technology at your disposal. So, for example, we calibrate the microphones of these devices so that we actually can measure the environmental noise accurately in real time while you’re doing the test. So, that’s a quality control metric that is captured in real-time and synced to the cloud so an audiologist can remotely review the program.

De Wet Swanepoel:

We also do things like, we track false positive responses, we track the quality index of the operator doing the testing. And we do this in an ecosystem that allows us to sync seamlessly from mobile device into the cloud-based platform as electronic health record system so that you can have program managers that can then monitor the quality of these programs remotely. And that’s really the tele-audiology concept, right?

Dave Kemp:

Yeah, no. That’s the way I view it is that this ability to, like you said, I think provide lay people, if you will, with something that is foolproof and it allows for you to facilitate these kinds of services in a way that you’re confident you’re going to ensure the right results. And so, if you’ve done a million of those tests, I mean, where was some of the initial uptake? And are all of these administered through a handheld device or some of them done through a website? Just help me to understand what comprises this million tests.

De Wet Swanepoel:

Yes. And I just started with the initial device, which is a medical grade pure-tone audiometer in essence, that functions on the Android device with a calibrated pair of headphones. That’s called hearScreen. We have a number of different hearing test products, and these million tests have been conducted across all these platforms. So, we also have a diagnostic version of this test which is called hear test, which is to conduct pure-tone audiometry and extended high-frequency pure-tone audiometry. And then we also have other options that are web-based.

De Wet Swanepoel:

So, these technologies I’ve just mentioned to you are technologies where we provide, or hearX provides the smartphone calibrated with a pair of headphones preloaded with the software. So, those apps you can download. But we have also been working with various colleagues and partners around the world on developing a digital noise tests where we provide them as apps and as a widget that people can embed on a website which allows for online hearing screening or app-based hearing screening.

De Wet Swanepoel:

In fact, we launched the first version of this as the first national hearing screening test that you can download as a freely downloadable app on iOS and Android called HearZA, which is the South African national hearing test. And it was such a success. We launched it in 2016 that we’ve worked with partners to launch several other iterations of this.

De Wet Swanepoel:

And in 2018, we launched hearWHO for the WHO, which uses our technology and we provide that solution for them. And we’re now working on expanding the different languages so that we support six languages in that app towards the end of this year. In fact, on the 3rd of March this year, we will add Spanish and Mandarin to the hearWHO app.

Dave Kemp:

That’s awesome. So, this idea of embedding a widget really catches my attention. A lot of the conversations that I’ve had on this podcast or outside of the podcast have been like this; the pandemic hits in March, 2020. And it became apparent very quickly that we need to adapt as an industry. And I think telehealth becomes a primary focus for not just the hearing care industry, but by and large for healthcare in general.

Dave Kemp:

And so, I think a lot of people were pushed outside of their comfort zones and were looking for, okay, what are these kinds of things that we can provide in a no touch or a low touch type model? And I want to really get into that a little bit further along in the conversation. But I think that what happened though is, obviously there was a necessity to innovate.

Dave Kemp:

And one of the ways that we’ll probably look back at the pandemic in hindsight will be it’s the great accelerant. It took some trends that were probably in their incubation periods that were on a trajectory to grow, but it just accelerated them big time. And I think tele-health will be one of those things, because I think it made it apparent that, okay, this is something that we need to fully wrap our heads around and figure out how do we go about implementing something like this?

Dave Kemp:

And then, as the fear started to recede into the summer and patients started coming back into the clinic, I think a lot of people felt, “Well, I’m going to just revert back to the way that I had been doing business because it’s just what I know and I’m more comfortable and being uncomfortable sucks.”

Dave Kemp:

But I think that there were a few things that happened even in that small window that are going to become relevant for a long time moving forward. And I think that this idea of having a widget on any website, if I’m a provider and I have my practice’s website, this to me seems like just a no-brainer. Put something on there where at home you can take a quick little screener and that will give you a sense of like, do I need to continue to pursue this? So, is that the thought here? And what has been some of the conversations that you’ve had with folks, providers that have been embedding hearScreen around their website?

De Wet Swanepoel:

Yes, Dave. So, that’s absolutely the way we’ve also been seeing the trends evolve. We’ve developed these technologies way ahead of COVID-19, but suddenly when COVID-19 came, it’s suddenly like they just fell into place. Providers suddenly realized where they fit in and why they’re so important. Previously, people were so hung up on doing things the way they’ve always done, but as soon as a crisis hits it really helps people to rethink and be inventive.

De Wet Swanepoel:

So, our digital noise widget, one of the things I should probably say is because we’re kind of a tech spun out from the university and we work closely with academic institutions, everything we’ve done is validated. So, we have a long list of more than 30 peer reviewed publications that have validated all our technology.

De Wet Swanepoel:

So, I think that also differentiates our widget, our online hearing test from many of the others that… You could put a hearing test on your website that has no validation and there’s no data to support it, but this digital noise has been widely validated and that’s why the WHO also has implemented it.

De Wet Swanepoel:

And in fact, we’ve partnered with a number of big organizations, I’m thinking of 23 and me who have also implemented our widget. And I think they’ve done more than 300,000 tests on their widgets for people who are doing their genomic screening. And that’s an exciting research area where we’re also involved in to see how can we link different genetic variants to your performance on a hearing and noise test.

Dave Kemp:

Yeah, that’s fascinating.

De Wet Swanepoel:

But in any case, to get back to the digital noise screener that you put in a website, I mean, for clinicians, it’s a wonderful way of actually marketing your practice. You’re putting a service out there that’s free of charge. People can go and do a validated, reliable screen in less than three minutes. And of course it’s a lead generation tool. So, audiologists can utilize that to generate leads directly into their practice.

De Wet Swanepoel:

And it’s a great tool to also capitalize on that with your digital marketing campaigns, on whether that’s Facebook or Google SEO to really get traction and get people’s attention. So, the widget is linked into a backend portal, which we call leads. So, you can customize the test with your logo and with the various colors that fits your brand. And then when someone finishes the test, they can leave their details and you get a pin to look up their details and then contact them.

Dave Kemp:

Yeah. I mean, I’m so glad that you mentioned the lead gen side, because from a business standpoint, this is a tremendous lead generation tool. And I love that you mentioned too making this part of a digital campaign. I can already see it, a Facebook ad that’s like, get your hearing tested in three minutes or get a screening something. And I agree with you where, by the audiologist for the audiologist.

Dave Kemp:

I think that’s extremely important that this type of tool is being developed. From audiologists who are doing this through the interest of, we understand the importance of providing a valid test. And so I love that. I think that’s such a great, actionable thing that any practice that anybody that’s listening to this today, get in touch with Wet because this is something that you could put into your website overnight.

Dave Kemp:

And I think it’s so cool that you already have the backend system where you’re just feeding them leads. “Hey, this person just took a test.” These are hot leads that you can then follow up on and be like, “Hey, I see that you just provided this,” or, “You just did one of these hearing screeners.” And that I guess is a good segue into where I think this can go is, more of like a click to chat option, right?

Dave Kemp:

And I want to get into your thoughts around the reason I initially found you. I’ve heard your name a number of times throughout the industry, but what really caught my attention was the piece that you wrote. I think it was either the Hearing Review or the Hearing Journal, and it was about no touch and low touch models. And it was right in April.

Dave Kemp:

And I remember reading it and I was like, “This is it. This is a really sophisticated way to be thinking about how to do business in a setting where you literally can’t interact with somebody face to face, or maybe you can but just a little bit.” And so, I’m just curious to get your thoughts as somebody that thinks about this day in and day out, if you’re already capturing somebody’s attention and then they’re providing you with their little results through this rudimentary thing, it seems the next step would be, let’s really have that consultation.

Dave Kemp:

And you’re putting a bit of an onus on that person to say, you need to come and visit me in person. I mean, if you’re using the analogy of like the game of baseball or something, you’re just setting yourself up with two strikes. You’re limiting your odds of actually seeing that person because you’re providing them with another excuse to say, no. They’ll say, “Well, there was absolutely no friction for me to take that hearing screener on your website that took me three minutes, but now not only are you asking for a time commitment, but you’re asking for an emotional commitment too. Because you’re making me recognize that I might be perceiving a problem that warrants me to take two hours or however long outside of my day.”

Dave Kemp:

So, I tend to think that if you can make that less of a commitment from the patient where they say, “Okay, I’ve committed three minutes to this. Now I can commit a 20 minute Zoom consultation.” But it would be through some sort of HIPPA-compliant platform. That to me seems like a really actionable thing that, again, practices can start to implement not necessarily at scale and say, “This is how the end all be all, this is how we’re going to do business.” I like the idea of a hybrid model.

Dave Kemp:

But again, part of what the pandemic did was it highlighted the need for these kinds of things in certain situations. And so, you can slowly put your foot into the water and say, “All right. Now we’re going to start to flush out what this aspect of my new service offering would look like.” What are your thoughts on this?

De Wet Swanepoel:

Yes, Dave. You raise a lot of very interesting and very valid points. So, I mean, there’s a very interesting world out there of research in terms of how do you convert a lead and get someone to actually make an appointment in the practice? And really, I mean, you’re absolutely right. We’ve developed this software with the audiologist in mind to see how can we support them, how can this technology help them to build their practice? It should be a tool that allows them to really maximize their reach, and it should be available to the small guys as well. You shouldn’t be a multi-site practice to be able to utilize this technology, right?

De Wet Swanepoel:

So, maybe I should say, the first thing is to generate your widget is extremely simple. You can go on the website, you choose your package, you can put your logo on, you can choose your colors, and then you literally generate a little bit of code. It’s a code snippet. And you could put it into your own website backend platform or get your web developer to do it.

De Wet Swanepoel:

And then it opens up a A-Frame that has the tests run in your website but it looks exactly like it’s embedded in your own website. So, that’s just to say it’s very simple. It doesn’t take any technical guru to actually do it. Even I can do it. So, that’s the one thing. But the integration and the conversion of leads from when someone’s done the tests, how do you convert them? Because it’s one thing to do the test and we’ve done a number of studies to see where the drop offs are.

De Wet Swanepoel:

So, some of the things we’ve done is to optimize the different pathways. And audiologists can also choose how they want to set up the widget and the results. So, one option is to, before you view the results, you ask for their details and it’s so that you can send them some information about healthy hearing habits, for example, right?

De Wet Swanepoel:

Or you could give them the result first and then ask for their details if they want to. What we’ve also done is some bespoke solutions for certain bigger practice groups where you can, after you’ve done the test, make an appointment directly into the practice. So, the widget integrates with practice management software. And of course, that’s actually the best way to do this. And then to have the functionality of a chat function. So, if there’s someone who can manage a live chat in real-time, then that’s an option to include in the bespoke widget options.

Dave Kemp:

This is all just so great because, first off, I love that you mentioned that this is for anybody like any kind of practice out there. And really, again, I keep talking about the pandemic, but I think that this is going to necessitate a whole lot of new services in there for service providers. And I think it’s really cool that you’re building this with the mom and pop practitioner in mind that might just have one practice.

Dave Kemp:

Because I think that we need to provide all of these different clinicians with tools so that they can… I think it wasn’t as if people said, I don’t want to necessarily embrace all of these telehealth options, these remote services. I think it was more like, okay, kind of exists. And first off, I don’t know where to even begin.

Dave Kemp:

And then second off, I don’t have the processes in place to really fully implement this into my practice. And so, I think it was like a fly by the seat of your pants. But I do think that that’s a really important thing. And I love that you mentioned this idea of having a chat system in place.

Dave Kemp:

I mean, in my mind, for a professional out there and practice owners, I think that the way they can be thinking this is just one piece at a time, right? You need a chat option, a quick to chat option. Do you integrate Facebook Messenger onto your website, right? Is that the chat system that you prefer or does your web service host, do they have that option?

Dave Kemp:

Regardless, I think it’s an awesome thing to be thinking about and pursuing, because to your point, all of these things start to then become a cohesive offering. Right? You take that screener and then you immediately get hit with an email or something that’s automated where the practice, it’s just not a lot of burden on their end. That’s how this is, I think, ultimately going to really become adopted at scale in this industry is for a lot of these new vendors, I think, or existing vendors to make it so turnkey and simple for the practice owner to just turn it on. And it’s really, really easy to then integrate into their practice.

De Wet Swanepoel:

Yeah. Exactly, Dave. And one of the other things, it’s not just the fact that you get a hearing test result on these patients, we also ask a couple of questions. And one of the important questions we ask people who take the screening test beforehand is based on a staging algorithm that classifies them in terms of their readiness to take action. So, that way you can reclassify on the backend the readiness of this lead.

De Wet Swanepoel:

So, you can actually prioritize those people who are ready to take action. They’re not just thinking they may have hearing loss and the hearing test may indicate that they do have some kind of problem, but they’re actually ready to take up an intervention. And those are the people that you want to contact straight away. Your discussion with them will be very different than your discussion would be with someone who says, “I’m thinking about a hearing appointment or a hearing loss.”

De Wet Swanepoel:

So, you can really tailor and personalize your approach as well based on the results you get on these consumers to really finish the space on your website. So, it’s not just the hearing test. And of course it’s a screening test because it’s online, but in fact, the audiologist on the backend gets a signal to noise ratio.

De Wet Swanepoel:

And because we’ve validated all those normative data, it’s really a diagnostic value that you can utilize to determine the severity of this person’s hearing loss as well. They only get it as a screening result, but you, as the audiologists, get a detailed result on what their ability is to hear speech and noise.

Dave Kemp:

Yeah. I think that’s really cool. Again, their robustness is only going to grow, I think. I think that if you look at the broad trajectory here, you can see that this is only going to become more robust in time with the type of data that you can get and the type of insight that you can gather.

Dave Kemp:

I just recently listened to a very interesting podcast with the founder of Teladoc. And I think it’s important for anybody that’s thinking about this stuff to really get an idea of what’s happening in the broader healthcare system. Because there’s two things that are really happening. First of all, the behavioral shift, right? So, you have to look at the way that people are thinking about… One of the biggest limitations that he cited with telehealth in general prior to the pandemic was more or less the adoption of video chat.

Dave Kemp:

And it was a foreign concept for a lot of people, but one of the things the pandemic has done is it’s ushered in a very high level of widespread competence of how to use Zoom, Google Meet, all of these different things. So, there has been a major behavioral change in terms of how people access these kinds of video chat services.

Dave Kemp:

And the other thing he said, and I’m going to tie these two together is he said, “We don’t have a healthcare system. We have a sick care system. And we have a tendency to just treat people when they’re sick.” And that’s why I love what you just said right there, where you might have some people that if you can give them a more approachable entryway into your entree of services, so not to say the only reason that you should ever contact me is if you feel as if you need a hearing aid. That really puts you at a disservice for all the… If that average time span, I saw it went from being seven, now they’re saying 10 years between when you recognize you have a hearing loss and when you take action on it.

Dave Kemp:

So, what about all those people that are in that 10 year gap? And I think that what you’re talking about here is this ability to appeal to those people, where you’re not necessarily saying, “Look, you’re going to schedule time with me, and you’re going to fall into my funnel of leads, and you’re going to work your way up to… Eventually, I’m going to sell you a hearing aid.”

Dave Kemp:

I don’t think it needs to be like that. I think that it can be, let’s just get you a consultation to have a conversation about where you stand. And as these types of remote tests and screeners become more robust and they have a higher yield of insight. And so you can have a conversation to say, “Look, this is maybe where you have a little bit of a deficiency. Here’s the types of things to watch out for.”

Dave Kemp:

And so, again, you have a population of people that are becoming way, way more adept at these kinds of consultations and video chat and all that. And then in addition, you have a lot of people that are becoming way more health conscious with this preventative health mindset, where they’re saying, “I don’t want to wait until my hearing is shot and all of this. I would rather have a conversation today about how I can preserve what I have.” And that to me is what all of this turns into is it becomes something that you’re appealing to a totally different type of patient than I think most providers have ever really seen before.

De Wet Swanepoel:

Yep. And I like the way you’ve put that, Dave. I mean, we’re reaching a different cohort of people online, but that cohort has also dramatically increased over the last year with the entire COVID pandemic changing digital habits entirely. And I mean, a recent survey I saw from Ericsson mobile, a connectivity report they sent out. They did a large survey in the U.K and the U.S. And they asked people what are their views about physician consultations in the future considering what the COVID pandemic?

De Wet Swanepoel:

And 6 out of 10 persons in the U.K and the U.S said that they predicted that a virtual physician appointments are going to be more popular than face-to-face appointments. I mean, I think that’s a massive shift, right? So, people are shifting towards this kind of a virtual platform. But this is also, in lieu of what you said, this is also where the clinician becomes so important, right? I mean, the test is great to have, but in the end, it’s the clinician and their ability to connect to the patient-

Dave Kemp:

100%.

De Wet Swanepoel:

… and advise them. And what we’ve found is that this is just a tool to get you talking to a patient. And ultimately, that’s where it’s become so important as a clinician to differentiate yourself and not just be a dispenser, but actually be a clinician who connects with the patient’s needs, understanding where they’re coming from, the whole person-centered concept of care.

De Wet Swanepoel:

And maybe it’s worth just making a mention here of some very useful teleaudiology tools as well that are provided by the Ida Institute. And they’re also free of charge and you can actually embed them into your website as well to help patients prepare for their first appointment.

De Wet Swanepoel:

So, typically what we would recommend is you have a hearing test, you have a consultation with them, send them the lead to some of these tools to prepare for your first appointment. And it helps the patient to actually think, reflect about what’s going to happen, but also about the potential treatments and the potential upsides of coming to an appointment ready so that they can make decisions there that are in their best interests.

De Wet Swanepoel:

So, I think you’ve touched some important point here that the person centeredness of these approaches are really great. And sometimes people think that technology is opposed to the clinician approach. But I think they work beautifully together hand in hand to support each other.

Dave Kemp:

Well, I love that you say that because I don’t look at this at all as a replacement or anything like that. I think that this is ultimately a way to amplify and extend your value. I think that the providers that really grab the bull by the horns here and adopt a lot of this will more or less just be able to facilitate their services that much more.

Dave Kemp:

I mean, I think it’s going to create a massive surge of efficiencies. Because again, it’s not to say that you won’t have face-to-face visits. I don’t think that’s going away anytime soon. A lot of people prefer that method. But you’re tapping into the portion of people that would love to just have that 20 minute consultation with you. And at the heart of this whole thing, is just like you said, these tests and screeners and all these different tools, they’re just a means to gather more information, to have a more comprehensive conversation, I think.

Dave Kemp:

And so, it’s not as if an algorithm or some online player can just come in and disrupt that, because really what we’re talking about is the knowledge and expertise that comes along with years and years of being in this profession and harnessing really the wisdom that comes with being a professional in this space.

Dave Kemp:

So, you’re not talking about disrupting that value per se, you’re talking about creating a means to extend and amplify that value. And that, to me means that you’ll be able to, if the cost of hearing aids continues to go down, which I’m sure it will. And you’re looking to compensate for that revenue that’s not going to be there. It seems like the thing that will be in high demand and an increasing amount of demand is going to be that consultative. I need to have a conversation with you to even understand where I stand in building those relationships over time.

Dave Kemp:

Some of those people might end up buying something from you, but a lot of those people in terms of how their customers, more or less, you’re going to bill them for your time.

De Wet Swanepoel:

Yep. Yeah, exactly. I mean, I think you’re touching on some of the sensitive points for the audiology industry at the moment, right? Is where does our value lie? Is it in doing on your metric assessment or is it in providing hearing aid? And I think, yes, all of those things are important, but at the heart of what’s most important is that we are professionals providing professional service. And our consultations and our time should be valued as such.

De Wet Swanepoel:

And I think technologies, in my view, should be there to allow us to do all these technical assessments and all these revisions of hearing aids very well, but they should also be there to free us up to really connect with patients, understand where they’re coming from and providing them with the care that they need.

De Wet Swanepoel:

We know patients with hearing loss, it’s not just a matter of putting on a pair of glasses, right? If you put on a pair of hearing aids or amplification, it has to be personalized. And it goes along with a lot of handholding and support. And that’s really the value of the clinician.

Dave Kemp:

Yeah, no, I couldn’t agree more. So, you have the hearing screener, let’s get into a few more of these services or product offerings that you have. I love this theme of empowering practices. So, what else falls along that same vein as the hearing screener?

De Wet Swanepoel:

Yeah. So, the hearing screener and the online widget is a good example of on the continuum to reach new patients, right? And that’s important. But if we think of, how do we take the next step to do some kind of diagnostic testing, especially in a COVID world? We combined a lot of the technologies that we’ve developed during COVID-19 and produced a new product offering that we called the self-test kit that was developed particularly to enable low touch and even no touch models of audiological service delivery.

De Wet Swanepoel:

And what we did is, it’s a tablet-based device with a calibrated pair of headphones that can be sent out to someone’s home. Very simple to open it up, put the headphones on and then go through a comprehensive assessment of hearing. So, it’s not just a screening. So, what we do there is we do a pure-tone audiogram. So, they’ll get instructed and it’s a self-guided assessment, so someone can do this by themselves or if they have a significant other in their home, that person can also support them to do the test. But it does this pure-tone audiogram.

De Wet Swanepoel:

And then we do a speech and noise test as well. So, digital noise test right after that. And we developed a proprietary algorithm during COVID-19 that we’ve just published it in the International Journal of Audiology that then utilizes the speech and noise result, your pure-tone audiogram, and using logistic regression analysis that also incorporates with the age of the person, we can then determine whether they have a conductive hearing loss or whether they have a sensorineural hearing loss.

De Wet Swanepoel:

So in other words, you can test outside of conventional environments. You don’t have to do this testing in a sound booth. It’s in someone’s home. It could be a curbside assessment or a drive-through type of assessment to really reduce the time and the risk for some of these patients.

De Wet Swanepoel:

And then the idea is that from there, you can prescribe a treatment for these patients. You can either see that they have a medical issue, which is the minority of these subjects, and they could be referred to a medical practitioner’s office, or if they have sensorineural hearing loss, you could already have a discussion with them about the types of devices that are available, their fitting ranges.

De Wet Swanepoel:

And if they are willing to try the device, you could actually set up a device pre-fitted and have them come in for a very quick assessment where you’ve just put on a device and then have them go for a hearing aid trial. And that’s a good example of a low touch model of care, right? So, the assessments may happen outside of the clinic. They may come in for a very quick fitting of the hearing aid and that’s it. So, it’s one appointment and then they do the trial and then the support can be done remotely.

De Wet Swanepoel:

So, the self-test kit has been really popular during COVID-19. It’s widely used. And it’s really has filled the gap. Traditionally, teleaudiology models allowed for the screening and the support of existing patients, but it’s that gap in between. How do we provide an assessment for new patients in a remote way or in an unconventional way outside of a clinic?

Dave Kemp:

Yeah, no. I think that’s really, really interesting. So, let me understand this. So, you send out this self-test kit. Does there need to be a professional on the other end of it while they’re doing the test or is it all done by the patient on their own and then the test results get assessed by the professional?

De Wet Swanepoel:

Yeah, that’s a good question. Let me clarify. So, there’s two ways in which that can be done. One is it can happen where they literally open it up, they go through the instructions, they do the testing, it takes about 12 to 15 minutes to run through the assessment. And it sinks back to the cloud and the audiologist can remotely review the results and then connect with the patient and provide them with a consultation.

De Wet Swanepoel:

If the patient has difficulty in the setup and they have difficulty understanding the instructions, the audiologist can connect in real-time as well with them to support them and talk them through the instructions. In our experience, that’s very rarely necessary. But that’s certainly an option. The idea is it should also free up the time from the audiologist so that they can then schedule an appointment slot to have this discussion with the patient. So, in terms of the type of hearing loss, the degree of hearing loss, what kinds of treatment options are available.

De Wet Swanepoel:

And that way, the audiologist also comes at the appointment prepared, right? And so, they can make the right recommendations, take them through some examples of samples, and that can obviously be done virtually to reduce the risk.

Dave Kemp:

Yeah, no, that makes a lot of sense. I think it’s a really fascinating way to, again, create efficiencies, like you said, administer the test to where it’s so easy they can do it on their own and then you have that conversation afterwards. So, they still feel like there’s a significant amount of value of working with the provider. Not to mention that they got this very professional looking test administered to them.

Dave Kemp:

So, it goes again to this notion of like, you have to create an experience in today’s day and age with big box retail, with all these online players that is unique and that puts the providers’ value front and center. And I think that that totally does. So, the other thing I wanted to talk about briefly is Lexie Lumen. So, you guys did just launch a line of your own hearing aids, I understand. So, can you tell me a little bit about the goal here with these hearing aids and what’s happened so far since you’ve launched them?

De Wet Swanepoel:

Sure, Dave, the solutions we’ve been discussing up until now, and there’s a number of other solutions as well, cool ones that’s always interesting to talk about. And maybe at some other point we could do that. They’re all intended for the clinical space. So, for audiologists do to support them in their practice. Maybe other healthcare providers, ENTs, general practitioners, but then also lay health workers, community health workers, et cetera. So, they’re clinical solutions, they’re FDA-approved, the company is ISO 13485 medical device-certified company. So, all of those are our business to business solutions-

Dave Kemp:

Yeah, that makes sense.

De Wet Swanepoel:

… that are intended for-

Dave Kemp:

For enterprise.

De Wet Swanepoel:

… for professionals. Yeah. So, what you’ve mentioned now is our foray into direct to consumer service provision and it fits with our vision of healthy hearing for everyone everywhere. Initially we started with screening diagnostics and now we’ve moved into providing intervention as well. So, we’re able to actually combine those test results and do a fitting of a hearing device based on our technologies. So, we’ve always had that in mind.

De Wet Swanepoel:

This is our first foray. So, Lexie Lumen is a direct to consumer hearing care service. We believe it’s a comprehensive service, so it’s not just providing a device, but it’s actually providing a comprehensive hearing care package to consumers. We know there’s a big, vast number of consumers already searching online for services, right? So, these are people who are probably not the guys who are going to come into a clinic and they’re probably not there yet. They may have milder hearing losses, mild to moderate hearing losses, or cost may be a barrier to them so they’re searching online.

De Wet Swanepoel:

So, we really wanted to provide a comprehensive solution for that group of people. And the Lexie hearing, we believe, hits that mark really well. I mean, the feedback we’ve gotten from this direct to consumer service and hearing aid provision has been extremely well, I mean, the reviews have been excellent.

De Wet Swanepoel:

So, let me just highlight the main components of how Lexie hearing works. We provide a high quality digital hearing aid to these consumers at a very affordable cost point. It’s a 16 channel device with directionality, with slim tube, so it’s also nearly invisible when you wear them. But what’s really great about the product is that we’ve used all our digital technologies to integrate with the hearing aid. So, someone who purchases the set of hearing aids, gets them delivered to their home, they download our Lexie hearing app from the Android or the iOS app store, and they then connect with the devices via Bluetooth. Very straightforward instructions on how to set them up.

De Wet Swanepoel:

And then you do a hearing test, in-situ hearing test from the app directly through the hearing aids. And this we’ve validated as well, so it’s extremely accurate. Once you’ve done the hearing test, you press program and it programs your hearing aids exactly according to your audiogram.

De Wet Swanepoel:

So, then you have a fitted pair of hearing aids. But then we also have developed acclimatization or a retention program based on the evidence that’s out there in terms of what do patients need to acclimatize to their hearing aids. And this is delivered through the app. So, they get the little videos, they get calls from the call center and they have little activities that they participate in to help them get used to these hearing aids.

De Wet Swanepoel:

We know that first week in particular is very important, so we focus there very much. And then we have a call center, a hearing hub with hearing experts and they’re all audiology-trained. They provide support, not just technical support, but actually this hand-holding to help the patients get used to their hearing aids, they listen to them. And they can remotely program the hearing aids as well.

De Wet Swanepoel:

So, they can connect through the call center to the device and do fine-tuning for these individuals. And then maybe just on the pricing side, what we’ve also done there is, we’ve brought the cost down for the once-off purchase, but most people go for the subscription. So, we have a monthly subscription. So it comes down to $49 per month. And that includes everything. The hearing aids, includes the batteries, includes all the disposables. So, it’s literally a all-in-one package.

De Wet Swanepoel:

And we’re the only and the first hearing aid provider that uses a behavioral incentive program. So, the more people wear their hearing aids and we track their usage through the app, the more discounts they get. So, we want to encourage healthy hearing habits. So, the more people use their hearing aids, the more they can reduce their monthly costs and get discounts on accessories, et cetera.

Dave Kemp:

Yeah. That’s actually touching on something that we’ll have to have a broad conversation about that someday, because I think that is fascinating. And it’s, again, one of these things that if you look outside of the industry, it’s happening in a lot of different places. There was actually before Google bought Fitbit, Fitbit had signed a deal with the government of Singapore all around more or less wearing these fitness trackers.

Dave Kemp:

And the government incentivizing you in various number of ways. You get benefits, you get all kinds of different things if you wear it, so encouraging healthy behavior. But I do think that’s a really interesting facet of this is too, a lot of these hearing aids today, you can actually see a lot of the usage data of them.

Dave Kemp:

And again, this ties into where I think the value proposition of the provider of the future will reside is understanding what the usage of the hearing aid has been like and talking through, “Why aren’t you wearing them in this situation? Why are you wearing them in that situation?” Because without that kind of data, everything’s just on a, tell me about your experience and it’s at a very abstract level. But when you can get into the nitty-gritty and you can see every day around 2:00 to 4:00 PM you don’t wear your hearing aids, why is that?

Dave Kemp:

You can have a conversation about that and maybe you compensate in some way to make it so that for whatever reason, maybe that period of time is now a little bit more appealing to wear their hearing aids. So, I do think that it’s representative, I think the first step was Bluetooth connectivity, which happened at the beginning of the 2010s in that decade. And now we’ve seen basically universal connectivity.

Dave Kemp:

So, the next phase I think is going to be really fascinating that now that we have the connectivity more or less in all of these different kinds of devices and you have devices like yours that are much more accessible. I keep thinking about the beginning of the conversation where you have parts of Africa that there’s no way they could afford for the types of products that exist. So, we have to meet people where they are. And I think that this idea of a subscription model is pretty brilliant. I would not be surprised if that becomes a more prevalent business model moving forward with a lot of these types of items.

Dave Kemp:

I just think the subscription model, particularly when you factor in the ability to upgrade and those kinds of things, it just makes a lot of sense to me. So, I know we’re getting close here to the end. Any closing thoughts, anything that you want to say to professionals out there, consumers, patients about the hearX group and why we should all be keeping an eye on you? Because I think that even in the five years that you guys have been around, you’ve really done a lot.

Dave Kemp:

And I think that the pandemic has only, I think, highlighted the potential for the remote services and these tele-health oriented options that exist. So, I’m keeping an eye on you, but curious to get your thoughts on what should we be keeping an eye on across the next few years with hearX?

De Wet Swanepoel:

Dave, yes. I mean, it’s an exciting era, right? And COVID has been a really negative influence on many different businesses and industries. In our instance, it’s actually been a very fortunate, good time for us because our technologies have just fit in the gap. And you mentioned some of the big trends around tele-doc and some of the tele-medicine platforms. That’s certainly the area where we believe we can really make a difference in and where we were already playing with some of the big partners around the world in terms of providing our digital solutions there.

De Wet Swanepoel:

We really see ourselves to reach this vision of healthy hearing for everyone everywhere. And that means we utilize our strength, which is the fact that we’re a digital earring tech company. We specialize on digital hearing technologies. We have about 65 people working on these solutions at the moment. We have a call center set up to support patients. So, we have these two divisions. I’ve shared the clinical part where we want to support clinicians with these digital technologies. But then we’ve also now launched this consumer business and where we really believe we’re kind of pushing some of the boundaries in terms of being innovative around both the financing models, but also the service delivery being comprehensive.

De Wet Swanepoel:

Utilizing the data we get. So we’re a data-driven company as well. We utilize data. A lot of our technologies use AI and machine learning as well to optimize and improve the way in which we do things. And we really believe that’s going to be the continuous trend as we refine this platform. We believe the Lexie platform is a platform that will continue to provide different types of hearing aids as well. The device is a small component of what Lexie is about. Lexie is a comprehensive care package that relies on a digital ecosystem.

Dave Kemp:

Love that.

De Wet Swanepoel:

And we believe that that’s really the direction that the industry should be moving. The technology is converging, so there’s not so much difference between the technologies these days. It’s actually the way they can integrate and where we can utilize the data to incentivize people. I loved what you said. It’s not just about treating, but we want to incentivize healthy living and healthy hearing habits. And we believe with the way in which we can track the data, give people feedback through their devices, that’s really the direction we’re moving in.

Dave Kemp:

Yeah, no. Well said. This has been such an awesome conversation. Definitely need to have you come back on the podcast at a future day to continue the conversation. Because I got a lot of things going on in my mind right now just racing a mile a minute about some of the things that you said. And like I said during the enterprise portion where we talked about a lot of the B2B services, I know a lot of my audience is professionals out there.

Dave Kemp:

And so, I hope that that really resonates with them because I’m firmly of the mind that we as an industry are going to need to move in this direction, become more remote-oriented. It’s not to say, again, that the old way of doing business is going anywhere, but I think that we need to augment a lot of these things and be cognizant of each, approaching it as a piecemeal type operation where little by little you just slowly integrate these different services in there and you become a little bit more conducive to remote services. So, De Wet, thank you so much for coming on the podcast today. Thanks for everybody who tuned in here to the end, and we will chat with you next time. Cheers.

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