LE Audio: Assisting the Hearing Aid Market

China’s recently conducted seventh census revealed changes in China’s demography that have attracted widespread attention. The results of the census show that the number of people above the age of 60 has reached 264 million, or 18.7% of the population, representing a 5.44% increase since 2010. Since the aging of the Chinese population is currently accelerating, improving elder care and activating the elder economy are hot topics of discussion.

It is understandably hard for the young to imagine the inconveniences caused by the deterioration of physical functions over the years. Hearing impairment is one of them. According to estimates by the World Health Organization (WHO), there were around 360 million people with hearing impairment worldwide in 2020, and 1 in 3 people above the age of 65 suffers from hearing impairment.

The most common solution for seniors suffering from impaired hearing is hearing aids. Hence logic dictates that the demand for hearing aids will continue to grow in the coming years as the global population ages. According to data published by Fortune Business Insights, the global hearing aid market was valued at about US$8.39 billion in 2018, and is expected to grow at a compound annual growth rate of 7.2% to reach US$14.45 billion in 2026.

That said, the current market penetration of hearing aids is not high. While data shows that around 24.6% of the hearing impaired in the US wear hearing aids, that number is only 5% in China. There is a vast untapped market. Some experts predict that due to the influences of population aging and low market penetration, the size of the hearing aid market in China could reach hundreds of billions in the future.

Changes in the Hearing Aid Market

In order to even begin to realize this vast market potential, some significant obstacles must be overcome, the main one being the limitations of existing hearing aid business models.

For almost a full century, hearing aids have always been defined as “medical devices.” Hence users need to be fitted by licensed hearing aid fitters, audiologists, or hearing experts, before purchasing and using them. This business service model of “standardized hearing aid + customization service” has remained constant to this day. Adherence to strict medical requirements has also inevitably increased the threshold for hearing aid users, which partly explains the low market penetration of the hearing aid industry.

However, with market and demand developments, this situation is changing. In the United States, Congress approved the use of over-the-counter (OTC) hearing aids in 2017. This means that future users will be able to purchase OTC hearing aids from retail or online stores, just like over-the-counter drugs, and fitting processes for hearing aids will be able to be conducted via mobile apps. Users will be able to use the app to perform hearing self-assessments, after which the app will prepare an audio settings report, then configure individualized settings. Users’ individual requirements will be fulfilled through the “customization” of hearing aids’ software.

The introduction of OTC hearing aids will bring many benefits. They include:

• It can solve the issue of medical resource shortages. In many low-income countries/regions, there is only a single hearing specialist for every 6 million people, so accessing professional medical resources is challenging.
• Easier access means that more potential hearing impairment patients can be served, especially patients with mild symptoms, thus allowing early intervention.

In August 2018, the first OTC hearing aid approved by the US FDA was released in the market. No doubt more countries will follow suit in the future, gradually relaxing the restrictions on hearing aid products to make way for the launch of OTC hearing aids.

In fact, the consumerization of professional medical resources has become a widespread and unstoppable trend in the medical and health care field. Many technology companies have joined the market by developing different products. Samsung, for example, has added hearing enhancement functions to its Galaxy Buds Pro Bluetooth earphones as a way to test the waters.

Figure 1: Samsung Galaxy Buds Pro Bluetooth earphones with hearing enhancement function (Image source: Internet)

Competitive Technical Drive

Now that the hearing aid market has been “stirred,” the development of the corresponding technical aspects must also be accelerated.

In principle, hearing aids are sound amplifiers. They use a microphone to receive external sounds and convert the sounds into an analog signal, which is then sent to the ADC and converted into a digital signal. Next, the digital signal is transferred to the DSP to be processed and modulated by a special algorithm. This is the most technical part of the entire process, and it includes multi-channel dynamic compression, automatic noise reduction, dynamic sound feedback suppression, and directional modulation. The processed and optimized digital signal is then reconverted to an analog signal and transformed into sound waves that the hearing aid user can hear.

However, an OTC hearing aid requires some new features besides the microphone, main processor, and receiver of traditional hearing aids. These include:

• Intelligent auditory diagnosis functions that can replace professional examiners, which requires the support of relevant hardware and software algorithms.
• Wireless connection technology that allows the hearing aid to interact with external devices (such as mobile phones), which is necessary for user data analysis and equipment software updates.
• Besides convenient wireless connections and better sound quality, richer expanded audio functions are critical for elevating user experiences.

In the future, the line between hearing aids and earphones will become less defined. For example, the noise reduction and transparent transmission functions objectives of wireless earphones are actually properties of hearing aids. By adding these consumer functions to hearing aid products, we can create exciting changes to future hearing aids.

Among the numerous technical factors that deal with repetitive computing upgrades for hearing aids, the technology that has garnered the most attention is LE Audio, a relatively new technology introduced for Bluetooth 5.2 specifications. According to the specifications, it is based on BLE low power consumption Bluetooth connections, not classic Bluetooth, for audio transmission and processing. It promises a new audio application experience on the premise of ensuring low power consumption.

In order to realize this dual objective, LE Audio incorporates three new innovations. They are:

• The new LC3 audio codec is equipped with high sound quality, low power consumption, and low latency features, which will surpass the SBC encoding of classic Bluetooth audio.
• The multi-stream audio technology supports the transmission of multiple independent and simultaneous audio streams between a single audio source and multiple audio receivers, thus realizing personalized audio content sharing.
• Audio broadcasts can allow audio source equipment to stream the audio to multiple wireless audio receivers, thus facilitating the highly efficient distribution of audio content.

Clearly, the low power consumption, high sound, and multi-stream audio of LE Audio will directly benefit the development of Bluetooth hearing aids. These features allow for low power consumption data and audio transmissions with just BLE connections, and can also help expand hearing aid applications through audio broadcasts and multi-stream audio, transforming the device from a simple hearing aid to a hub for audio information. The potential commercial value of these improvements is vast and waiting to be monetized.

Figure 2: The four new features of LE Audio (Image source: SIG）

Of course, with an “established” technology like hearing aids, change will not happen overnight. However, with the support of technologies such as LE Audio and the influence of the entire Bluetooth technology community, much more attention and energy will be focused on the hearing aid industry. It may be just what the market needs to finally achieve its potential.