Two Pi VoiceChoice technology for self-fit OTC hearing aids

Very interesting. Do we know if it is available on any aids at present? I program my own aids but don’t find it easy to program my wife’s as she has difficulty in explaining what is wrong with what she is hearing. This system might be just what she needs.

Have no idea. Go to the “About us” link, then “contact us” and ask them. I’ve asked questions of them before and they’ve been pretty responsive.

I’ve often wondered why the end user can’t buy a set of hearing aid, plug in the numbers from their audiogram and get a correct prescription for the hearing aids.

Sure that can be abused, but so can just about anything.

And I wonder if this machine learning will work better.

This will be interesting to watch.


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It’s coming!! Not yet but soon.

This is going to be the death of the professional Audiologist/Dispenser in years to come. As the highest percentage of people we currently serve aren’t tech savvy enough to do this, It’s going to be a few years before it has that much of an impact.

When the boomers start to become a greater part of those who acknowledge hearing loss, and seek help it’s going to be a disaster for those who have made their living selling/dispensing/fitting hearing aids.

The technology is already there, but the big manufacturers just have not been brave enough to make the jump and betray the dispensers/audiologists to that level…yet. Just as they did with 3rd party groups, they will do with “self fit” OTC/DTC. You can count on it, DTC/OTC smart tech hearing aids are going to be a wrecking ball for business as we know it.

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My fear is that going this way will hurt people’s ears more than help. But I see it could get more people to wear hearing aids, and I can see a lot of new hearing aids looking like ear buds

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When I read the article I didn’t get the steps to how it works. The science is there.
The brick and mortar audiologist will still be needed for those with severe/profound loss and those who just like having someone else do things for them.


I don’t think so…

The self guided fitting is already available in most fitting software used by dispensers.

Starkey already has an app that can detect a fall, and send an alert to pre-designated emergency contacts, link with Amazon Alexa, sense heart rate, count steps and activity, translate language, and locate the hearing aids if they’ve been misplaced.They have had “sound point” in their software for several years too where the patient can use a touch screen to make changes and find what’s comfortable for them.

Creating an app that guides a patient through a fitting, and adjusts for complaints should be child’s play for software engineers.

The “art” and intuition required to guide people through successful fittings will be missing, but again, as tech gets smarter, that can be addressed through AI. Also, when you can buy the aids at 50% to 70% less than what you would pay a dispenser, it makes the aids a lot easier to keep.

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@eric.cobb You may be right but since many HA users will be older folks and there will be mechanical problems, adjustment problems that the patient or his/her assistant does not understand, I think there will always be a market for audiologist/providers, e.g., I’m not sure, for example, for liability reasons that Costco wants to turn its HA customers loose with self-fitting but a fitter brings the knowledge and skill that most customers may never have. Just like there are physicians who run a concierge business, I think there will always be a market, too, for concierge providers who offer all the extra goodies that you can’t get through self-fitting. Will molds be a self-fitting process?

I’m always overly optimistic. I hope OTC will greatly expand the market to those that currently can’t afford HA’s, will help make self-fitting more allowed by HA OEM’s (as an answer to OTC) but the better off (who currently seem to be a good fraction of premium HA users) will to a large extent still prefer to see a highly trained provider rather than spend the time required to acquire the knowledge themselves.

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Some here seem to be missing the point. Yes, they will be cheaper but the real impact is that they will be better. Once we have the power to make the adjustments ourselves we will hear better.

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This is probably true. The public who wear the aids will drive the product at this point.

Because believe it or not setting up a hearing aid is not that simple.

The devices themselves cannot be trusted to be putting in the amount of amplification they say they are (which is why real ear measures are important)

Most people have bias towards either under amplification or over amplification and need monitoring.

Lots of people who need hearing aids have enough trouble learning how to place the device in their ear or change batteries; having them calibrate the hearing aids themselves is beyond most hearing aid wearers.

And there are many pathological reasons as to why the hearing loss exists which should be reviewed by a trained hearing professional.

Having said all that there are a specific group of people who would do greatly with this type of technology, and this group will grow over time.

This will also work really well in places where audiologists don’t exist.

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They wouldn’t be a good fit for me, but I think could help a lot of people who have ordinary age related high frequency loss. The sooner hearing assistive devices move away from the medical sales model to the electronic device model, the better. People with hard to fit loss will still need to be seen by a professional.

It’s been a good ride for the major hearing aid manufacturers to be able to charge such exorbitant rates for the hearing aids, and likewise for the audiologists to be able “bundle” services, both of which have to be paid upfront. In many ways, both have created their own problem that will open the door for people to find less costly ways for those with less severe hearing loss to be able to afford solutions. When the market sees many new hearing aids that are less expensive and require less services, the currently existing model won’t be sustainable. The above mentioned approach won’t be for everyone, but for many it will work well (even if a little tweaking is required from an audiologist). If I were an audiologist I would immediately discontinue the bundled approach and let people pay for services only when needed so when the new generation of hearing aids hits the market, audiologists will still be able to provide services if/when needed for these new aids as well as for the more sophisticated traditional hearing aids.


I agree with you…

The expense is a huge driver of the downfall of our industry. The following is an article, opinion piece I wrote back in 2016 that really addresses the broader issue of how stupid manufacturers of hearing aids are when it comes to understanding the big picture, and how the industry has shot holes in it’s own boat.

So yeah, there are a lot of us that do pretty well, we sell some hearing aids, make a good living, maybe even more than that. But on a broader scale, what is really going on?

My contemplative nature drives me to look deeper into most everything that I participate in, and having been in the industry for 21 years, I have had a lot of time to think about it.

What is it you ask? It is the fact that compared to any other technology driven industry, we have an absolutely abysmal level of market penetration. Furthermore, though our technological advances have given us opportunities to do things that we were just hoping for and dreaming of 15 years ago, the return percentage is higher than it was when I came into the industry in 1995. How is this possible? I believe much of it comes back to how we market.

To make sense of this, I believe we must first look at the numbers. When the sales results were tallied for last year, 2015, there were several articles in the journals trumpeting our success, and patting our industry on it’s collective back for a 7.2% increase over the previous year, 2014. Which totaled a whopping 3.36 million units sold for the year of 2015 within the United States. Whoopee! Gaze upon our success and marvel! Or not. Before we get too full of ourselves, there are more numbers to consider.

According to the NIDCD, there are approximately, 28.8 million people in the United States could benefit from the use of hearing aids. Most certainly, there are a great number of those people could not afford, have no insurance, or otherwise have no means to obtain or purchase hearing aids, and that fact may allow us to save face to some degree.

Even if we go easy on ourselves, and cut that number in half, (14.4 million) then subtract another, rather generous exemption of say, 25% (3.6 million) of those as patients who have hearing aids that are they feel function effectively enough that they aren’t in the market, that is a potential untapped customer base of 10.8 million users. And if we once again give ourselves the benefit of the doubt, and imagine that ALL of the units sold in 2015 were sold to first time users (which is a huge exaggeration at best,) at a 71% binaural rate, we collectively sold hearing aids to approximately 2,322,000 (two million three hundred and twenty two thousand) people. Approximately 19% (441,180) of which returned their hearing aids for credit. Leaving us with an overall market penetration of (drum roll please) 17.4 percent! Yahoo! Or not.

What is at the core of such a poor performance? Let’s take a look at some of what passes for marketing within our industry.

“This new technology is designed to improve speech understanding in all situations, especially in noisy places like restaurants or crowded rooms.”

On the surface, that makes sense, or does it? It may be “designed” that way, and to a software engineer who can show in a controlled environment, on a plastic head, in a test chamber, that the phenomenal algorithm he or she designed can do just that, it makes perfect sense. But people don’t have plastic heads, and don’t live in test chambers, so in real life, not so much.

I don’t know much, but one thing I am certain of is that our shortcomings as an industry has driven the delay in patients getting help: Most people wait so long that their results are drastically reduced, especially in noisy environments. The average delay has stayed relatively the same as long as I have been in the business: 9 years.

That is 9 years (as an average) that a potential patient will live with enough hearing loss to cause difficulties before the even walk into one of our offices, or call one of us to look for help. During which time the hearing system is losing acuity, and their ability to understand is degrading. As such, it is very difficult at best to give someone like this good word discrimination, comfortable listening, and reasonably good understanding in noisy environments.

“Imagine a hearing aid that automatically adapts to your surroundings and reflects your specific lifestyle. Imagine a hearing aid that is so pleasant to wear that it gives a new meaning to the phrase “customer satisfaction.” Well, imagine no more - With this breakthrough technology comes the first hearing aid ever developed to address your most important needs.”

So pleasant to wear that they give new meaning to the phrase customer satisfaction? Not so fast my friends. I tell all of my first time patients, and many returning patients upgrading from older technology, that they WILL NOT LIKE THEIR HEARING AIDS! during the first few days to a couple of weeks anyway.

I find that the descriptions of what they are hearing that patients often convey at their first follow up appointment, lead me to believe that the auditory system is literally in shock because of all the new information (not really new, just things they used to hear that they haven’t in a long time) that a high quality digital product can provide. Much like waking up in the middle of the night to get a drink of water, and turning the light on, the contrast between the two seems overwhelming for a short time.

I believe that the inclination to make such lofty promises, and hesitancy to tell patients what they should really expect, is, perhaps, the main driver behind the high return rates, and a big part of why so many people choose not to take action earlier to onset of hearing loss: I.E. The expectations created by our marketing promise the moon, when many times we can’t get out of orbit.

This leads us to another problem: People don’t come and see us because their neighbor got hearing aids, with expectations, based on how they were marketed and sold, that the hearing aids would do things that they may, or may not, and in the neighbor’s case, did not.

Remember, human nature dictates that people who are unhappy with something will tell ten people. If they are happy with something, they will tell one, maybe two. Also, when you are selling a product that no one really wants to solve a problem that most won’t admit, most are looking for another excuse NOT to get the help that they really need.

So, what is the answer? I could get into details about different approaches I have seen work, in my own practice, but that would be like giving away the special sauce recipe, and special sauce don’t come cheap!

In a general sense, the manufacturers need to take the lead on this. Many of those hired to create the direction of our marketing campaigns have never done a hearing test, recommended a hearing aid to a patient, or covered an objection to make a sale. They have never had to interpret what the patient is describing when they complain about something they are hearing, or figure out what to do about it when they do, and they most certainly have never had to try to hold a sale together so they could draw a paycheck this week when the patient is dead set on returning their hearing aids because they didn’t live up to their expectations.

I believe that the major manufacturers should quit with the competitive urination (a polite way of saying something my father used to say a lot: having a p_____ng contest.) Stop with the whole: “Mine is bigger! Ours is faster! We have the most bands! Our algorithms are so smart that they can carry on a conversation with you!” etc, etc ad infinitum.

The truth is that if any one of us was blindfolded, and listened to the best hearing aids that all the top manufacturers have to offer, one after another, back to back, we probably couldn’t tell a nickel’s worth of difference between them. Those who really care about growing our industry for the future need to begin working together to change the perception of hearing aids, and the expectations of those who choose to pursue help through the use of their products.

While the technology makes it possible to do things we only dreamed of when I first came into the industry in 1995, it should not be the main thing we use to drive patients through our doors.

Imagine what would be possible if the major players in our industry would all cooperate and throw in together and create a ten, or twenty, or thirty million dollar public education campaign to reform how people view hearing loss, and hearing aids, and help to set proper expectations within out potential patient pool. Is it possible that we might, instead of fighting over the same small piece of the pie so we can brag about our market share, that we could grow the pie to two or three times the size it is? If we could achieve this, we would all have more business than we could handle, and millions more people could benefit, improving the quality of their lives through the use of properly fit amplification.

I know that the marketing can not bear the whole weight of our poor performance as an industry. At street level, the dispenser, and the audiologist alike have fallen victim to trusting technology to do all the work (a topic for a future article) and that needs to change. But, perhaps, if the approach were different further up the chain, we would feel more free to tell people what they should really expect, and what they shouldn’t, and in so doing create a better experience for millions more potential patients.

P.S. The numbers found herein all came from statistics compiled by the HIA ( NIDCD( and Market Trak Publications ( This being my first submission, I couldn’t figure out how to put those cool source numbers that sit above the quotation. I’ll do better next time. :wink:


Thank you for the shout-out.
The self-fitting VoiceChoice technology is not yet commercialized, not yet available in any hearing-aid product. Prototypes are available in the second generation, based on ON-semiconductor hardware and iOS app. We are pushing for commercialization within 2 years time-frame, as a medical device, and/or as device-agnostic “digital heath supply”. Mild to moderate hearing loss will be addressed.
Two Pi is basically a hearing aid company, operating according to the rules of traditional medical device space, including clinical trials, therefore somewhat longer time-to-market.
If you have any particular questions, I will be glad to answer.

Tarik Zukic, CEO Two Pi

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@tzukic Do you have any info on progress towards a BT5 hearing aid standard? I’m beginning to wonder if this is ever going to be a useful thing. All current approaches to BT that is compatible with Android seem to be BT4.2, either by Phonak or Google and Resound with ASHA. To me, a lay person, it seems like the increased bandwidth possibilities for LE BT5 would be advantageous to hearing aid streaming.

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ASHA and Apple MFi links are using BT-Low Energy - and are already a de-facto standard. The motivation for standardizing BLE “Hearing aid profile” is therefore melting away. At one moment, the BLE-Hearing aid profile standard was “promissed” for 2018, obviously not here yet.

The main use-case, involving smartphone and streaming phone calls and content to hearing aids is reserved exclusivelly for premium hearing aids, so the marketing peaople are not very keen to declare it “standardized”, using istead their custom links, and even custom dongles (at extra cost). It might take years for BLE to propagate into mainstream, OTC newcommers might accelerate that.