A need to perfect testing and fitting systems prompted hearing aid dispenser Ron Buck to oversee the development of the Otoscope and establish MedRx Inc.

 MedRx Inc recently moved its expanding company into a new 18,000-square-foot building in Largo, Fla.

In the early 1990s, Ron Buck, a hearing aid dispenser with 15 years’ experience, saw a need for better testing and fitting systems. The then-current fitting video otoscopy technology tended to be both fragile and expensive to repair. “When we looked into entering the video otoscopy arena, the systems that were available at the time had what was called a rod-lens probe,” he says. “In meeting with an engineer, we developed and patented the concept of a tapered stainless cylinder that was far more durable than what was previously available in the marketplace. That was what gave us an edge.”

In addition to fragility, the older fitting systems had not kept pace with advancing hearing aid technology. “You know how high buyer remorse is or how high the return is with digital instruments, and the reason they are high [is because] we’re not using the [best] technology that’s necessary to fit the higher technology hearing aid,” says Buck.

To fill this need, Buck closed his practice and opened MedRx in 1994. He is currently president of the company. MedRx’s first product, the Otoscope, which perfected the existing technology, proved to be immediately successful. “[With] the video otoscope…the eardrum is magnified substantially on the screen and there’s far more information than with the handheld scope,” says Buck. “It also allows the hearing instrument dispenser and the audiologist to be able to share that information with the patient, to show that there is no wax in their ears, there are no abnormalities, or there are abnormalities. That image can be stored and printed.” Today there are 8,000 Otoscopes in use all over the world from England to Japan to Australia to Mexico. The company will soon have sales representatives in about 120 countries.

BuckRon Buck, president of MedRX

MedRx’s 31 employees oversee support, sales, and manufacturing from the company’s Largo, Fla, headquarters. Although product components are manufactured in France, Germany, Denmark, and in other parts of the United States, all of the equipment the company sells is assembled and tested in Florida. To accommodate its constantly expanding growth, the company moved to a new 18,000-square-foot facility in June, which Buck expects to outgrow in the near future. “Fortunately, we’re in a building [in which] there is another 15,000 square feet adjacent to us that is available, and we can take that in portions,” he says. “We’re already considering taking another 5,000 feet of that building at this time.”

Integrated Technology
Though the company was a success because of the Otoscope and its peripherals, Buck refused to sit on his laurels. In 1998, the company introduced a new, integrated solution—the Otowizard. This new device combined every testing and fitting component—an audiometer, a video otoscope, tympanometry, real ear measurement, live speech mapping, loudness scaling, occlusion effect software, and a hearing loss simulator—an audiologist would need into a single piece of hardware. The device comes in both full-sized and transportable versions. The Otowizard was developed to help bring standardization to the industry. “Everyone has their own idea as to how much gain a hearing aid should provide for a particular hearing loss,” says Michael Poe, the Otowizard’s developer. “But instead of writing a rule that tried to approach how much gain a hearing aid had, we simply looked at the auditory area map, or the dynamic range of the patient from threshold to their uncomfortable level. We plot the user’s auditory area, their dynamic range, on the screen. We modify the long-term average speech spectrum and fit it within this dynamic range. That becomes the target, based simply on math. It’s all done with proportionality.”

And in developing the integrated system, Poe was able to help take the guesswork and mystery out of fitting. “We do take a much more scientific approach, but put it in lay terms,” he says. “Instead of painting a bunch of squiggly lines that only the clinician can understand, we thought, why not get everyone involved in this? It’s a great counseling tool. It’s a great fitting tool, but it lets the patient see that you’ve fixed the problem.”

When developing the Otowizard, which took about 2 years, Poe studied the most successful audiology practices in the country and surveyed what services they offered to successfully fit and sell hearing instruments. The key to selling components of the new integrated system is the hearing loss simulator and live speech mapping.

With the Otowizard, MedRx has been slightly ahead of the technology curve, particularly in the area of live speech mapping. “We see more and more people recognizing that live speech mapping is the correct way to fit a hearing instrument, because we’re considering all the parameters involved individually,” says Buck.

PoeMichael Poe, Otowizard developer

The hearing loss simulator is aimed more at the patients’ loved ones—spouses in particular—than at the patients. “The simulator is probably one of the best sales tools that we’ve ever seen in terms of third-party involvement,” says Poe. “All the audiologists, all the dispensers out there, know that in order to make the sale they have to impress upon that significant other the severity of the problem, and the hearing loss simulator is an absolutely fantastic way to do that because it lets them hear the problem. You can let the third party hear that and see it as well as the patient.”

For Poe, another advantage of the Otowizard is that it is more than a tool to fit hearing aids. “Not only is the [Otowizard] a cash register for sales, it is also a very dynamic fitting tool for rehab and counseling,” he says. “It really takes audiology back to its rehab roots, because it allows them to get the patient involved in the process. As the Baby Boomers come online, they want to be engaged in these processes more so than the generation before them.”

The Otowizard’s software operates in a Windows environment and is NOAH compatible. Once an audiologist or dispenser has purchased an Otowizard, they can travel to Florida for a free training seminar. MedRx further offsets training costs by paying for food and lodging.

Though ideal for audiologists, the Otowizard has a broad customer profile, which includes hospitals, Veterans Administration medical centers, and manufacturers—the latter use the Otowizard to prove the effectiveness of their technology. The key trait of all the owners of the 800 Otowizards currently in service is a savviness about technology.

Selling the Otowizard to the hearing health community has required Buck and Poe to take its message directly to the company’s constituency, through regional, company-sponsored seminars and at professional meetings.

More Than Technology
Although MedRx is built on a technological foundation, it also has a strong customer support component. Troubleshooting information is available on the company’s Web site. The company maintains a support desk, which can also help solve problems.

Hardware failures are, if possible, assigned to vendors local to the user. “In a worst case scenario, if they have to overnight the product back to us, we repair it the same day, and overnight it back, so there would be one down day, which has happened on occasion,” says Buck. “We’ve built this company based on good technical support.”

Unexpected Offshoot
In 1997, Buck received a call from a veterinarian in Montgomery, Ala, about adapting the Otoscope technology for use with animals. “After sending my engineers up to meet with him, we spent months and months developing a product specifically for veterinarians,” says Buck. “That product was the first built specifically for veterinarians where optics were concerned. Previously veterinarians had just purchased used human equipment and tried to make it fit to applications they had. This product was built application-specific. Its backbone is the same as the otoscope’s backbone. The difference is the nozzle on the end.”

The veterinary division of MedRx was begun in 1998, and now accounts for about 50% of the company’s revenues.

A Work in Progress
Even with the success of the Otoscope and the Otowizard—the company’s revenues have increased threefold since 1994—Buck considers the technology a work in progress. “We’re continuously redeveloping, we’re continuously providing software upgrades, software enhancements,” he says. “We listen to the input from our users and see what changes we can make. All that programming is all done in-house. We’re very quick as far as our reaction time. We also now provide our upgrades via our Web site.”

He adds that the company is constantly monitoring hearing device manufacturers to spot new trends that can be incorporated into MedRx’s product line. “We’re small enough to be able to react quickly, but large enough to meet market demand,” he says.

The company recently introduced the Otomaster, which does live speech mapping, hearing loss simulation, otoscopy, and tympanometry—essentially the Otowizard without the audiometer and hearing aid test pot. The Otomaster is available either as an entire system or as a USB solution.

Chris Wolski is associate editor of Hearing Products Report.