Providing Cerumen Management in the Hearing Healthcare Clinic, Live from the FHH 2023 Conference

It. All right, well, welcome to the future of hearing healthcare and a panel on Cerumen management. We know that cerumen is a common issue that many consumers experience. And with me today are three guests whose companies provide resources and strategies to manage this issue. So in bottom right hand corner there is Jackie Phillips from Safkan Health. On the left there is Mark Campbell Foster from Redux. And on the bottom left here of my screen is Rob Koch from AHead Simulation. So thank you all for being here, and I’m ready to dive in and get into this. Yes, we’re excited. All right, so let’s start out with a quick introduction of our panelists. So, Jackie, if you wouldn’t mind starting us off, please. Yeah. Thank you so much, Amyn And thank you guys for having me. Really excited to be part of this panel and part of this conference. So my name is Jackie Phillips. I am the VP of Sales at Safkan Health. Safkan Health has a device called the Otoset that helps clinicians administer wax removal automatically. And it’s the only FDA cleared device. So that’s kind of where I’m from. All right, Mark, would you introduce yourself, please? Hello, everyone. My name is Mark Campbell Foster, and I’m the audiologist and director of audiology sales and marketing at Redux. I have bilateral- bilateral hearing loss as well, with cochlear implants, and I work for a company called Redux. And we make a dryer that essentially revives dead devices more than 50% of the time and makes weak devices and good devices sound better more than 80% of the time. So I’m looking forward to chatting more about that. And thank you to all for having me chat today. Wonderful, thank you. And Rob, would you mind sharing yourself with the audience, please? Absolutely. Thanks, Amyn. My name is Rob Koch. I’m the president and founder at AHead Simulations. And we produce CARL, which is a simulator for a wide variety of purposes within hearing healthcare, including training, research, and demonstration. And for our purposes today, CARL is one of the leading tools that are used to train individuals on cerumen management. All right, so let’s dive in. So cerumen is one of these things that we continually hear about, and it’s one of these barriers, if you will, to use. It’s also a barrier in clinic when you can’t remove the earwax and test the individual or fit them with a device or what have you. And as you all pointed out, you all come from companies that provide tools and resources and technology that will help overcome this. But let’s start out with the most basic question. It. Why is cerumen such a big issue? Yeah, I guess I can start with that. I would say out of the US. There are 35 million Americans who are impacted with earwax impaction. And every year over 12 million people or patients are seeking professional help for this and is also the leading cause of conductive hearing loss and one success. Statistics I find it very interesting is one in three over the age of 65 have earwax issues. So the numbers are there and the patients are really seeking a solution to their problems. So how we can tie into that is that earwax impaction can also cause hearing aids to sound like they’re dead. And so if you’re putting in your ear, it leads to frustration. And so Redux offers a solution for drying out hearing aids because also moisture comes from earwax as well. So when you have a hearing aid receiver inside near earwax, you’re essentially soaking that receiver is taking on moisture. And so Redux can really dry out those receivers in the electronics of the device. But also we really need like services like Otoset and AHead like CARL ratherto be able to manage cerumen. Because if we have the cerumen removed, the hearing aid sound better because there’s no longer the occlusion, there’s no longer that moisture going into the device. So it really is this team approach, I think. I’d also add that is such a crucial part of the clinical workflow. It’s something that I don’t think really got enough attention in the years before. And now people are really recognizing that in clinical practice and when you’re seeing patients, it’s not every now and then it is really becoming more and more important and it’s getting the emphasis that it finally needs. So it’s really, really critical to the actual workflow that the clinicians work through. And to back up Mark really quickly on the stats there, it’s 70% based on the top five hearing aid companies, 70% of hearing aid going in for repair are due to wax. So that’s a high percentage. And let’s talk about the fact that ear wax is like a self cleaning oven, right? Anytime you stick something in the ear, you generate wax. So just the inherent use of hearing aids is really going to promote needing management. Sorry, Amyn, I didn’t mean to jump in there. No, this is a great conversation and where I was going to go with this is kind of take what Rob talked about and that is the whole clinical efficiency piece. When I was a clinician, I had a lot of my peers who had been trained in their academic institutions and through their externships on how to remove wax. But once they got into clinic, they either didn’t want anything to do with it or they weren’t allowed to do anything with, depending on the policies of that particular workplace. And so, as we’re talking about these. Workflows. How is it that your companies now help overcome some of these issues? Whether it’s fear or whether it’s lack of training because you haven’t done it in a while? Or how is it that you can now partner with a physician and say, you know what, I know how to do this. Let me help you, because by me doing this, it frees up your time to do something else. Can go. I didn’t know if I want to go first or again, but I don’t want to dominate. But, yeah, the request for us, for our company, what we’re doing is our device was created by a user, by someone who went to a physician’s office with impacted earwax and felt the need to create something that was not intimidating to the consumer, to the patient, or to the clinician. So that’s why he created a headset that is all the waste and the water is all self contained in the headset. So then therefore, it’s not messy for the patient or the clinician, but also it’s an automated system where you press the button and it automatically does the work for the clinician. So those clinicians who are a little nervous or intimidated maybe about putting digging down into the ear canal deep. If it’s a deep impaction, we’re alleviating that concern or that fear of hurting the patient because we have an FDA cleared device that is a press of a button that will help the patient and the clinician to have a safe and reliable experience and to support that statement. So while this ear cleaning is going on, if they’re using devices, they can’t wear their hearing devices, so you’re able to put them in the redux. So talk about clinic efficiency is that you finally have a dryer that can dry hearing aids for the clinician in six to eight minutes on average. Current dryers that we have today don’t remove all moisture like Redux does. So, again, that’s one of the talk about clinical efficiencies. Get a Redux dryer because that’s six to eight minutes, and that restores and resolves a large majority of the devices being affected by moisture issues, such as with earwax. Yeah. And on our side here, earwax removal is really one of the few things that within hearing healthcare. It has some potential to do some bad and do some damage if it’s not done effectively. And so being able to have your clinicians properly trained, not only a certified online check mark, but actually feel confident when there’s a patient in front of you and know how to navigate around different kinds of impacted earwax, that’s where we’ve tried to emphasize our training solution. And that you can on our CARL Mannequin. You’re not going to hurt Carl. You can poke and prod at his ears. You can do things wrong. You can get comfortable. And then only once you have the technique down, you can move on to patients. And what we’ve seen that as well is s when we started talking to individuals in clinic. there was one case where there was probably five to ten locations that a clinic had in, let’s say, 100 miles radius. Within those ten locations, there was one clinician that was trained and confident on earwax. And whenever there was anyone who came to any one of those ten clinics, they would then refer them out and send them to that one location so that that one expert could take care of it in an ideal situation. There’s awesome equipment like in Oto Set, and there’s a redux to make that a lot more easier at each one of those locations. And then, ideally, all the relevant staff at each location are equipped with the tools and the confidence in order to deal with that on the spot so that there’s not risk of revenue leaving the door if they can’t be resolved right away. I think that’s fantastic to be able to have that option where you can take the fear factor away before working directly with the patient. Because I think, Jackie, you’re 100% right to me and you brought it up. We were kind of trained to shy away from cerumen management. Actually, I never have removed Cerumen as an audiologist for almost 14 years because I came from a program that trained not to do it. And so I’m right there, Jackie. And just to piggie back off what Mark said on efficiency that’s crucial in busy clinics, or any clinic, actually. And something that Mark and I have discussed before is that the time it takes to dry the hearing aids when the patient comes in is the time it takes to clean the hearing aids Excuse me? The ears canal. So basically, take the hearing aids off, go dry and come back, do a clean with Otoset or whatever method you’re using, and do two things at once. And so that way you’re chair time your patients a lot less, they’re a lot happier. So I think efficiency is key, and I think that comes hand in hand and being proactive with that. So benefits and how practices can offer that is like offering services like the care package, right? Every three to six months, you can come in and choose your frequency because we have a snowbird, we have our kids going to college and school, we have these weddings coming up and people go off the air. And to your point, Bob, you want to find the one clinician that can do it and not the another nine that you mentioned that can’t. So this is all about let’s give our patients the best access to everything so that talking about future of hearing healthcare. Let’s have the front edge of tools so we can like I always say, I want patients to be able to hear for dinner today and not have to hear in dinner in two weeks from now. Because they didn’t have a Redux and they had to ship it out. So now I don’t want to take up too much time. Now I feel like I’m dominating. Jackie, one of the providers I actually talked to up in Canada as well, he has multiple months where his revenue from cerumen management actually surpassed the revenue that he made from hearing aid sales. It has the potential to do that for practices and practices who. Are not doing that right now or have staff who are unable to really take that on is really leaving a lot on the table. Well, and also just the fact that when they refer out to that one person that you said, Rob, they may not get them back. So take all that time and money to get the person to come to the clinic and then you send them back out. So how frustrating is it to the patient and then also the clinician who may or may not get the person back? And even if it’s like early on in their journey as well, cerumen management can even be used for people who may not have hearing aids yet. And it’s almost like a less high pressure way of lead generation and getting those contacts that might not be coming into your clinic for hearing aids specifically yet. They may just be having some issues. And really, it’s building that base, and it offers a great way to just open up your practice to more potential clients who may be able to use your services and try to shift the general thought that, oh, I need to go to a GP or I need to go to my doctor or nursing to get this done, when in reality, there’s extra costs that may be associated with that. The timeline to do so may be quite difficult compared to going around the corner to your hearing clinic that they can take care of it like that. That’s incredible. Yeah. And I think you guys brought up a really critical point here. We’re in a point in our evolution where everything is moving towards the do it yourself kind of model, right? Purchase your own devices, self hearing testing, screen your own hearing so that if you’re in these hazardous noisy environments, you can monitor yourself. This is one of those things that you have to have the clinician there to help you. And I think that’s an important piece because of two reasons. Number one, as you all have pointed out, it helps build that relationship. And even though we brush our teeth and we floss our teeth, we still go to the dentist in order to get care. So you still need that general wellness checkup from time to time. I think the second piece of this is, and I think this is the real important piece, is as a profession, we’ve got to be able to have services that we can hang our hat on in order to make ourselves part of the broader hearing, the broader healthcare landscape. And this is one of those ways to do it. And so I’d like your thoughts on kind of those two properties, if you will. Just talking about reduction specific to management and not just having being hearing devices, but in expansion. Of services, but anybody that wears hearing devices like EarPods and Earbuds or OTCs or whatnot are going to want a solution to these devices. I mean, these devices aren’t cheap, right? So if you can differentiate and be able to prove for us like Redux can, I mean, we got our start by saving dead cell phones more than 50% of the time. So now we have that same technology for hearing aids and hearing devices. So if you can guarantee that, you know what, if you come in with a dead device, I’m pretty sure more than 50% of the time I can bring it back to life. Like that tells you you’re offering a service that you really won’t hear from anybody else. You’re going to hear, oh, it may take up to two weeks, but this person is now saying, hey, I have a fair shot, I’m invested, I have the current technology. So I think with that you’re set up for success and you’re willing to be open mind, I guess, to other thought, if that makes sense. Yeah, on your second point there, with just hearing care being seen as the practitioners for ear and hearing, it makes me kind of sad that there’s even a scenario in which someone may have an earwax problem and they don’t think to go to an audiologist. It’s been kind of narrowed down to hearing aids for so long. And I think there’s sort of that keyword that has been going around for quite a bit, which is practicing to your full scope of practice and really being able to be as broad as you can within the hearing space in order to be seen as that expert and seen as that practitioner. In the same way that no one thinks twice. If there’s something in your teeth, there’s something going on, it’s a dentist, there’s no going to a doctor, there’s no nothing. It really should be the same thing with ear and an audiologist and cerumen management. One of the things that can tie that together extremely well. And just to echo on that, I think what we’re seeing is that there are so many clinicians who are having to refer out and when they do that, the patient sees them as like, well, I thought you’re the hearing healthcare expert and now you’re sending me out to someone else that they have to go to. So I think when you are offering this value added service to your patients, you elevate your expertise and you own what you really should own. We as audiologists should own this space, not someone else urgent care. I mean, you would not believe how many people I know refer out to their urgent care around the corner or downstairs or whatever in their building because they don’t want to do surround management. So it definitely elevates your image to the patient, which I think is what we should do to these points, which I think are tremendous. How would you then convey a message to your peers? That one this is important. And number two, what’s the next step in order to move in that direction, what would you tell them? It honestly, if you’re not offering some cerumen management, I would ask yourself what’s the barrier to doing that right now? Is it that you don’t feel comfortable? Well, is it then you want to connect with Rob to do a hands on with CARL? Is it to connect with Jackie? To get the Otoset I guess just find out what it is. Is it that you haven’t established the ENT relationship? Because what in my eyes is that it’s not many shows up to your doorstep and you identify through otoscopy that they’re included. There should be a pathway rather than, hey, I got to refer you out. I hope this guy can see you today. Let’s have a solution for these people. And so let’s figure that out. I think you’re right asking what the barrier is. If they didn’t get to train in college or university, then recommend them. There’s online classes at the national and state level. There’s usually a cerumen management class that you can take. There’s also your peers that you can reach out to. The CARL. There’s so many places, and if it’s cost wise and they think it’s out of their price range or it’s just too much to invest in, I think beg to differ. I mean, there’s so many options that are not costly that they could take notice. That is not costly. There’s a lot of ways they can get it without spending a lot of money. But then also it is a self pay. And so the bottom line, the return on investment is actually really well as well. Rob mentioned earlier that in slow months it can actually be more than a hearing aid cells, so there’s really no excuse and just find the reason and then have a solution for them. Is my suggestion. If I were to get really tactical too, for sort of assessing how someone could start with this. In most people’s businesses, they talk about the customer journey and mapping out what stages do they go through and what stages is there friction or what stages are they referring out, whatever that may be, just on your own in 20 minutes of the whiteboard in front of you, what does that customer journey look like? And I pretty much guarantee that not being able to remove wax within that customer journey is going to have an enormous negative impact on that journey for quite a few folks. Yeah. Again, providing the services impacts the way that you’re perceived it, impacts your revenue stream. It’s going to impact the consumer. Mark, I know that Antonio, the gentleman who is in Puerto Rico, has been using your device for some time. I text with him from time to time and he just absolutely loves it. He does some philanthropic work and it has allowed those individuals who cannot afford hearing aids who are getting them for free, not to have to pay for repairs. Caused by high humidity in Puerto Rico. And that’s been a wonderful thing for him. Do you want to add that? Well, and that’s really what it is. And that’s why panels like this is so important, is that Redux really is onto something where we can truly remove moisture. And what current dryers do is that they’re using ambient air. So if you think about it, the hearing aid, at best, it’s going to reach homeostasis within the environment. It will never truly remove all moisture. That’s why that desiccant has an end life, right? Once it absorbs all the moisture, it can’t keep doing its job. But Redux actually can rejuvenate that desiccant. We have, which we don’t like to say too much, but it’ll take forever if you do it. But we have truly a closed chamber that we pull a strong vacuum at body temperature so it’s completely safe. And we have humidity sensors. No, dryer currently has a humidity sensor. So how can you monitor if humidity is gone and how do you remove it all if you create homeostasis in the environment? And so that’s why we offer 30 day risk free trials. Because what people like Antonio see patient it’s night and day. Like, I talk about my own sister, she has MS, and so she has a lesion on her spine that sometimes infringes how well she can hear. And she has hearing loss. We have family history of hearing loss. She was a receiver in the ear. And when she puts them in the Redux, she knows that it’s not the MS, it’s just my hearing aid. And that to me, is why I work for Redux, because that was my AHA moment to this. So I will get on a horse about anything. That’s a bad example. But just because this is Dryer is life changing because of what you just said. We’re happy to always do free trial and philanthropy is definitely our big thing. So reach out to us anytime. [email protected] and I want to urge all of our attendees and even the other exhibitors, go by their booths, see what they have. It’s a great way to expand your mind about the different service offerings that are available in the marketplace. If you’ve got questions, feel free to reach out to these experts. I’m sure they’ll get you the responses that you need. And if you need demos, they’re happy to bring those demos to you. But the whole service provision piece of this, I think, is an important key component, especially as we moved into our future. And I want to thank all three of you for, one, being here. And then number two, representing companies that allow the consumer and the provider to benefit from a barrier that is naturally caused, that we have the opportunity to somehow lessen so that folks can continue to use their devices, maybe elongate the time that they’re using their devices. In the AHead simulation case, if you’re not. Real comfortable with doing those techniques. This gives you that opportunity to become more comfortable. And then with the Otoset, which I pride, it’s just a wonderful piece of device that allows you to remove that earwax. Jackie funny story. When I was learning how to do cerumen management, we got water everywhere. And every time I see your product, it brings back those memories in … Hall at Purdue University, where we were just out of control and it was like having balloon fights with water everywhere. But you don’t have that problem because yours is all self contained and it’s just a fabulous product. Yeah, and what’s interesting about that is the water basin syringe has been used over 200 years. And so I think someone earlier mentioned that Earwax has been a neglected area. I wholeheartedly agree. It’s an area that’s just been kind of pushed to the side and not taken too seriously. But it’s a huge problem for our patients. And so it’s just amazing the technology that’s still using the day at over 200 years old. So it was time for something that’s more innovative and advanced as like the Otoset. So we’re super excited. We see the changes that make some people’s lives. And we actually also have an outreach in humanitarian mission work as well, where we’re seeing refugees in Jordan and Israel right now. We have someone who goes a couple of times a year. She is taking our devices, and she said that it’s very life changing for those patients who are not able to get the help they need only in the refugee camps for the medical teams that are going to see them. So we are strong about that as well. And we really believe in helping every person in the world with earwax we can. Wonderful stories. Wonderful stories. Well, again, thank you all for being here. Again, their booths or their virtual booths are up. Please pay them a visit, and we hope to continue this discussion down the road at some point. Hopefully, we’ll be at a point where everyone is doing this and they’re all benefiting both from clinical efficiencies revenues and the patients are benefiting because they’re getting to have clean ears and use their devices on a more regular basis without them having to break down. So thank you all for being here. Thank you for sharing this information, and best of luck to you all, and we’ll talk soon.