Signia Pure 13 BT Detailed Hearing Aid Review

Over the last two months, I’ve had the opportunity to wear another top-of-the-line hearing aid — the Pure 13 BT from Signia. Hearing Tracker and Signia worked together to organize and support this trial with the hopes of providing hearing aid users a glimpse into the latest innovations in hearing aid technology. As an unbiased user with no affiliation to the hearing industry, the contents of this article are derived entirely through my personal experience. You may notice references to the Oticon Opn 1 as it’s the only other modern hearing aid I’ve worn that measures up for an apples-to-apples comparison. My main goal is to provide another perspective when evaluating the latest-and-greatest hearing aids regardless of whether you’re in the market or just trying to familiarize yourself with their capabilities.

A brief introduction into the Signia Pure 13 BT

• Released on May 15, 2017
• Receiver-In-The-Ear (RITE) Hearing Aid
• Direct Bluetooth Connectivity – Made for iPhone (MFi Certified)

I realize as I write this, that Signia just announced their Pure 13 Nx and Pure 312 Nx, but I suspect those models are incremental improvements over the Pure 13 BT. It’s likely that they share many common characteristics amongst the new features and enhancements, hence making this review somewhat applicable to them as well.

Physical Design

The words that come to mind when describing the Pure 13 BT are: rugged and sturdy. The shell seems strong enough to sustain the accidental drop, exposure to the elements, or an active lifestyle. It does come with the option to use domes or molds for the receiver in the ear. The degree of hearing loss is likely the determining factor on the most appropriate option for you. The rocker switch on the hearing aid can be programmed as a volume control, program changer, or as a hybrid of the other two options. I, personally, found the Pure 13 BTs a little bit bulky when worn with glasses, and noticed the glasses slipping off my face a bit easier than with the Oticon Opn 1s. This might not be a problem for most users, but be sure to look out for it if you wear glasses for large periods of time or move your head in different directions frequently. I attributed the “bulkiness” to the required size 13 battery, so if this an issue be sure to look at hearing aids that use the thinner size 312 battery – like the Pure 312 Nx. The only physical design flaw — if I could call it that — was with the battery door. If I happened to hold the hearing aid upside down or on an angle when opening the battery door fully, the battery would fall right out. I often change my hearing aid batteries while the hearing aid is still in my ear or as I’m doing something else – mainly relying on the my sense of touch rather than sight. This led me to dropping batteries frequently and some general clumsiness. If I were to design the ideal battery door, I’d make sure the battery required a gentle pull to disengage it before it fell out.

Sound Quality / Listening Experience

Before delving into this section, I want to emphasize that how one perceives sound is very subjective. It depends on your degree of hearing loss, sound preference, and many other factors which can vary from one person to the next. Everything written in this section should be taken with a grain of salt.

The Universal Program on the Pure 13 BT faired well with providing a good general listening experience in most day-to-day environments. I thought the Noisy Environment and the Reverberant (i.e. echoey) Room programs stood out in making speech easy to understand in their respective operating environments without sacrificing background noise. The sound was well balanced between speech and noise, and made communication in those environments relatively easy. The specific use cases for testing these features were: talking with my wife in the car over the radio, dining in a loud restaurant, and conversing in the middle of a bustling mall. One interesting feature on the Pure 13 BT worthy of mentioning is the Spatial Configurator, which gives one the ability to focus the hearing aid’s microphones towards a specific sound source. I didn’t have to use it very often, but when I did it certainly made listening to a specific sounds easier. This feature is particularly useful in noisy environments where the hearing aid may not be smart enough to figure out what exactly you’re trying to listen to or tune out.

One of my biggest pet peeves with the Pure 13 BT was the volume control. Once you start changing the volume, there is no concept of default or midway volume level. Most hearing aids I’ve worn have always had a reference tone that sounded different from the volume up or down tones. With the Pure 13 BTs, unless the iPhone app is open it’s difficult to know how far you are from the minimum, maximum, or default volume setting. The only workaround I came across was switch to another program and then switch back, which effectively reset the volume to the default setting. I’m not sure if this was just not enabled by default or is missing altogether, but it was definitely annoying.

How does all of this compare to the listening experience on the Oticon Opn 1? Well, I missed its Universal Program. With the Opn 1, I rarely change programs at all because adjustments in volume are usually all that I need. The Pure 13 BT’s Universal Program was not able to match that experience and I had to switch programs more often as a result. However, the Noisy Environment and Reverberant Room programs I mentioned earlier performed better in those listening scenarios than what Opn 1 offered. On the whole, I find the sound from the Opn 1 to be more “natural” to my ears and I seemed to have an easier time hearing sound, understanding speech, and adjusting to the hearing aid. The ability to understand people when conversing in general listening environments is the singular, most critical quality that makes me pick the Opn 1 over the the Pure 13 BT as my hearing aid of choice, despite the shortfalls in the Opn 1’s feature set and bluetooth issues. If the Pure 13 BT’s sound works well for you, the additional features it supports would make it the winner in a head-to-head comparison with the Opn 1 from my point of view.

Battery Life

The size 13 batteries seemed to last me on average around 4 days, with moderate bluetooth streaming. This is on par with the Oticon Opn 1, which uses size 312 batteries, and falls within the normal range for battery life according to Hearing Tracker’s hearing aid battery life survey.

Feedback System

No one likes to hear squealing and whistling from their hearing aids and I’d say the Pure 13 BT delivers on this experience fairly well given my severe hearing loss. I have yet to wear a hearing aid with zero feedback, but this one did a good job at keeping it to a minimum. I noticed feedback most frequently when my hearing aid was directly touching another object like a pillow or couch cushion, or when giving someone a hug. Tightly fitted molds or domes are crucial to providing this experience, so if you’re noticing a lot of feedback with this hearing aid be sure to get in touch with your hearing professional. Overall, I thought the feedback system on the Pure 13 BT functioned better than the one on my Oticon Opn 1s.

Bluetooth Connectivity & Streaming

Like all other Made for iPhone hearing aids, the Pure 13 BT can connect directly to an iPod, iPhone, or iPad. It has the ability to stream audio directly to the hearing aids when music or videos are playing on the device, through voice and video messaging apps like WhatsApp or Skype, and during phone calls. By clicking the home button 3 times, you have the ability to select which interface you want sound coming out from, and also configure some personal preferences. For example, you can instruct the iPhone to only use one hearing aid or both for phone calls.

What impressed me, was the quality of the Bluetooth stream. In normal usage conditions the stream was mostly free from jitter and clicking, and the sound quality was great. Compared to the Oticon Opn 1’s bluetooth connectivity and streaming, this experience was much better in both phone calls and audio streaming. Binge watching Game of Thrones and work meetings over the phone provided hours of uninterrupted bluetooth audio streaming to support these results.

In addition to the above, the Pure 13 BT also supports a Bluetooth-enabled TV Streamer – a device that hooks up to the back of your TV and streams the audio directly to your hearing aids. Pairing your hearing aids with it as easy as placing your hearing aids on top of the device. This is a big feature for me, and I found that I relied less on the subtitles.

The main downside to Bluetooth streaming on the Pure 13 BT is that it does not have dynamic controls that let the user set the volume of the sound entering the microphones. There is fixed level of muting that takes effect as soon as you start streaming or you can mute the microphones entirely. These options are a bit too rigid to be practical in daily life, because different circumstances require different settings and the user only has two options. This is the one feature I miss from the Oticon Opn 1 when it comes to Bluetooth streaming.

The major shortcoming of the Pure 13 BT’s Bluetooth abilities is that it does not yet support streaming from Android devices and it lacks a fully compliant Bluetooth Low Energy implementation. This is an important bridge that must be crossed in order to truly make this hearing aid a global success. More than 86% of mobile devices worldwide run on Android as of Q1 2017 according to Statisa – a statistics website. This means a large segment of the global population that is being neglected in order to cater to the 14% iOS market. The Phonak Audeo B-Direct is currently the only hearing aid that caters to Android users by providing audio streaming abilities and phone calls over Bluetooth. The lack of Android support is inherent to all “Made for iPhone” hearing aids, not just the Pure 13 BT.

Phone Apps

The Pure 13 BT comes with two apps from Signia – myControl and myHearing. The myControl app is the “remote control” for the Pure 13 BT and the myHearing app provides the remote fitting ability through Telecare. This section will mainly focus on the myControl app while the myHearing app will be discussed more in depth the section on Telecare.

The myControl and myHearing phone apps for iPhone/iPad are functional, but the user interface (UI) seems a bit dull and dated compared to the modern UIs found on any of the Top 50 apps in the Apple App Store. They both provide standard controls for volume and program changes through sliders and drop downs. Based on the current look and feel of the UI, I’d guess that Signia is more focussed on developing the core logic of the features rather than a flashy user experience. However, they shouldn’t wait too long improve the UI since it’s the main interaction point with the end customer. It needs to be visually appealing, intuitive, and simple.

The data gathering and analytics features that track hearing aid wear time, complexity of listening environment, sound loudness, and more are useful tools in helping users understand how they use the hear aid. It provides the user with concrete data that can be useful in current and future bug reporting, fine tuning, self-help, and machine learning applications.

Telecare

This feature is the crown jewel and main differentiator for the Pure 13 BT when compared other hearing aids in its class. Telecare allows a hearing aid to be configured remotely by a hearing professional through the myHearing app. There is definitely a gap in feature parity between Telecare and fitting software in clinics, but foresee this gap closing quickly.

During the setup process, the phone must have cellular network connectivity in order to receive an SMS message containing a 6-digit access code sent by your hearing professional. This access code enables the Telecare and your hearing aid to establish a secure connection. To get past the setup screen on the myHearing app when it is run for the first time, that SMS code needs to be entered into the prompt. Once that is complete, the myHearing app should work as long the phone and hearing aid are paired via Bluetooth, and the phone has a working internet connection over Wi-Fi or cellular network.

On the surface, the myHearing app is a lot like the myControl app – they share a common look and feel. It also has controls to change programs and adjust hearing aid volume with a slider, and has the same data analytics capabilities that can track your wear time, listening environment complexity, program changes, volumes, and average loudness on an hourly time scale. All that analytics information is available to the user in the form of some rudimentary graphs that are accessible over the user interface. The main difference, is that all that data is now periodically uploaded to the cloud and available for a hearing professional to examine. This allows them to actively track the satisfaction and progress of the patient as they get used to the hearing aids in near real-time. Before Telecare, that data could only be shared when the patient physically went to the hearing professional’s office and the hearing aid was connected to the fitting software. Now, that is a thing of the past! The myHearing app also has built-in ratings system that ask the user daily to rate their listening experience with the hearing aid. There are exercises a hearing aid user can go through test various aspects of the hearing aid’s settings. It’s a great means for the hearing professional to gather daily data points on the satisfaction the user in specific listening scenarios. This is especially important when a user first starts wearing the hearing aid since that’s when most of the “big” issues are uncovered. If too much time passes before audibility issues are resolved, the user loses interest and returns the hearing aid citing a bad hearing experience. Through Telecare and the myHearing app, providing quick solutions through software configuration tweaks has the potential enhance the on-boarding experience and user satisfaction by many orders of magnitude.

The myHearing app is also equipped with a built-in Instant Messenger (IM) that is functionally similar to WhatsApp or Skype. The user has the ability to a write a quick message to their hearing professional and let them know their current experience in a particular situation. No more trying to remember things for the next visit! For example, while shopping in the mall I quickly pull out my phone and write “I’m having a hard time clearly hearing my wife when walking around the mall due to all the noise”. Your hearing professional is notified of this message seconds later, and they can either message you back to get additional information or provide a new change to your hearing aid’s configuration via a software update. That change is sent to your phone, and you receive a notification that the hearing professional has proposed an update to a specific program. You have the choice whether to accept it or decline it. Once the change is made, you can immediately test it out. The turnaround time depends on your hearing aid provider’s availability and time of day, but this whole processes can be completed from beginning to end in as little as 5 minutes. This whole process can be repeated many times until you have converged on your optimal settings and are fully satisfied with the hearing aid’s performance. I suspect that hearing aid providers will institute Service Level Agreements (SLAs), that specify the turnaround time to respond messages and to provide support as this method of hearing aid fitting becomes widely used. Patients should have options to pay for varying levels of support for the 3 to 5 year term of their hearing aids, or pay-per-use for those who are cost-conscious. These types of cost structure support the current efforts to unbundle services from the upfront costs of hearing aids thereby enabling consumers to optimally use what they pay for.

One feature that I did not get a chance try out with the myHearing app, was the audio / video calling. Rather than using the Instant Messenger to reach your hearing professional, you can instead reached them via a phone or video call. I personally preferred the Instant Messenger option because it seemed a lot less time consuming and requiring less of my attention. Most things I asked for were minor adjustments; however, had it been a more complex issue that required a lot of explanation I probably would have opted for the phone or video call.

A word of caution when using Telecare: monitor your mobile data usage! If the features mentioned above are used over mobile data, you may get an unpleasant surprise at the end of the month when your phone bill arrives. Video calls are notorious for their data usage, and even some of the data analytics cloud uploads, instant messaging, and receiving of new configurations may have a significant impact on your data plan. This is an area that I feel Signia needs to closely monitor, test, and optimize through their software because it has the potential to frustrate users if data overage charges start appearing on mobile phone bills.

My experience with Telecare was good given the newness of the technology. I was able to uncover a few software glitches here and there. The main ones were some battery drain issues with the myHearing app, the occasional crash that required me to restart the app, and some lag when switching between the main screen and the Instant Messenger. I fully expect all these growing pain issues will be resolved in near future given the rapid pace of development on the myHearing app. The cloud fitting software, Telecare, is also undergoing rapid development in tandem with the myHearing app in order to establish feature parity with their current, in-office fitting software. Overall, I commend Signia for leading the industry in breaking new ground with this great technology! Hearing users around the world stand to benefit from the time savings and quicker process of getting onboarded to a new set of hearing aids.

The Verdict

The Pure 13 BT is a very capable hearing aid and one that competes well with other hearing aids in its class. If I was shopping for top-of-the-line hearing aids today, I’d definitely add it to my Top 3 shortlist of hearing aids – especially given its rich feature set and remote fitting capabilities. Telecare is not only a unique differentiator, but it’s a game changer for the hearing industry as whole. It will force all other manufacturers to provide similar solutions as the remote fittings trend takes hold, which is a benefit to hearing aid users worldwide. While I’ve also pointed out some shortcomings in the design and features of the Pure 13 BT, there is not much that can’t be modified through a software upgrades – unless it’s a hardware-related issue or limitation. I do hope to see the ability for firmware upgrades to the Pure 13 BT be delivered via the myControl app alongside regular updates to the iPhone apps. Bluetooth support for Android devices is also high on my list, given the amount of hearing aid users that can potentially benefit from it. The Pure 13 BT was a great introduction to Signia’s hearing aids for me, and I look forward to future developments in their product portfolio. Thank you to Hearing Tracker and Signia for their support in making this review possible.

Corrections: An earlier version of this article erroneously stated that Oticon did not have a TV streamer for Opn. It has been pointed that the Signia Pure 13 BT received a recent firmware update that fixed the default volume beep issue that was cited as the “biggest pet peeve”. While I cannot confirm it for myself, please be aware that it should no longer exist.