Cochlear and Google are part of a coalition looking to make hearing health more accessible to all.
Late last month, cochlear implant maker Cochlear announced a coalition with Australian Hearing Hub members, National Acoustic Laboratories, Macquarie University, The Shepherd Centre, NextSense, and Google in a collaborative effort to “uncover new solutions to help people with hearing loss.” In a press release announcing the news, Cochlear said the initiative, which is a multi-year partnership, “brings together expertise and resources from hearing, research, technology, academia, government, healthcare and information sciences sectors.”
As part of the partnership, Cochlear also announced the “first-ever international guidelines” on who should qualify to receive a cochlear implant, which are evidence-based recommendations. The company said hearing health experts found out of 100 American adults who could benefit from a cochlear implant, only three would actually undergo the surgery. “This is in part due to inconsistent practices that mean people with hearing loss don’t know when to seek help, and many who do, don’t get the advice they need,” Cochlear wrote in the press release.
As causes like mental health have risen in prominence in context of the pandemic’s lasting effects, hearing health has forged a similar growth in the last few years largely due to earbuds like Apple’s AirPods and Google’s Pixel Buds and their bundled software in iOS and Android, respectively. Indeed, the confluence of hearing health, technology, and disability has been a popular source of coverage in this space; recently, I spoke with two audiologists about the importance of hearing health and how hearing aids (and cochlear implants) are increasingly becoming much more computer-like and, akin to the immense popularity of AirPods, much cooler. The caveat here should be obvious: these earbuds are designed to be passive listening devices for music and podcasts for mass market consumers, with only a soupçon of health benefit. They’re not hearing aids, certainly not cochlear implants. They’re not meant to be a replacement for medical-grade devices.
A cochlear implant is undoubtedly medical-grade hardware.
For Lou Ferrigno, getting a cochlear implant has quite literally changed his life. The 71-year-old actor and former bodybuilder, best known for his role as the Hulk in the CBS drama The Incredible Hulk that aired from 1977 to 1982, has coped with severe hearing loss all his life after a series of ear infections after birth. In an interview with me via videoconference earlier this month, Ferrigno told me the socio-emotional effects of his hearing loss negatively affected him for much of life, especially during his youth. The experience was harrowing for him growing up, as he was teased mercilessly after getting his first hearing aid when he was close to 5 years old. “At that time, in the early 50s, I had to deal with people making fun of me [and] calling me names because of my hearing aids,” Ferrigno said. He spent most of his life getting a new hearing aid in one ear every six months because, as he explained, he “couldn’t afford a second hearing aid for the other ear.”
Three years after switching to a cochlear implant, Ferrigno said it’s been life-changing for him. The quality of life improvement, especially in terms of clarity and volume of dialogue, has been appreciable. “For me, it [the cochlear implant] made my life a lot easier,” he said. “I don’t have to struggle like I used to, and it’s such a pleasure because I hear different sounds now that I never heard before.”
In an interview concurrent to Ferrigno’s, Dr. Brian Kaplan explained the actual procedure for getting a cochlear implant is an easy one. Dr. Kaplan, a surgeon and chairman of the otolaryngology department and director of the cochlear implant program at Greater Baltimore Medical Center, said the surgery typically is an outpatient affair that involves a “very small incision” behind the ear (obviously, there’s no noticeable scarring) with very little pain afterwards. The surgery takes a little more than an hour, and patients usually go home an hour or so following the operation, according to Kaplan. In a nod to Ferrigno’s lived experiences, Dr. Kaplan noted a crucial differentiator between hearing aids and cochlear implants comes down to nerves. As hearing loss is attributed to nerve damage, hearing aids can’t repair the physical problem. They can’t reverse the damage; all they can do, Dr. Kaplan said, is “improve the volume” of sounds. But that just means sounds are louder, not more intelligible. Cochlear implants, on the other hand, is a “very thin electrode, thinner than a little piece of spaghetti that goes into the inner ear” that directly stimulates the nerve. Thus, the cochlear implant’s huge advantage is its ability to improve volume and intelligibility, both qualities that Ferrigno loves.
As for Google’s part in this collective endeavor, a critical cog in making all this machinations actually work is Sam Sepah. Sepah, who is Deaf, works at Google as the lead accessibility research product manager. He’s a member of a broader group at the company that works on a a host of research projects, some of which end up in Google’s products, are made open-source, or even integrated into the more ambitious moonshot projects. Sepah specialty lies in artificial intelligence and machine learning, working on the research efforts that are destined for Google’s consumer-oriented products. The venture with Cochlear and the others is but one example of the kind of work Sepah focuses on in his day-to-day work.
In a nutshell, Google’s contribution here is about, Sepah told me, “[leveraging] amazing AI solutions and eventually implement that into the hearing science experience around the world.” It’s Sepah’s belief that we’re amidst a “golden era for accessibility” in the technology industry and, as such, he’s excited for what artificial intelligence can do for good in terms of making tech more empathetic and inclusive of everyone. The truth is, he said, there has been “rapid improvements” in the accessibility space over the last decade, citing technologies such as Live Transcribe and Live Captions for Calls on Android that rely upon artificial intelligence to function. Google, he said, has pushed to help lead the way because it wants to make accessing the world’s information more equitable and inclusive.
“[Accessibility] is not a new space for Google at all. We work on many different accessibility products [and] aim to elevate the user experience—whether it’s hearing or other things,” Sepah said. “There are many different products that we have have worked on to tackle some of these challenges that people experience with hearing loss, but the ultimate goal [is enabling] people to have access to the world’s information in an equivalent way. If products are not accessible, then it makes it so that not everyone is able to access that world’s information. With AI tools, this is something that could be leveraged to level the playing field, and to be able to help people connect and move forward in the world.”
To that point, Sepah noted 1.5 billion people worldwide have some sort of hearing loss. That’s a lot of people who could use better hearing technology to live a better life. “There’s quite a spectrum of folks out there,” Sepah said.
Scientifically speaking, Dr. Kaplan said the heightened awareness of hearing health can traced back to a 2017 issue of the Lancet Medical Journal dedicated to dementia care. An “eye-opening” finding, reiterated in a followup published in 2020, was treating hearing health as a so-called “modifiable risk factor” goes a long way towards at least trying to prevent dementia. This is an important bulwark against things beyond anyone’s control such as aging or genes. Hearing health, Dr. Kaplan said, “trumps all of the other medical conditions.” Additional research has begun showing a link between hearing loss and cognitive decline. In other words, Dr. Kaplan said hearing health is becoming less a matter of lifestyle and more a matter of medical concern, not unlike treating diabetes or getting colonoscopies. These are things you keep tabs on because they’re pathways to living better; the same is true of hearing health. “There’s something you could do about each of these conditions that’s going to give you a longer, healthier, happier life. And hearing loss is now becoming part of that conversation now,” Dr. Kaplan said.
Ferrigno concurred. “It’s about choice, if you want to hear better,” he said.
When asked about the guidelines surrounding cochlear implants, Dr. Kaplan told me it’s been a multi-year project between experts in audiology and surgery around the globe coming together to create the first-ever set of recommendations for cochlear implants. He reiterated the statistic that only 3% of eligible patients receive a cochlear implant, and these guidelines were built in part to get more people aware that an implant may be a viable option for them. Dr. Kaplan described the guidelines as a “living” document, insofar as “you can constantly update them every year as new literature comes out to be able to give very clear guidance from a referral of a who’s a candidate to treatment to the aftercare based on all the available best data and best evidence,” he said. There are around 50 providers using the new guidelines today, according to Dr. Kaplan.
As for the future, Dr. Kaplan said hearing health tech is a bit like iPhone upgrades: some things are more incremental year-over-year while others may be more substantive. Cochlear has a $100 million research and development budget, with Kaplan telling me the company has put a “massive investment” into doing this work. There’s also excitement from a pharmaceutical aspect with what Dr. Kaplan described as “various drug delivery techniques” that will work in conjunction with the implant itself to restore connection and give a clearer signal for improved hearing. For his part, Sepah is excited for all the advancements in technology because he considers accessibility a human rights issue. If disabled people are able to access the world in the same ways as anyone else, he said, it engenders feelings of respect and inclusivity like disabled people can partake like anyone else. “I’m really excited about this project because we are continuing to push through some of those barriers and solve this problem and create an equivalent life experience for more people,” he said. “I’m excited to see where this goes in the future. It could have many impacts on the industry, just to really create better lives for people.”
For Ferrigno, he can love his grandchildren more thanks to his cochlear implant.
“I enjoy life more with a cochlear implant,” he said.
