Jacoti, a Belgium-based hearing software research company recently emerged from stealth mode and has already won the prestigious 2016 CES Innovation Award for their smartphone-based Jacoti Hearing Suite. By leveraging the widespread availability of consumer devices with high quality audio capability, Jacoti seeks to make hearing assistance normative and ubiquitous, encouraging many more people to use professional audiological services earlier. In the United States, only between 16 to 35 percent of people with hearing loss in the US use hearing aids (HLAA, 2015) while internationally, nearly 80% of people with hearing loss “cannot access hearing healthcare services because they reside in developing countries where audiologists or hearing healthcare workers are unavailable” (Swanepoel, 2013).
While Jacoti Hearing Suite is a fully functional showcase for Jacoti’s approach to hearing healthcare, the patented and patent-pending core technologies can be incorporated into smartphone operating systems and new, custom hardware (including hearing aids) that would be “Jacoti-enabled.”
In this blog post, I’ll describe the design concepts behind Jacoti Hearing Suite and give an overview of the functionality of each component (Full disclosure: I regularly consult for Jacoti). Along the way, I’ll describe specific use cases and how the interconnectable and interoperable apps in Jacoti Hearing Suite work together. If you have an iPhone and are interested in trying Jacoti’s technology for yourself, the individual components of Jacoti Hearing Suite – including ListenApp, the world’s first FDA-registered and CE-certified hearing aid app – can be downloaded for free from Apple’s App Store.
Ubiquitous Personalized Hearing Assistance
Jacoti’s approach to development proceeds from the assumption that we can all benefit from audio personalized to our individual hearing needs, regardless of whether we have normal hearing or a clinically significant hearing loss. The challenge is how to provide personalized audio that can be empirically verified as effective.The approach Jacoti has taken provides clinically valid hearing assistance that just happens to run on your smartphone.
Jacoti Hearing Suite
Jacoti Hearing Suite presently comprises 4 interconnectable hearing applications, including Jacoti Hearing Center, Jacoti ListenApp, Jacoti Lola Classroom, and MyJacoti:
Jacoti Hearing Center is a hearing test that can be run on a stock iPhone and EarPods in quiet real-life environments. According to the labeling, “When used by consumers in real-life environments without the assistance of a hearing expert, Jacoti Hearing Center is intended as a screening device for informational purposes. When used under the guidance of an audiologist or a hearing professional, Jacoti Hearing Center is intended to be used as a hearing fitting and hearing diagnostic audiometer.”
Hearing Center is based upon a new patented method called DuoTone® that was developed by German audiologist Frans Coninx and acquired by Jacoti. Both clinical studies and calibration tests demonstrate that DuoTone provides results comparable to standard pure-tone audiometry tests without specialized equipment or special soundproof rooms (publication in progress).
Such a simple testing protocol has many real-world uses. For example, an audiologist in the the US can do onsite hearing evaluations in schools without requiring an isolation booth. In developing countries, Jacoti Hearing Center can be used by a telehealth facilitator to screen large populations (such as an entire rural province in India) and the hearing profiles generated can then be emailed to audiologists (e.g., in the US) for remote evaluation. In addition, Jacoti Hearing Center can be used by anyone to check their hearing informally whenever they want to.
Jacoti ListenApp is the world’s first software hearing aid that is CE approved and also registered by the US FDA as a medical device. Suitable for use by people with mild to moderately-severe hearing loss, it enables an iPhone to be used for hearing loss compensation in, for example, restaurants and theaters (I use it that way several times a week with excellent results). ListenApp also provides customized audio for any iOS Inter-App audio-enabled application, including a user’s music library and other Jacoti applications.
To start, an audiogram is entered into ListenApp (future iterations will enable the results of Jacoti Hearing Center to be entered directly). ListenApp then generates an audiological fitting (using a proprietary algorithm) which is stored in the cloud and can be adjusted by a remote expert (myJacoti, see description below). The user then selects either the iPhone’s mic (or an Inter-App audio-enabled application from within ListenApp) and the fitting is applied to the sound before it is output to the earphones. The result is personalized audio for anyone with clinically normal hearing to those with moderate to moderately-severe hearing loss. The sound of ListenApp can be further adjusted by the user via four presets – Natural Sound, Speech, Music, or Movie – as well as by simple volume and tone controls.
Jacoti Lola® Classroom is an app that turns iPhones and iPads connected to a standard WiFi network into an extremely low-latency bidirectional classroom assistive listening system. The sound quality of a Lola system approaches CD quality. All users of a Jacoti Lola Classroom system can use their devices both as transmitters or receivers.
There is no limit to the number of devices that can be connected to a single Lola network. A single WiFi router can handle from 5-15 Lola-enabled devices depending upon the router. If more are needed, additional routers can be added to the network and easily linked together with no degradation in performance.
In a One-to-One classroom (where each student has his or her own device), a Jacoti Lola Classroom system is a very cost effective and non-stigmatizing assistive listening system. When acoustics are poor – or for high quality sound streaming from media – students with normal hearing can use Jacoti Lola Classroom directly. For students with hearing loss, Jacoti Lola Classroom interconnects seamlessly with Jacoti ListenApp, enabling all students to use the same listening system.
The technology behind Jacoti Lola has numerous use cases beyond the classroom, of course. For example, installed in a movie theater, Lola can deliver customized audio via WiFi over a patron’s own smartphone and earphones. In a noisy convention hall, Jacoti Lola can be used to provide clean wireless audio with a high signal-to-noise ratio for talks or demos via a listener’s own smartphone or tablet – no special headsets need to be checked out or returned.
MyJacoti is a web service that allows audiologists and users to store audio profiles in the cloud and share them across devices. Users can connect to a remote Hearing Expert for remote fitting adjustment. For example, a new user would open up a HIPAA-compliant account and download Jacoti Hearing Center onto her iPhone. After taking the hearing test, a hearing profile as well as the generated fitting is stored in myJacoti. From there, the hearing profile can be downloaded to, say, an iPad, Apple Watch, or computer, for audio customized in a consistent manner across devices.
Audiologists using myJacoti can access a full platform of audiological fitting algorithms and tools similar to NOAH that provide extensive customization of a hearing fitting. This enables best practices to be followed remotely in many parts of the developing world where hearing healthcare professionals are few and far between – or not available at all.
From Products to Services
While the traditional model of hearing healthcare is dependent upon selling specialized, proprietary products such as hearing aids with a bundled package of services, a model of hearing healthcare utilizing common consumer technology implies a “services model” for the delivery of hearing healthcare. In a services model, familiar, off-the-shelf and easily obtained consumer devices are configured via software to deliver cutting-edge hearing healthcare based on audiological best practices. Many consumer devices such as an Apple or Samsung smartphone have superb audio specs and include powerful audio digital signal processing (DSP) that can be configured for use in accord with audiological science.
Thus, software companies like Jacoti can create applications that run on consumer devices and audiologists can charge to set them up, interpret test results, supervise fittings, and – because the technology is only one component of effective hearing healthcare – suggest auditory rehabilitation protocols.
Low-latency, high-quality wireless audio streaming between a mobile device and headphones/earphones is still in an early stage of commercial implementation. It can – and soon will be – vastly improved because of the numerous consumer applications that could benefit from a fast wireless protocol including gaming, virtual reality, and other interactive use cases.
The happy beneficiary of this low-latency protocol will be people with hearing loss who will have a wide range of hearing devices to choose from. Some of these devices will be small and nearly invisible like today’s hearing aids, but many will be larger and as fashionable as designer eyeglasses.The ubiquitous public deployment of in-ear devices in the general population is a growing trend. The growing use of very visible headphones and Bluetooth headsets it is likely to help reduce stigma for the use of hearing assistance technology among people with hearing loss. And as hearing assistance technology becomes more widely used – and even hip! – more people with serious hearing problems are likely to seek out professional audiological services and do so sooner.
Hearing healthcare should be widely accessible and widely used. However, too often – and especially in the developing world – it is too expensive, too difficult to find access to qualified professionals, and too often, people who could benefit from hearing assistance tech simply don’t use it.
Jacoti’s approach to hearing healthcare utilizes consumer tech to make empirically valid hearing assistance widely accessible so that more people can get the help they need. Doing so is likely to motivate people with hearing problems to enter the professional hearing care environment sooner and to give audiologists an opportunity to focus on holistic care for their patients.
HLAA (2015, April) – Wider Access to the Full Spectrum of Hearing Technology
Benefiting People with Hearing Loss. Hearing Loss Association of America.
Swanepoel, D. (2013, October). 20Q: Audiology to the people – combining technology and connectivity for services by telehealth. AudiologyOnline, Article 12183. Retrieved from: http://www.audiologyonline.com on December 14, 2015
About Richard Einhorn
Richard Einhorn is a composer, former record producer, hearing loss advocate and consultant. His music is performed all over the world and his production of the Bach Cello Suites with Yo-Yo Ma won a Grammy. On the Board of The Hearing Loss Association of America, Richard’s advocacy for better hearing healthcare has been featured numerous times in major media and he regularly speaks and writes articles on the subject of hearing loss technology.
Last modified: January 17, 2016