Why Hearing Aid Benefits Fail to Convince Patients

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0:00 Nobody wants a hearing aid right I mean you nobody wakes up in the morning and is like gosh I can't wait to go get a hearing aid right Often they're not ready when someone has a hearing loss it took once they realized they have a hearing loss typically takes about five or six years before they actually buy a hearing aid.

I can tell you that when my wife listened to our hearing loss simulation for the first time, and I make this joke, but it's really not a joke, but she you did the experience and heard what my hearing sounds like, looked up at me and said, jeez, I thought you were just a jackass.

If someone doesn't receive a demo like just any kind of live demo or anything, it's a forty-six, forty-six percent conversion. If they receive a demonstration, it's a 70% conversion. Revenue doesn't stall because your team stopped trying. It stalls because of friction. I sit down with other commercial leaders who find that friction and fix it. I'm Terry Coutsolioutsos. Let's get into it. Terry Coutsolioutsos here and welcome to the Zero Friction Podcast. I have a unique guest with me today, Jeff Cummins. He is the CEO, co-founder of Immersive Hearing Technologies.

Jeff and I go back probably five or six years ago, and he's, he's always been a commercial player helping technology sort of leave that university space. And, and Jeff and I met a while back and we reconnected here with Immersive Hearing Technologies. Jeff, great to have you on the program today. Once again, you are in the midst of launching and delivering, you know, transformative healthcare delivery. So tell us about your journey and give us a little background on Immersive and what you guys are doing. Yeah, you bet. Hey, thanks for having me Terry. It's great to be here.

So yeah, so a little bit about me. I'm biz dev finance guy, you know, startups, fast growth companies for 25 years, been sort of industry agnostic from dust collection to magazines to the internet to car keys and things like that. And the last 10 years or so been working more sort of university commercialization kind of things, including, you you know, software providing binary guidance for stent placement things like that. But now I have a really great application that is close to my heart with Immersive Hearing Technologies.

2:41 So we are creating an immersive demonstration tool for hearing aids. The purpose is to help audiologists increase adoption of hearing aids and differentiate premium levels of technology, and things like that. The way that works is we have an application in the clinic that lets very practical virtual reality that helps patients understand hearing loss and lets them listen to the benefits of hearing aids in real-world scenes, adjusted to their specific loss. Let's patients understand how hearing aids work. You know, it's a really interesting concept. And so I'm sure that, you know, hearing challenges is a very sort of, it's a challenging healthcare space. Just, you know, underserved, probably people don't even recognize they have an issue till it's way past its time.

And then, you know, convincing somebody to actually get help when they do have the hearing problem. It's probably a pretty complex process and, Yeah, you absolutely. know, so, so tell us a little about some of the problems that now your, your main customers are audiologists and people that are serving that community. But what, what are the big problems that the audiologist has in terms of trying to serve that, that patient who has a hearing challenge. Great. Well, first and foremost, nobody wants a hearing aid right I mean you nobody wakes up in the morning and is like gosh I can't wait to go get a hearing aid right so and often as you mentioned they don't nobody people don't realize what they can't hear they don't realize the impact that it's having on their life you know it's easy to sort of justify your why you can't hear ah my wife mumbles you ah, you know, there's there's lots of reasons why you're not hearing and the fact that just understanding what what you can't hear is one of the real challenges, right?

So typically audiologists have a real challenge in that respect so the explanation of the patient's loss, you know the testing and explanation of their loss is a challenge but then you know the describing the benefits of a hearing aid to someone that is it's a little skeptical or you know, they're not you know often they're not ready when someone has a hearing loss it took once they realized they have a hearing loss typically takes about five or six years before they actually buy Wow. a hearing aid.

5:30 So Really? yeah, yeah, that's correct. Yeah. Yeah, so That's crazy. yeah, and you know one of the one of the What's things that the big stumbling block on that? So like, what does the market say? Like, why are they waiting five and six years? well, there's you know, there are a lot of hurdles to overcome from for hearing aids, right? So there's the stigma of looking old and, you know, having a, you know, your grandpa had this big chunk on his ear and he was Yeah.

Clearly an old man, right? Or, you know, so, but that stigma, I think, is abating a little bit, right? Not all the way, but with sort of more people putting AirPods in their ears and, you know, things like that and just the technology to hearing aids is much better. So it's a much more useful tool relative to like, I'm using my hearing aids as my headphones today. So the sound you're hearing is coming through my headphones and Bluetoothing to the computer, for instance. But so there's the stigma, there's the cost hearing aids are expensive.

So from 1500 bucks for a set at Costco to $6,000, $7,000 for a premium set from a high-end audiologist. So they're expensive. It's a whole new device that you have to manage, you know? You don't think about all the effort you put into managing your phone every day, right? Because you got used to it. But now that you have a new set of technology that you have to tote around and deal with every day, it's a whole thing. I can also tell you that initialize, you know, your initial experience with hearing aids is not always great, because it literally takes your brain a month or more to adjust to this new sound coming into your brain, right?

It's not like glasses. You go to the optometrist the first time, right? And you walk out of the office and look around and you're like, wow, there's leaves on trees. So this is fantastic, you know, ah, I'm fixed, right? So that's a corrective, right? This is assistive. So it's a it's a big challenge because it takes a while for it to sound normal like it, you know, so there are a lot of hurdles to overcome in the in the audiology space you know and one of the big ones and the one that we're sort of attacking is this sort of helping people just understand the benefits in a simple and easy way so yeah, those are some of the challenges and we're taking on some of them, right?

8:17 And how are you doing that? So tell us a little bit about the platform and how it works, what it offers and what it's really doing to sort of take that friction, removing the friction out of, you know, that, you know, I just can't imagine living with a problem for five or six years. that's what keeps resounding back in my head is that like, once you've been diagnosed with a hearing problem and you recognize it, you're waiting five and six years to sort of fix it.

And, you know, that's just not normal kind of in the healthcare space. Usually when something's wrong, you get it fixed. And, you know, Right. that definitely there's a, there's something in there that's, that's, that's standing in the way, Yeah. whether Well, it's those money or one of time or just, you know, getting emotionally or psychologically over the fact that, know you need to get help. are all some of the challenges. But one of the biggest challenges is that people don't really understand what they're not hearing.

Right? You're like, hey, I've been getting by. I'm doing fine. You you people mumble a little, but I just listen a little harder. and maybe I don't go out as much as I used to, but that's okay, that's all right. You make accommodations for this in your life and then it's easy for you to justify that you're fine. One of the things, we're addressing that, understanding the benefits of hearing aids. When I say that, a lot of that really in the simple way to put it is that we helped you understand what you could be hearing.

Right. So an audiologist can explain what you aren't hearing. Right. They do your hearing test. Hey, you're not hearing birds. You're not hearing things that based on your hearing test. But that's not as powerful as if you could listen to what you could. Right. So we created a, this is technology out of the University of Louisville created by researchers. there, Dr. Pavel Zahorik and Dr. Matthew Neal, they're experts in virtual acoustics and loudness perception, and created a virtual reality system that would let you listen to hearing aids. So we took that and did some projects.

10:48 We did a lot of, obviously, a lot of customer discovery and research, but we boiled all that down into what I call very practical virtual reality. It's a reality that runs on a tablet and a set of headphones. So what we do is we create scenes like where you need hearing aids. So that will help you understand how hearing aids will help you. So one is a quiet living room, maybe a park with bird sounds and children playing in the park, and then the noisy restaurant, which is a place where everybody, that's the first place you know you can't hear.

So that's a place where you're out with your friends or your family, and you start to realize you're not part of conversation or you can't make out what the person on the other end of the table is saying. So we create these scenes and we take you to these scenes and let you listen with your hearing. You hit a button and then you can hear what a hearing aid would sound like personalized to your loss in that scene. So this sort of hitting that engaging you in this process and you hit this button is this A-B comparison and it lets you very easily hear the difference like oh this is what a hearing aid would sound like in this exact scene and that is a way for you to understand how a hearing aid will help That's pretty cool. So it gives you a before and after kind of like that.

Here's before and here's what you would hear after and that you. amplifies the opportunity for the patient probably to understand the impact, right? That's exactly right. That's exactly right. One of the other interesting pieces of this that I'll share with you is we also have a loss simulator on as part of the application. So this is a piece for the companion of the of the of the patient so they can listen to the loss of the of Okay. Huh. the patient. So we have a very technical, I won't bore you with the technical part of that, but we put the we put the audiogram which is the results of the hearing test into the system and it creates and let's say it plays back a correct hearing aid for the patient, but it also will let the significant other listen to the loss of the patient. What we found is this is a very powerful piece of the tool because often, the reason a person is at the audiologist just because their spouse, companion, friend says, ''Hey man,

13:22 You can't hear.'' you need to go to the audiologist, and Right. bringing that companion along in the past has always been helpful because they're there to encourage and help. Support, But when right? this person is able to hear the loss of the patient, and then in these same very practical virtual reality scenes, and then hear the loss of the patient and then hear what hearing aid would sound like for them, it's very powerful, and it creates a ton of empathy and education for this companion but it also lets them sort of become part of the decision-making process because you know in the past they sat in the corner and said, how does it sound?

You know, which is not in the patient can say whatever they wanted or Right. nothing or whatever you know, but now they're part of the plan they're part of the decision-making process and this is we this is proven to be a very powerful piece of the tool as well so Well I can imagine, you know, having that additional support and probably becomes energetic when they also understand the before and after aspect and they're probably the one that's most frustrated with the hearing loss anyhow, right? That's probably a big part of it, that's a huge part of it.

And that is a huge part of hearing loss is the frustration that it creates. Just because it's sort of a silent affliction, you don't know right? what that person can hear You know, you and don't you don't know know what you're what, not hearing because you don't hear it, right? You know, the other person's right. the one that's suffering, And you're you know, because you're not hearing it. right. So I'll tell you, so I have hearing loss myself, right? Okay Which makes this an important part oh, of what a great part passion of the mission, right? Absolutely project for me, so I've been wearing hearing aids for about 15 years. I had not great hearing and I had ringing in my ears, tinnitus, and started in my mid-20s.

But two weeks before my 40th birthday, I got the shingles in my head and not rushing off to the doctor. Long story short, it took out a big chunk of my right ear. I had little girls at home, seven, eight-year-old girls, beep, beep, beep, voices couldn't make out what they were saying anymore. So I've been into hearing aids since then. So I have a pretty severe hearing loss. And I can tell you that when my wife listened to our hearing loss simulation for the first time, and I make this joke, but it's really not a joke, but she you did the experience and heard what my hearing sounds like, looked up at me and said, jeez, I thought you were just a jackass. ha And, but, you know, I make this joke, and right, by the way, I'll but, say that I've known you a long time and I would not put you in the jackass category so, so.

16:23 Well, she might, no. but part of it was that I couldn't hear what she was saying, right, and it literally changed the way we communicate. So, you know, she realizes now that I can't hear around corners. And if you surprise me out of context, you know, I'm hearing one or two out of three words and I have to think through context. And if you catch me out of context, it's more difficult for me to you have the conversation. So they're just these things that it's an important part of counseling for someone with hearing loss that their family understands what they're going through and can help them accommodate them in some ways, right?

So it's just a powerful piece of the tool as well. so, know, this, does this happen in the clinic? Can this happen in the home? How does this system work? So this is a tool. We're creating a tool for audiologists to help Okay, them do their job better. got it, Okay, so it's a clinical application. A tablet could sit, sits right on their desk a tablet and a set of headphones sits right on their desk. The idea, it has a few business cases and places you can use it like health fairs for lead generation and other things like that.

But the primary use is just immediately following the hearing test. Just, let's go listen to how hearing aids will help you. right. And you just step in, put their audiogram in, it's three to seven minutes of listening that does a lot of the explaining for the audiologist, right? So they're part of, you know, trying to describe hearing loss and describing sounds and things like that is a challenging job. And what this does is it helps them grasp that much faster. It's much more emotional and they get it much more clearly than if you're just sort of trying to use logic to explain something to them.

It's an experiential sort of effect. So the idea, you know, in the past it was, they would pull out a brochure, point at some icons and describe what hearing loss was, right? So this is just a different way to do it. It's a tool to help them explain to the patient the benefits of hearing aids. So what are the biggest challenges when audiologists are fitting patients for hearing aids? Like is it like a one and done? What's the success rate? Like does this, you other than creating a better experience in terms of understanding before and after, how does it help with technology selection?

19:11 How does it enhance that experience so that the patient, depending on the budget, can really optimize the value of what they're buying? Yeah. yeah, so. The way it works now as an audiologist is explaining the benefits. Sometimes they will fit you with a set of hearing aids and talk to you in the quiet room. Sometimes they'll play some speakers and try to demonstrate some of the benefits of the hearing aids. But this process of a live demonstration is a real challenge for one you know this like as I mentioned it's difficult to acclimate into hearing aids and it's you know poking something in someone's ears and there are a lot of sort of challenges during this appointment with the patient so they what we're creating it and well, I'll tell you that some audiologists you know that the sort of conversion rate in audiology is somewhere between 45 and about 80 85 so and that's a pretty big difference right so there are different skill

Levels for audiologists so with a lot more experience and being able to do a really good live demo demonstration which is complicated there's a lot of moving parts and programming softwares and computers and media I mean, there's a lot going on. A very experienced, good audiologist can be in that higher range and what but what we're creating is a tool that helps get the job done, right? So if you are less experienced or even if you are fully experienced, it's a tool and the way I describe it is this is an analogy.

I've been using lately Terry so audiologists are out there, they have an axe and they're out there cutting down trees all day, right, right? So some of them have, you know, huge muscles and technique and sharp axe and they bring down lots of trees in a day, right?

Other audiologists, axe not so sharp, I'm pretty new at this, you know, I have other challenges, whatever, you know, they're not bringing down as many trees, right? What we're creating is a tool to help them get that job done better. So what we're providing them is a chainsaw.

So the idea is that this helps, it significantly helps the audiologists that need the help, right? But it can also make the job better for those exceptional audiologists as well. So we're creating a tool to help get that job done. How does the industry, from a manufacturer perspective, this sounds like a big, great tool for a big supplier or manufacturer on that side.

22:11 Does your business model include looking at that kind of opportunity as well. Absolutely, it sure does. And that's a very important player in this in that we're recording actual hearing aid makes and models. So, the more manufacturers we can get involved, the more hearing aids we can put on there. And we're not really trying to compare one brand to the other, but just provide the opportunity if someone provides a Widex hearing aid, they can use our Widex app, or if they provide a Phonak hearing aid, they can provide a Phonak.

But yeah, there are opportunities there for them in lots of areas of their business as well. They often, the hearing aid manufacturers own about a third of the audiology clinics in the world. So they've gone through a phase of acquiring clinics and they provide this, the audiology clinics now, right?

So getting them involved is big and the idea is to increase adoption, which increases the number of hearing aids out in the world. So there's that benefit to them. If they can improve the tools that their customers have, which are the audiologists or their customers, they select certain brands depending on their preferences and things like that. But helping their customers do their jobs better just helps them as well in lots of different ways, financially, but also just improving the experience for their customers as well. And what does, what does it look like when a hearing aid fitting doesn't go well?

Like what, like if it's not fitted properly, what does that feel like for the, I mean, I think I understand what it feels like for the patient, but is the clinic taking hearing aids back? Is it like, you know, is it, obviously it's Yeah. fine. It's like, so how does that financial implication work? work. Yeah, a lot of times audiology clinics have a return policy. And if the hearing aid is not fit well, it often comes back. Or really, a lot of it is the counseling.

If the patient isn't counseled well and the hearing aid is not fit well, it has a much better chance of coming back. And you've spent all the time and effort and the fittings and that to get it done. and then if it comes back, obviously that's bad, right? And you've often lost a patient for years because someone that's, their hearing loss is not gonna go away, right? So you want to have repeat business, right? You wanna help this person for the rest of their life, right?

25:01 Right. So, but you know, if it looks, if there are things like feedback can happen and you know, too much, it sounds too tinny or it just doesn't sound natural in a lot of ways. It's a pretty big turnoff for people. A lot of that is being able to take the time and effort to acclimate. And you really need one of the things that people don't get is that you really got to wear these things from when you get up until you go to bed for a month or two to acclimate to them. And it's just better for you in your life if you just keep them in. And a lot of people try to pull them out of the drawer.

We're going out to dinner with the family and pop them in and think that will help, and it'll help a little, but it's not the real benefit when your brain has acclimated to the hearing aids and really make out the speech better and things like that. So you mentioned something, you know, as we kind wrap up part of this conversation is that typically five or six years before somebody actually gets fitted, this technology pulls that forward, right? Like that sort of is the whole concept That's a of earlier adoption and you're helping the clinic when their opportunity for conversion to a therapy is probably the lowest, right?

So how does that like, does that translate for them when they're looking at, you know, because they may not even understand they have a problem until you've brought this solution to them. So how do you sort of, how do you go through that friction of like handling like the customer side where, you know, I don't have a problem. So how does that, you know, how does this solution actually end up being a solution when they don't even realize they have a problem? yeah, good question, Terry, and that's one of the real challenges of being an entrepreneur and trying to launch new innovative interesting technologies.

As always, So what there's are they always telling that you these friction. days? So like that's, you know, as you're doing, it's like, what's sort of the concept behind it? Well, a lot of the early adopters are the people that are really good at what they do right so sometimes those early adopters are the ones that have the sharp axe and have the technique right and sometimes they are like well I'm pretty good at this already I'm not sure I want to add a different you know piece of technology to you know my experience my patient journey so that's a challenge sometimes right helping them understand that this will help them do their job better it's a chainsaw you know, you're great at swinging that axe, but we can we can help you do this will help.

27:39 Okay and it'll be a better experience for your patients. It'll be a better experience for their companions there'll be a better experience for you because you don't have to go through all the explanations that you've been doing but They, you know a lot of what we're do they keep track of their conversion rate? So when they have patients coming in and is there like a, a standard, you know, on your first visit versus your third time you've come in five years, is it like, is there like a number so out there that, you know, you can land on?

It's interesting because it you think you know, I will thought well sure they'll know their conversion rate right? You know, that'll be the first surely that's the on the tip of their tongue, right? Right. a lot of them don't really know. Okay. They think, well, it must be like 80 percent. I would guess. That's been a challenge is that, and they don't think of it in that way often. This is an interesting dynamic because these people are, they're there to help, they're medical you doctors, and they're there to help patients, and they want to help people improve their lives and things.

And they often don't think of this as a sales job, right? And it's not, you know, it's really not, It's but a patient conversion you know, not, job. I mean, it's, it's client conversion. it's okay. It's patient conversion. It's All right, maybe 90, it's not 95, sales, but there's a different way to look at it. You're moving the patient from maybe being a patient to being a patient. It's, it's, you know, that's like, correct. how do you get them from the front door to the back door kind of thing?

That's right. And 95% of the revenue comes from selling hearing aids There or you go. providing hearing I'm guessing aids, you have right? an audience for this then. So there are, yeah, I'm getting more and more attention. So the challenges are there, you know, changing someone's workflow that they've been working through, helping people understand that they could That's have hard, a man. tool that will help them. It's it's not easy. Ooh, no, It's not easy but we're we're having success though. We started selling our SaaS product we've enjoyed some some really great sort of custom applications for large hearing aid manufacturer and now we're selling our SaaS software to individual audiologists and you know, it's it's baby steps right now but it's it's coming along and you know, it's I'm excited about you know the opportunity in the sounds future like a so great opportunity. I mean, you think about like just looking at baseline data before and after, just like, you know, you're selling them a system that the patient gets a chance to see

30:10 Before and after they get their hearing aid. You know looking at this where here's your conversion rate before and here's your conversion right after especially with your first timers, you know, and I'm sure yeah there's industry standards and then knowing that you know typically patients on their first visit do not convert to you know, a new sale that might be some interesting opportunity really kind of do some case study work too. That might be fun. oh yeah and that's what I'm hard at trying you know can trying to collect that data right now you know That'd be fun.

Yeah yeah yeah yeah yeah I mean it's the the proof is in the pudding you know always right you gotta you gotta show the results I can tell you the the gist is that if someone doesn't receive a demo like just any kind of live demo or anything, Sure it's a forty-six, forty-six percent conversion. If they receive a demonstration, it's a 70% conversion. okay. So there's this huge benefit from helping the patient understand how the technology works and providing a listening experience for them. So we're creating a tool that makes that easy to accomplish for all audiologists for the benefit of patients and their companions Well, I love that. I love the concept of it and I'd love to see if I can help you do a case study or two as well.

Cause that's, yeah. that's kind of what I do for my business is I work on conversion all the time. That's part of what we do is we help healthcare practices, consumer healthcare practices, not just bring leads into the business, but we actually help them process and convert them into actual clients and patients. And so you've got a great tool that is serving the entire ecosystem around that whether it's patients, whether it's manufacturers, and your customers as well. So good stuff. Yeah, you're speaking my language, Terry.

We need to do that. Good stuff. Well, awesome. Well, so what's next? Like you have a new software platform you just launched. Is there anything coming out new with the technology or just going to ride this for now and take it to the next stage when you get there? So, you know, the crown jewel of this, the whole benefit and really proven out that value proposition of helping the patient understand hearing loss and understand the benefits of hearing aids is the mission, right? The demonstration is the crown jewel of this.

32:42 One of the things that I'm working on and discovering and you know finding amongst my customers is that this a tablet in a clinic is a fantastic little content delivery system for patients it's sort of patient and provider facing technology so we're looking it's amazing what you can do these days you can do anything you want right but we're looking to we're adding additional sort of educational and content to the to the application that will help you know further that mission right so more education more motivation and more things like that and it you know so that's one of the things that's sort of on the horizon for us still the the demonstration of the hearing aid is the crown jewel of the content of course but there are other ways that that I think that our application can in the audiology clinic as well. Even if you build a community that people are using it, they can share best practices and build around all that as well.

How exciting. That's right. I have Yeah, one more question very good. for you though. I have one more Well, question for you. And it's lay a question it on me. I ask all my guests and ask it really slowly. So I'll give your brain some opportunity to digest it a little bit, but it really is going to revolve around, you know, Jeff, you've had a lot of great experiences as in business development and being an entrepreneur multiple times. Right. So if current day Jeff could go all the way back to a pivotal time in earlier Jeff's life, whether it's 18 or 22, one of those sort of bifurcating life opportunities, whether it's high school into the next thing or college into the next thing. What would one piece of advice that current day Jeff would go back and deliver to younger Jeff?

Just one piece of what could be professional, can be financial, can be personal. But what would be that one piece of advice you would offer your younger self, learning what you Great, learned today, it's a great question, Terry. What advice would I give myself?

I think that I've never, I haven't struggled with confidence in my life necessarily, right? but I would just continue to encourage and coach myself to be confident about what you're doing and the good that you can do and you know be confident in yourself and the things that you think are right and stand behind you know your ethics and the things that you believe in and just go hard you know that's I was always in sports and things like that just play hard and and feel and have confidence in yourself That's great.

35:43 So stay true to your core. Follow that North Star is always great advice. Well, Jeff Cummins, Immersive Hearing Technologies, great success to you both. And we look forward to great things. And Jeff, I look forward to working with you in the future as well. yeah hey thanks a lot Terry it's been a lot of fun I appreciate it.