Starkey Sound Bites: Hearing Aids, Tinnitus, and Hearing Healthcare
Being a successful hearing care professional requires balancing a passion for helping people hear with the day-to-day needs of running a small business.In every episode of Starkey Sound Bites, Dr. Dave Fabry — Starkey’s Chief Health Officer and an audiologist with 40-years of experience in the hearing industry — talks to industry insiders, business experts and hearing aid wearers to dig into the latest trends, technology and insights hearing care professionals need to keep their clinics thriving and patients hearing their best. If better hearing is your passion and profession, you won’t want to miss Starkey Sound Bites.
Starkey Sound Bites: Hearing Aids, Tinnitus, and Hearing Healthcare
Dr. Sara Burdak Explains “The Why” Behind Starkey Genesis AI
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Starkey’s revolutionary hearing technology was designed specifically to make life easier for hearing healthcare providers. In this episode, Starkey’s Chief Audiology Officer and Executive Vice President of Product Strategy, Dr. Sara Burdak, joins Dave to talk about exactly what that means. From fitting software that works in a matter of minutes to a more intuitive app, learn about the decisions that went into Genesis AI – all of them, with the provider in mind.
Welcome to Starkey Soundbites. I'm Dave Fabry, Starkey's Chief Innovation Officer. Now you know that we've recently launched some groundbreaking technology. And last time on the podcast, we geeked out with Achen Bolmick and myself. And today, now we're going to focus a little bit more on the why. And I'm very pleased to have my friend and colleague, Dr. Sarah Burdack, Starkey's Chief Audiology Officer and EVP of Product Strategy, joining us today on the podcast. And Sarah, thanks. This is, I think, you're you hold the record now. You're this is your third time. So delighted to have you back on the podcast and look forward to our discussion today.
SPEAKER_01It's always fun. We go way back, don't we, Dan?
SPEAKER_02But we'll just say a few years, because that's anything more than two.
SPEAKER_01A few years, and I get to geek out as well. I know.
SPEAKER_02Well, we geek out on different things. Like you and I have always talked about, we've laughed because in the past, you know, we've said for the last five years, as we've been developing Genesis, we've been in the midst of saying, we're trying to make hearing aids cool. And you and I have said, you know, we I always thought hearing aids were cool. And uh and I love geeking out about the why, because both both you and I are audiologists, and we have the distinct pleasure of not only helping to develop this next generation of product that we're j we just launched, but we also then get the benefit of talking to patients and professionals and their experience with this technology really is the why about why it is that we want to um uh play with this technology and deliver it to market.
SPEAKER_01Yeah, I think that's one of the coolest things about my position is I do get to see things from the very beginning. So for the past five years and how we've been developing this all the way to our classes and then seeing the performance on the patient. And when we set out to really accomplish what we have with Genesis AI, we really looked at what do the professionals need? Yeah. And then more importantly, what do the patients need? But it was really challenging because when you think of this whole ecosystem, it's unlike anything we've had previously. And it's not And I would say the industry is the industry is absolutely because it is all new hardware, it is a new fitting software methodology, it is a new app with the My Hearing app, as well as the accessory pieces as well. So when people say, Well, what did you set out to do? And I I think we've always said job one is the best hearing in every environment, and that's a big ask, but that's what we're going for in the delivery of Genesis AI. But more importantly, it has to be reliable and robust and easy to use. Absolutely. And I think we've nailed it. You know, when when we've said to the professionals and even patients, this was really developed by you for you, it's because we've had their input every single step of the way.
SPEAKER_02Yeah, talk a little bit about that because really we've not we've had uh how many hundreds of patients that you and Michelle Hicks and and the clinical research team have worked with this, how many hours out in the field? I've never been involved with any sort of product development process and verification validation process before the product was delivered to market. Talk a little bit about that.
SPEAKER_01I think this definitely is the largest clinical trial and the most validated product in Starkey's history, but I would put it to the test really in our industry. Yeah. Because we knew everything was built from the ground up, as you said, and that meant a whole different level of what we needed to do for verification and validation. So our clinical research team for gosh, easily the past 18 months, if not longer, they have been putting this to the test. So, with that, we have fit this on over 500 subjects. It is incredible. And they were providing us constant feedback. We were doing all of our data collection, but what that translates into is 11,000 hours of in-field wear time before we ever even released this product. So we know the claims that we're making, and one of those that I'm really proud of is this provides a 10% improvement in speech intelligibility over our previous technology. Which people thought was amazing. So we're able to have those points out of the gate. Yeah. And I think that's really, really impressive.
SPEAKER_02Well, as you know, my office is over by your clinical research team. And they have just been a buzz for, like you said, the last 18 months and and uh the last six months has been just a flurry of activity. And then recently we had our RD forum where we met with uh over 400 engineers and and um professionals that have been involved in the development of this product. I think every single person in the RD side of the organization has touched this product uh or process in some way or another, whether it's hardware, firmware, software, the app team, et cetera. Um, you know, I don't know how you do it because you get, you know, with the with the product strategy part of this, you're involved in the early stages of this. And then um there is, you know, at least a moment where uh the RD team, we can take a breath, but then you immediately have to transition into the market development side, and all the classes have started. And I know for the past several weeks what your travel schedule is like because I've been with you, but but you weather it much better than I do. But I mean there is no rest for the weary, I guess, in this. But it's fun, it's exciting.
SPEAKER_01It is fun, and that's that's what I think is so amazing. And when I look at the reactions as we've been starting to roll this out from the professional perspective, that is what gives me a lot of energy. Because when I look at our ProFit software, there are so many really just thoughtful enhancements. I know people don't like change. And so when I'm talking to other professionals, I say it really is enhanced. And anything that you may have thought in our previous software, oh, why isn't that better? It is better, and it's seamless, and the software really is comfortable. And we've added really just nice uh flow. And when I think about how somebody would go into a fitting, there's now preparation, there is fitting and follow-up, and that's just so thoughtful on how the patient journey works as well.
SPEAKER_02So let's let's break that down a little bit and talk about some of those enhancements because I agree with you. Uh, in talking to the many professionals, in addition to those hundreds of patients who participated, you also ensured that this was designed with input by the professionals for their use. And many who were comfortable with fitting with Inspire and familiar with it said, wait a minute, uh, you know, I really like it a lot, so don't change it. But then I think, as you said, we didn't throw the baby out with the bathwater and wanted to enhance in those areas um where there were subtle touches and improvements that could be made without giving up um the for people who really like me like to get in under the hood and be able to go into on the on the 2400, you know, 24 channels, soft, medium, and loud inputs plus MPO and being able to go in and fine-tune and tweak in each of those channels for each of those input levels. You can still do that. You can. But that's not everybody. So talk a little bit about this. You talk about this simplicity. Let's say people that haven't worked with us before, professionals that have only dabbled or haven't been really familiar with this. It can sometimes be a daunting task when you're really familiar with a specific manufacturer or a couple manufacturer software, and then taking on a new one. Sometimes, you know, that alone can prevent someone from trying what they think might be cool technology because they don't want to look silly in front of their patients at those first fits. Talk about what you did with that.
SPEAKER_01Sure, Ken, because I feel the same way. And so I think that's an important message too. A lot of the teams within our product management group, they are audiologists. They have they have experience, a lot of experience fitting the technology. So, similar to our clinical trials within our software development, we had more than 50 focus groups that had global input asking, what do you want? What do you what should this look like? All of the steps along the way. But it is that easy and it is familiar, and even somebody who hasn't used our software before would have no problems getting connected. And that is because one of the things that we really thought through is how do you get to your best first fit. Right. And that needs to be efficient. And with what we're doing with our proprietary fitting formula, which is Ztat 2.0, we are closer than we've ever been. But what we talk about is truly a minute fit and getting from unboxing to your best fit in four clicks.
SPEAKER_02Four clicks.
SPEAKER_01Because we want the professional to get there as efficiently and as precisely as possible out of the gate because we understand there's other things to talk about with your patients. Right. A lot of that is counseling and how they're getting devices in and in their ear and how they care for them and cleaning and checking. So we want to up front nail that down. And then the other piece is our smart connect feature, which I love as well, because the software, when it connects to a hearing aid, knows where it is in the fitting process.
SPEAKER_00Yeah.
SPEAKER_01And it'll take that professional to that point. So again, whether it's in fitting or follow-up. But as you said, we have left the navigation in place that if somebody wants to go step by step, and you can go down or you can go back. You can go down or across. It is still all there for those that need to make more adjustments, but we wanted to nail it down out of the gate to make the professionals' lives easier and make the patient experience easier as well.
SPEAKER_02Yeah, a couple things there. Um, you know, Tany Austin uh has talked for years about George Blankenship's uh Expo Hearing Innovation Expo talking about from 2018. In there, he's formerly the chief uh uh marketing officer for Apple and also for Tesla. And in that he was talking about when Tesla was introducing their products, they they put their their stores in malls rather than in the traditional auto uh uh you know lot that you'd expect. And they were, you know, uh they were confronted by disruption at that point in time from other uh combustion engines, and they were trying to make EVs seen as a performance vehicle, as a high-tech vehicle, because up until that time, people were buying EVs, were buying Prius's and they were doing for ecological purposes more than performance reasons. So they had to demonstrate a higher price point, think about OTC versus the prescriptive process, and overcome that barrier that people would have, apprehension about considering that uh prescriptive path, let's say. And uh in his presentation, and still it still uh rings in my head, he talked about putting the kid in the car. And um what he did was uh uh said that when they put these uh stores in the malls, parents would bring their kids in, they could design their car, and they could um have the kid sit in the car and say, you know, let's let's put a picture up on Facebook. And the kids broke down the barrier to the parents, and they didn't have the sticker shop showing right away. And you talk about putting the kid in the car, broke down that first level of barrier. I think that Minute Fit is a way that the professional has a way to put the kid in the car, particularly for first-time hearing aid users who are hit with all of these options, and we applaud the new channels. But the issue is with this technology, we know and we'll talk about how well it's performing in terms of intelligibility and sound quality. But people have to start hearing with it. And if you can go from the box to best fit, you're still gonna be able to adjust as much as you want. But to get to that best fit in four clicks is putting the kid in the car, getting them hearing while you're talking about all of those other things. So I think that is a subtle but really important point, not only for the professional, but for the patient to start hearing right away at how well they can do with these devices.
SPEAKER_01Well, I completely agree because it it is in a minute, and we always talk about demoing technology and putting the hearing aids on the ear is similar to putting the kid in the car. And one of the things that I've already experienced is how the moment of putting Genesis AI, and Dave, I'm hearing this from professionals too, that say, let me listen to them. And when they do, their own experience, even if they don't have the hearing loss, is just an awe of how these sound. And that is a key difference from whether you're the professional. I strongly encourage everyone to listen to this technology. But importantly, every patient, you should be giving them the opportunity to hear this technology up front while you're talking through the process, while you're certainly counseling on next steps. I think it's critically important.
SPEAKER_02Yeah. And, you know, a few of the numbers behind this. We've lowered the noise floor by 20 dB. We now have a 118 dB input dynamic range, which is the largest in our industry. Yeah. That really enables uh Mead Killian has for years since he developed the CAM talked about people with hearing loss don't want to live life under a hundred watt light bulb. They want to hear all the dynamics of sound, all the nuance that's so important to communication between people, to pick up those dynamics. And we're able to do this with 118 dB dynamic range and lowering that noise for because I know many professionals like to do sound checks and listening with devices. And one of the things that they often comment about hearing aids is they hear like bacon frying in the back or noise.
SPEAKER_01That's circuit noise.
SPEAKER_02And circuit noise. And what what we're hearing, as as you said, with clinicians and patients alike, are are responding almost immediately about how quiet they are.
SPEAKER_01How quiet they are, yet they are hearing speech better than they ever have before.
SPEAKER_00Yeah.
SPEAKER_01And that's what I think is so impressive. As in our clinical trials, the data was showing that 84% of the participants preferred this technology over any other previous technology in the hardest listening environment, which is speech understanding and noise. So that's a significant preference for Genesis AI. Yeah.
SPEAKER_02And then the other thing that I've really found interesting about the data that Michelle Hicks and her team has found is that in comparison to previous products, which as we said, people have already been glowing about Evolve AI, with increasing hearing loss, people found a bigger difference in performance as their hearing loss progressed. And uh with more hearing losses, the preference was stronger. And I think it's really due to this additive compression system that we're using that combined slower and faster release times to target the uh the residual auditory area for overall level while allowing the sh the faster time constants in each of those channels to make sure that they're audible but not uncomfortable. And it's been another thing that we've really heard about not only the sound quality, but the speech intelligibility.
SPEAKER_01It has been. So when we talk about our neuroprocessor, and part of that is this additive compressor. Yeah. One of the things that we really look at is how are we mimicking the normal human auditory system? And I think that's why we're getting, of course, this clarity and this comfort. And I'm often asked, and so are you. Well, when I'm talking to patients, what do I say about that? What is the language about AI and DNN? And I try to simplify it as much as possible because I really think what we're doing is to allow the patient to hear and not have to interact with the technology. Right. And that's key. If they want to interact with the technology, they can. And we can talk about the app and we can talk about edge mode plus, because that is giving the patient some control if they want it, where they can choose intent. Is it comfort at that point in time? Is it speech understanding at that point in time? But what I think with this technology that is so important is I'm hearing over and over again that the patient didn't have to do anything. Right. They don't have to change programs, they don't have to make selections. I've even been having some patients where they've had accessories, which I highly recommend for certain situations, of course, but they felt like they didn't need it at that point in time because of, I'll use your word, how automatic uh this is. And that's the whole point of the neuroprocessor. Yeah. That is the whole point of making sure that we are as automatic and seamless in what we're doing with our environment classification schemes.
SPEAKER_00Yep.
SPEAKER_01And then giving them the extra edge with edge mode plus to make sure that they don't have to constantly be making adjustments. And you've heard that from you know some of the fittings you've experienced as well.
SPEAKER_02I was just gonna say, with you know, for those patients who were comfortable using the automated processing, that is the automatic environmental classifier, they still love that and they find that it's even more automatic than on previous technology. Some prefer to use that listener intent, as you say. With edge mode, they could just double tap or press in the app a button that would do an acoustic snapshot in that environment to optimize for more audibility. With edge mode plus, as you say, they still have that one touch or one button, convenience, the easy button, to just press the button and do that and know that we're gonna provide the best audio for them. But now, for those who are even a little bit more sophisticated, they can optimize either for comfort or clarity. And it may seem a subtle difference, but even within individuals, sometimes if you go to a, let's say you go to a lecture and you want to ensure that you've optimized and provided those offsets to optimize audibility even more than in the past. Um, but then later, let's say it let's say it's a reception that then gets a little more boisterous at a bar, then you may be a little tired and you may want to optimize comfort. For those individuals who want one touch, they still have it. But those who want that additional precision, they have it. And I think that's really what we what the team went to go for was to improve the ease of use, that seamless, automatic functionality while still giving the capability for people to go into more sophisticated processing and take advantage of all of the computing power that we have in Genesis AI if they want it.
SPEAKER_01Yeah, I agree. It's it's really at their control and at their fingertips. And I think that also provides a lot of peace of mind. Yeah. And you were talking about how we do that in the the app, and we re-engineered the app from the ground up as well. So with the MyStarky app, it is very clear. Um, it's easy to look at if you're making a program change. If you want to integrate Edge Mode Plus, there are good. I knew you would have it.
SPEAKER_02So it's so simple in terms of the view.
SPEAKER_01And again, we we took it to heart. We learned from what we had previously. We said, what does this new app need to have? Again, it was easy.
SPEAKER_02It needs to all those functions that are the most used ones are there turn to volume screen. Edge mode plus is up here, programs is there, the my hearing button. And it it still is such a clean look.
SPEAKER_01It's such a clean look. And then I want you to show the swipe. The swipe.
SPEAKER_02It's such a subtle detail as well that I can just swipe across there. And as somebody that has suffered lifelong visual challenges, I can just look at the color scheme on the base, on the base palette changes as I swipe across there. So I don't have to, all I have to remember is that the blue program is the telephone program, and I can swipe back and forth. I can even save an edge mode setting if I want for a custom setting that I applied and liked when I went to Starbucks for coffee. Right at front to the user right up front.
SPEAKER_01And one of the things I will talk about too is with the my hearing area. Yep. Is we have put in more information to help the patient and have more counseling, general hearing aid information, cleaning. We're doing so much. Self-check.
SPEAKER_02Get your users to use self-check on a daily basis. That one. I know.
SPEAKER_01Which I think is important as well, because that is part of making the professionals' lives easier as well as the patient. And getting to, I've already mentioned that that best fit, where everyone's really comfortable with the technology, is very, very important. And that's what we're really delivering with Genesis AI.
SPEAKER_02And under that my hearing uh button, too, talk a little bit about firmware updates. In this setting, right now, within the app, it says my firmware is up to date. What if it wasn't?
SPEAKER_01Thank you for for I had that on my list of things for profit because that is really exciting. And you can tell that Dave and I are both could go on and on about this technology. Really? Really, I know. We're like, oh yeah, and there's this and this and this and this. But one of the things that is very exciting is a patient now has the opportunity, if they were to choose to do this, to do a firmware update to their hearing aid through the MyStarky app.
SPEAKER_02And it's fast.
SPEAKER_01And it's fast. It's very, very fast. And we know not every patient is going to know how to do that or where to go. We've made it easy. But certainly we've heard from the professionals that they also want it equally as easy. And so within the ProFit software, we are thrilled to say that we now have sped up our firmware update process significantly. It's four times faster. What that translates into, though, is that you can update a wireless pair of hearing aids, so a binaural set in under three minutes within the Profit software, which when we've shared that information that's like cheering, you know, from um anybody who's listening that understands time is money.
SPEAKER_02Time is efficiency for other things that you need to talk about.
SPEAKER_01That matter. And so that's a really exciting piece of this update as well. And I am glad that you uh brought it up because again, we we both have been going back and forth on all of the things. It's easy to kind of forget something.
SPEAKER_02Well, and to that end, there is one other feature in the Profit that personally I always found a um a sort uh a challenge in the past with my again, my visual challenges is that Smart ID. You talked about Smart Connect. Talk a little bit about what Smart ID does, because that's one of my personal favorites in the uh Profit updates.
SPEAKER_01Yeah, so it's going to recognize what you have connected and from a right-left perspective as well. So when you talk about saving time, I think that's critical. But I too have been trying to do that. Looking at the serial number, trying to figure out and play the tones and it just takes time. Exactly right. Then playing the tones, and can you hear the tones and can you find the device? So that is again part of when we talk about the the minute fit, yeah, that's going to automatically pull those devices in, side specific. You don't have to be reading everything, and I think that's a a big piece of it too. So when you they're connecting, then you still want to choose um what you have connected to the device from other acoustic um components, your fitting formula, and that's it. It's gonna best fit and do all of that right away.
SPEAKER_02And one more thing, I mean, it clearly um, you know, you need to contact your sales rep or your trainer and and and see this for yourself. But there's one other one that I I really want you to talk a little bit about, and that's the way that we're incorporating optimization for the venting and the insertion of the device with the feedback initialization.
SPEAKER_01Yes. So that those are always really, really important things as well. So when you think about Starkey has led in feedback cancellation, gosh, we always talk about, you know, from destiny perspective since 2006. So we are always working to make the initialization process certainly better. Um, but importantly from what we're doing with vent modeling and making sure we get that right out of the gate, too. Um, that's really, really important as part of your whole entire best fit routine. And so modeling that vent experience and making that right up front when you're selecting your acoustic properties and the device is also making sure that we're getting the right first fit much more um quickly than we ever had. We always previously were proud of ourselves for saying after best fit, Estat, you could likely get to your true best fit within a couple more clicks. So, one of the things that I've had to be talking to other professionals about is this is all new. Yeah, it is a new algorithm. So whether you were saying every time you hit best fit previously, you would do these three things. Yeah, don't do that. Right, right, right. Don't do that. This is new. Yeah, our vent modeling, all of what we're doing from our best fit perspective, um, even our receiver cables. Yeah. Uh so I'm trying to tell professionals really best fit. Yeah, don't automatically think you're going to make these additional adjustments, because chances are you will not have to.
SPEAKER_02Right. You must unlearn.
SPEAKER_01Uh it is very true, though.
SPEAKER_02And here's a here's a couple things. So I know that there are still some people that are concerned with the feedback initialization stimulus being too loud. Yeah. Which always seems crazy for me because we should, if if there's a moment where we can control the loudness for our patients before they go out into the real world, it should be in a clinical environment. And that feedback initialization process is so important. You need to run the feedback initialization on everybody to take into consideration the vent optimization. And you need to do it in their ears, not on the table. Because I know that some people do that. So do it in the ears because it will get to that optimization faster.
SPEAKER_01Yes, I I completely agree. That is great coaching for professionals because I've seen that as well. The nice thing is we always recommend that you do the initialization. You start with the best parameters, you start with what was how the device was fitting in the ear. But importantly, the feedback cancellor then does continue to learn over the first several hours of where. So it will get better, but why not start with the exact measurement of how that device fits in that patient's.
SPEAKER_02Completely agree. And then, you know, even with that minute fit and the four clicks, we still have the capability and we continue to enhance the ability to integrate with real ear measurements for those people who use it. It cuts the time down by half to get to that optimization. We're we're already optimizing on the venting for the individual patient, but then for those, and I believe real ear is an important part of best practice. We have made that more efficient in time too.
SPEAKER_01It's more efficient and much more accurate. Yeah. And we've proven that. Yeah. You know, our through our clinical trials as well, we're showing that it it can save you um half the time, but it as is as accurate as what you would get through a traditional measurement. Yeah.
SPEAKER_02And a couple things with uh we already run out of time because as as we know, we can talk about this all day. But um with ESTAT 2.0, and what we found in the clinical trials was we're delivering more high frequency gain above 3K without patient complaint of harshness. Yeah. And more audibility for those soft sounds. And patient testimonials have shown they're hearing things like watch ticks and some of the patients that I've been talking to, they're hearing things, but naturally. They're hearing them, discovering the sounds that they've missed, but they're finding that it's not oppressive, but it's rather they're delighted with the fact that they're hearing some of these sounds over that 118 dB dynamic range and finding that they don't have to listen as loud. It's not harsh, but they're finding they're hearing with greater clarity and greater sound quality.
SPEAKER_01Yeah, I think that's an important message. And you were talking earlier about the the way we've set up our compression scheme. Because the Estat 2.0 has about 6 dB more additional gain in the high frequencies, which may to some people then translate into oh my gosh, is is that gonna be too much or is that shrill? No. We didn't hear it. We have not heard it, and that is what's contributing to um the 10% improvement in speech intelligibility. We we've over unaided, which you might expect, but that's still a large number. Over unaided, it was 30% improvement in speech intelligibility, all while everyone's saying it still sounds natural. It feels quiet, other than I'm hearing speech incredibly well. And so it it has been very, very seamless.
SPEAKER_02Yeah. Well, thank you for this rapid fire uh discussion of the patient benefits, the professional enhancements. Um, we're obviously very excited about this to see uh for those of you who worked with us with the past, thank you for those who are considering uh this new technology. We haven't even gotten into things like the battery life, which is it blows people away when they have up to 51 hours of battery life.
SPEAKER_01I know I was thinking through some of that when early on we were talking about this being really robust technology designed for all day wear.
SPEAKER_00Right.
SPEAKER_01I hope you're able to have another podcast and talk through because we need to.
SPEAKER_02The the the battery life issues, the how robust and durable these devices are. We know that everyone can be delighted with the sound quality and intelligibility at the start, but they have to have the peace of mind to know that they have all day comfort and that it's gonna stand up in the environments where they're wearing their hearing aids. Exactly.
SPEAKER_01We we don't win unless the hearing aids can be worn and working. Right. Right. They have to be. They have to be. And and wearing hearing aids all day is is very different than some of the other technologies. And these are designed for beyond all the longest day that you can come up with.
SPEAKER_02The longest day that you can come up with. Some of those days we've been having lately. Right. But um, yeah, and so we'll we'll we'll continue this discussion. But thank you for this focus today on patient and professional benefits to our listeners. I hope you enjoyed this session of uh Soundbites. And uh please rate and review us and like us, subscribe so you don't miss a single episode when we come back to talk about some of the more amazing benefits that we've introduced with Genesis AI. And um tell your colleagues and your friends about this and feel free to forward it to them if you think it might be of interest to them. And then we also want to know what's on your mind? What sorts of questions or issues for the professionals do you have that you'd like to see us cover in future uh SoundBite podcasts? Um, you know, we we have a whole host of people here uh that can are experts and subject matter experts in different areas. So please uh send us a note at uh soundbites at starkey.com, and we'll be happy to uh try to feature some of your questions and comments and ideas for future podcasts uh in the future. And until then, I thank you, uh uh Sarah, for being here with us today and uh look forward to seeing and hearing you all again soon.