Friday Audiogram: Patient First, Technology Second

Start with a person, not a feature list. That’s the thread that runs through our conversation with Brandon Sawalich and Dr. Dave Fabry about how hearing technology actually improves lives: by putting the patient first, then letting smart tools do the heavy lifting in the background. We dig into how AI moved from a buzzword to a real advantage in tough listening environments, why sound quality remains the non-negotiable foundation, and how “the ear is the new wrist” reframes what a hearing aid can be.

We share the inside story of building Starkey's Omega AI and the eighth generation of sound processing, including DNN 360 and a neuroprocessor designed to make great hearing the default. Think of it as an easy button for clinicians: set a strong baseline fast, then spend time on what only humans can do—listening, coaching, and fitting for comfort. The Da Vinci surgical system offers a useful metaphor: technology doesn’t replace expertise; it amplifies it. That’s how we see the partnership between AI and hearing care professionals, and why robots won’t be fitting ears anytime soon.

Beyond better hearing in noise, Brandon and Dave talk about the bigger health picture. Untreated hearing loss intersects with cardiovascular health, cognition, and social engagement. So Starkey built tools that track activity, encourage connection, and enable voice control without adding another gadget to your routine. They're honest about the pushback that comes with change, the “Swiss Army knife” moment, and what they learned about leading with clarity: it’s a hearing aid first, with multipurpose superpowers second.

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Chapters

• 0:00 Patient-First Philosophy
• 0:21 Privately Held, Faster Decisions
• 1:25 AI Moves From Buzzword To Reality
• 2:06 From Hearing Aid To Multipurpose Device
• 3:06 Empowering Pros, Not Replacing Them
• 4:20 The Ear Is More Than An Audiogram
• 5:24 Health Links And Activity Tracking
• 6:12 Pushback, Learning, And Clear Messaging

Transcript

Blaise Delfino: 0:00

This is the Friday audiogram.

Brandon Sawalich: 0:02

Let's go. Well, it starts with a patient, right? We all know this. And everything that we do, you know, is it best for the patient. And this the philosophy that hearing is essential. And what allows us the flexibility is I mean, first thing is, you know, the patient is number one, and we're privately held. So our priorities are what's best for the patient, is best for our customers, is best for Starkey. So we can make decisions that we know that the patient, what the patient benefits require. But also, you know, we can make the decisions on, you know, or I'll say we can take risks. So we could make the decision to take certain risks. And if, as Dave, as you know, is we try it and it we build on it if it's successful. And if it's not, you fail fast and move on.

Blaise Delfino: 0:50

Something that you you always say, Brandon, is that customers are are the shareholders and and the people of Starkey are the shareholders. And being a privately held company, you really don't have that bottleneck of a board. I mean, the people of Starkey are the board. And um, being a hearing care professional myself, growing up in the industry as well, and seeing the evolution of where Starkey has been even from 2017 to now, um, on behalf of the industry, thank both of you for what you've done and continue to do for the patient, because we know that you lead with the heart and it's all for the patient. Brandon, AI. A couple of years ago it was a buzzword. Now it's it's real. Um, health monitoring, many companies are are essentially playing catch-up. What is it about Starkey's leadership mindset that allows Starkey to really push the boundaries or even push the edge of what's possible?

Brandon Sawalich: 1:46

Well, we started the AI revolution in the hearing industry in 2018. And again, it was all about the sound quality and we wanted the best hearing aid. And then taking that from single purpose to multipurpose. And I think you know, Dave uh one time coined uh the year is the new wrist. And I used that, but I give you credit for it because people instantly can relate. Um, using AI to help people not just hear better, but be the best that they could be each and every day. We empower them. So we're empowering them through our health features, um, along with personal assistant and other other areas, but we don't lose focus on what's best. And it starts with you know the sound quality because people want to hear better noise. So we're on our eighth generation now, uh, just launched, uh, the best generation uh with Omega AI. And the uh the sound quality there is is uh out of this league. And because you know, two 2023, I made a statement that in five years I'm gonna be 10 years ahead. And in order to do that, you have to set the pace of innovation, and and we're doing that with the team here.

Blaise Delfino: 2:51

It's so incredible to witness because we bring up Jim Collins good to great, and Starkey will be and is is definitely on the road to becoming that great company. And it all comes down to that leadership and the people that make up the organization. The three of us co-wrote an article on emerging technologies, and we talked about the Da Vinci surgical system. And when this was introduced, I mean, Dave, you had said, hey guys, we should talk about the DaVinci surgical system and how uh a lot of physicians thought that this specific system would totally annihilate what they were doing uh in terms of surgery. Can you unpack how Starkey's using AI to empower, not overshadow hearing care professionals, especially now with Omega AI?

Dave Fabry: 3:39

Sure. Um and and just for those who hadn't or aren't familiar with either that article or uh what Da Vinci's surgical system was, it was introduced probably like 25 years ago, around the turn of the century. And they were using robotics in the OR to do some of the fine motor control that really the robot can do better than a human. But many of the surgeons felt that it was an attempt to replace them rather than augment their skills. And so, similar to us, we believe that our technology in the professional's hands delivers the best outcome for the patient, and we'll never deviate from that. As Brandon said, you know, it's all about the patient, but we also know that it's the expertise of the professional with our technology that can optimize, personalize, customize those solutions for the patient and their lifestyle better than anything else. In the same way that that Da Vinci, um, when they came out and said robotics are gonna eliminate the need for surgical expertise, it failed. Till they came back and they built a bridge that now works so that the surgeon and the robot work in tandem to deliver better outcomes. And so it is consistent and it is a good metaphor for where we're going.

Brandon Sawalich: 4:50

What we're doing is, you know, with our AI, DNN 360, and our neuroprocessor, we're putting in a built-in easy button for the professional so that allows them to save time so they can focus on the patient and understand what the patient needs are, less with having to uh worry about the technology. I mean, we're making it better and easier and sound incredible, but then they could focus on the human aspect. Trevor Burrus, Jr.

Dave Fabry: 5:15

Exactly. And what I've said for many years is that you don't know your patient until you know your patient. The patient is far more than the audiogram. In fact, the audiogram is a blunt instrument, and every professional listening has had two patients that have the same audiometric parameters but have very different experiences with hearing loss or even with hearing aids. And it's because of all of that human element. Right. And and the role of the professional that can never be commoditized is caring and learning and really listening intently to that patient and what his or her concerns are regarding their hearing loss, what are their fears about, or or what stigma do they carry with them if they're first-time users.

Brandon Sawalich: 5:55

Trevor Burrus, Jr.: It's really what Bill was talking to us about yesterday is is, you know, and we do this when, and I know you do when you're seeing your patients, is finding the ability. Yes. But not worrying about what's wrong and the negative connotation and you know, how we talk, I think it, you know, one thing we've done a good job of is how to think differently and and use um different terminology. Um and it's really finding somebody's ability and not what the loss is. But that's individualized.

Dave Fabry: 6:21

Personalized. And and and the issue, you know, Brandon uh talks about this in the uh as friendly AI in many ways. We're not doing and we're not using AI for the purpose of eliminating or automating this, and the machines aren't going to take over the world anytime soon, in my opinion, because I can tell you how many times I see um uh patients that are fitted, but but maybe they didn't do the little things, like understanding that the patient has really narrow ear canals and the devices are uncomfortable. You can have the best technology in the world, but if it's not fitting in the ear comfortably or that they can't get it easily in and out of their ears, it's not gonna be a good experience for them. So you have to take every element and operate at the top of your scope of practice. And then Brandon also said, you know, since 2018 we've been on this journey. Job one is always hearing better. The other, hearing loss doesn't occur in a vacuum. And many people outside of our discipline don't think about the links between uh untreated hearing loss and cardiovascular disease. That that helps uh uh indicate, you know, many cardiovascular surgeons will say that in an aging individual, their audiogram is often the best barometer of cardiovascular health because of the blood supply issues that go, that minute blood supply that goes to the ears. Hence we built in devices that can track physical activity, cognitive function in terms of the social engagement, and we've taken that ball and run with it. And then, as you said, with the generative AI now, it it's crazy the things that people can do to command and control their hearing aids using just their voice.

Blaise Delfino: 7:47

You had said that when Starkey first introduced Livio, and I mean, I was practicing and I was like, holy smokes, this is incredible. This is like a switch army knife for hearing aids. It's it's amazing, it'll do everything. But you and and Starkey experienced what we would call some pushback from even some of your most loyal customers, people that you knew for 20, 30 years. As a leader, how did you digest all that information and even assure them that it's going to be okay because in five years from now, like your concerns are gonna be sort of not concerned anymore?

Brandon Sawalich: 8:24

We were learning too. I mean, it's you know, it was an opportunity, it's the way I look at it, because you know, there's gonna be certain things you try and it doesn't work. Uh, but a lot of the futures that we started with were still building and expanding and making them them better. And, you know, our um our the people of Starkey and from myself, you know, everyone else really had to learn how to talk about it because we were excited, but you mentioned it and you've uh you know, I I've called it this is we kind of talked about like a Swiss Army knife, and it just we you know, everybody's eyes would get big and we just kind of gloss right over. Um the main important part was it's a hearing aid and it sounds it here's what the functionality and it has this. We talked about everything because we were excited. So it was an opportunity to educate, train, but really the opportunity there was the possibility of what can be done and really bringing the hearing aid into that multi-purpose personal assistant type device. And you know, I will say that you know, when you when you're first out, you're gonna get a lot of pushback, something new, it's change, right? And people's time is valuable. And so they had to learn how to talk about it as well. And that was from our learning moments, uh, following up, you know, with with our uh other products afterwards. It's you know, we made it easier, but our excitement kind of uh uh you know, brought excitement to the industry, but also uh a little bit of confusion where we had to step back and and understand how you know we trained and developed and what they needed to focus on.