Hearing deficiency is not something many of us worry too much about. We forego check-ups when we encounter slight trouble with our hearing. Quite often, this could be nothing but sometimes it leads to hearing loss. Hearing solutions like care and equipment – hearing aids – have not kept pace with technology. Quadio Devices Private Limited based in Pune has sought to make technology the basis of its hearing care offerings and solutions. They have launched the first mobile app that also doubles up as a hearing aid and for this achievement have been shortlisted as the finalists at the Vodafone Mobile for Good Awards.
Networked India speaks to Neeraj Dotel, CEO about what this recognition means, how the mobile app actually works as a hearing aid and the mobile clinics and camps Quadio runs which are powered by technology and the internet to remotely test and fit patients for hearing loss in rural areas of India.
Networked India (NI): Quadio was started by Paresh Patel who suffered hearing loss, to help others like him lead better lives. Tell us a bit more about this.
Neeraj Dotel (ND): Paresh is a reasonably educated man. He has gone to IIT in India and has a Master’s from Cornell. On his return to India he finds that hearing aid technology has not really improved much in the last 15 to 20 years. People should have been innovating around this but if you speak to anybody who is using currently available hearing aids, most of them are dissatisfied with the devices. You have absolutely no control over the environment, the fittings are mostly not done properly and issues like that. So these are the problems that he decided to find solutions to as there were none available at that point in time.
NI: What kind of hearing solutions does Quadio offer?
ND: When he started the company, we initially started off manufacturing hearing aids. Then we discovered the challenge was actually distribution. You can have the world’s best hearing aids, but if they are sitting in Pune and not with the people who need them that’s going to be the big challenge. Which is why we resorted to technology. So we created our own telemedicine offering to connect our audiologists, doctors sitting in Pune with patients across the country and we have been doing this for about 2-3 years. After talking to people, we realised, in India especially, price is an extremely sensitive issue. We can’t even afford decent quality hearing aids for the price point of Rs. 5000 – Rs. 6000. This is another problem we looked to tackle through technology.
We also make our own diagnostic equipment, we still manufacture our own hearing aids. We have a traditional business that’s going alright. With a traditional business you are limited by your network, by your distribution channels. We are looking to software to solve a lot of these problems. Going mobile and automating the process of hearing care is our goal.
So initially we started off trying to make a mobile app that could work with our hearing aids and then we realised the electronics in the phone is much better than anything you can fit inside somebody’s ear. So we decided to fit the hearing aid into the phone itself. That would solve two problems – one is the circuitry where you would get access to high quality electronics and the second issue it would solve is that of distribution because the app only needs to be distributed to the app stores. This has been the guiding principle behind creating the app which has been shortlisted for the Mobile for Good awards.
NI: Quadio was the first to launch a mobile hearing app equipped with all the features of a conventional hearing tool for both Android and iOS. What does the app aim to achieve?
ND: There are four main gaps in India. The first is access to specialised professionals – the audiologists. There are only 2000 practicing audiologists across the whole of India and most of these are clustered in the metros and tier 1 cities. So as you go to the villages we are finding people who have had hearing problems for 20-25 years and until we take our vans and go down to these villages, they haven’t ever seen a specialist. So the problem is access to specialists. And in a country as diverse and with a difficult network as in India, this is a big problem.
Second problem is affordability of devices. Third one of course is user satisfaction. Most hearing aids have to be customised by a visit to a professional; if you don’t have a professional, what you have is what you get. The last issue is a big one – stigma. People don’t want to wear hearing aids because its visible and people point at them.
So these are the four main challenges that we set out to resolve. And we think the app successfully addresses all of these. The app itself has two parts to it. First part is a hearing test. So you download the app and you take your own hearing test. It’s completely compliant with standards for calibration, etc. It’s reasonably accurate as well. So it’s like going to a doctor and asking what is the degree of the hearing loss I have. So we have tested the app alongside our own diagnostic equipment and the tolerance is within 5% which is reasonably accurate.
The second part is the app takes the results of the hearing test and uses the electronics of the cell phone to compensate for loss at different frequencies. So it’s not just an amplifier. If you have losses at specific frequencies in your hearing, the app actually uses the electronics in your phone to compensate for this. So these two parts work together. Even people who don’t have hearing loss can actually use the app to monitor their hearing regularly to ensure they’re not at risk of hearing loss.
NI: Tell us a bit about the team powering Quadio.
ND: Paresh Patel is the founder and MD. I joined after 20 years on the software industry. I spent 12 years in Microsoft, mostly in sales and marketing roles. We have Ketan Pandya who is an electrical engineer from IIT Bombay and is in charge of our mobile apps development. We have an audiology team consisting of seven audiologists right now which we are looking to expand.
NI: Your unique Net Dispensing solution allows Quadio to help diagnose and fit candidates with hearing aids remotely. How does this work?
ND: There aren’t enough audiologists in India and there’s no specialist in local hospitals to diagnose ear problems. We are tying up with hospitals in tier 2 and 3 cities since they have footfalls. If they can give us some space we can put an attendant out there with our equipment who can connect over the internet with our call centre/medical process centre in Pune and we can do an accurate hearing test for people who need them. So what this basically does is it creates a network of audiologists who are connected over the internet anywhere in the country. Net Dispensing is a form of remote diagnostics.
NI: Are the Quadio and Mobile clinics powered by the Net Dispensing solution? How useful have you found these clinics to be in terms of reach?
ND: Yes, Net Dispensing is the basis of the Quadio and Mobile clinics as well. There are two kinds of people. There are the people who have been using hearing aids for years who come to clinics for better discounts or replacements. So 30% of those people are existing users of hearing aids but about 75% or more are actually first time users. They suspect they have a problem but don’t know what to do about them. More often than not they are brought to the clinics by their family members. On an average we get 200-220 people a day who come to these clinics.
NI: In Quadio’s experience thus far, what are the major impediments you have noticed that the rural population suffers from? Is affordability of and access to solutions the main challenges they face?
ND: Quite a bit of these are occupational – people who work in noisy environments, factories, etc. who have been exposed to noise for a long time. Most of the people are also older folks so it’s also age related. We are also seeing a number of young children which is very disturbing. Others who come are there for hearing aids which we give as a social cause. So we see all kinds of people there but mostly the common complaint is noise related hearing decline and age related. Access and affordability are the two main issues we see.
Net Dispensing Audiometry test
NI: Quadio is involved in a number of social initiatives. Do you partner with any Trust, NGO or government initiatives to help people who cannot afford access to diagnosis?
ND: We have started working with them. We do a lot of work with schools. And then once we launched the mobile app in a few schools, we said teachers can download it and we can teach them how to get every child’s hearing test done. We are also approaching some of these NGOs, so we’re looking to partner with a few people who do these mobile clinics like SMILE Foundation, Akshay, Prakruti. So we are looking to partner with as many people as possible.
We have also organised a few camps in partnership with Apollo Spectra in Mumbai and we are looking to roll out more of these as a social cause. The initial target of these was low income school children who cannot afford hearing care. We looked at the database that we collected and out of the 350 students that we were testing per day about 10% had to be referred back to an ENT, so they had a problem before coming in. Either it was the onset of hearing loss or it was infection and infection that’s not treated can also damage your hearing. So we test about 3000-4000 school children with Apollo Spectra. The next phase is going with them to the Traffic Police of Mumbai because these people are at extremely high risk of hearing loss. So we’ll look at this section of society, then we’ll go to factory workers, airline pilots and such people.
NI: One of Quadio’s objectives is to reduce stigma around hearing loss and create awareness. How do you aim to do this? Will technology play a role here as well?
ND: That’s where the app fits in beautifully because with the app a user is not distinguishable from somebody else who is out on the streets listening to music. So you can’t tell the difference between a person who is using the mobile app as a hearing aid versus a normal consumer of music or who’s on the phone, etc.
So the app is a very discrete solution. It is private and makes it very difficult to stigmatise someone with hearing loss if they are using the app. As bluetooth phones become more prevalent, we’ll see a lot of people moving to the app as opposed to the traditional hearing aids because those can still be identified.
We do run awareness camps but these are only Maharastra and Gujarat right now. What we would like is the ability to scale out faster and this where the Vodafone Mobile for Good awards help
create awareness and people are aware that there is a solution out there. We also talk about how if you don’t treat hearing loss in time there are consequences – social isolation, loss of productivity but increasingly doctors are beginning to link premature hearing loss with more serious issues like depression, dementia, Alzheimer’s. So they are beginning to wake up to the fact that hearing loss is not something you should ignore.
NI: What are the future goals for Quadio?
ND: What we would like to do is a one-stop solution for people with hearing impairment which is why we came out with the first mobile app that’s a hearing aid. Next week we are launching on Diwali day a music app specifically for hearing impaired people. What we would also like to do is create a solution that would give a user control over their hearing environment. In the world of visual or eye care there are so many solutions – sunglasses, different shades – but very few of these are available in the world of sound. So we would like to give users the ability to control what they hear and they want to hear it.
NI: Quadio has been nominated for the Vodafone Mobile for Good Awards. Should the company win, how much impetus would it provide in achieving the above mentioned goals?
ND: It will help some of the handset manufacturers take us a little more seriously. There is a huge market for smartphones in India and if we could work with the Indian manufacturers to come out with a smartphone priced at Rs. 5000 or Rs. 6000 that also doubles up as somebody’s hearing aids, then that would solve a lot of challenges – distribution, awareness, etc. It would also give the smartphone manufacturer a competitive advantage. It would be India’s first smartphone that doubles up as a hearing aid. Additionally it would raise awareness in people that if you have a problem, don’t wait till the expert finds you. Just download the free app and take your own hearing test.