The novel idea of using an open-platform hearing aid to allow patients to try amplification with little or no risk is an intriguing blend of both technology and marketing. But does it work? HR interviews Unitron’s Jan Metzdorff, Rodney Schutt, and Bruce Brown for their perspectives.

At the April 2013 AudiologyNOW! convention, Unitron introduced Flex:trial™ and Flex:upgrade™ to a broader range of customers, after what the company views as a very successful pilot launch. According to Unitron, the Flex™ program is the industry’s first risk- and obligation-free option for first-time users to “test drive” personalized hearing aids.

According to several industry surveys, about 50% of all potential first-time users who visit a hearing care practice leave without a purchase, mainly due to concerns about cost and benefits—and many never return. Last October at the EUHA Congress in Germany, Unitron launched Flex as a pilot program, which included more than 50 US clinics. The new program is envisioned as a solution for patients who wish to experience the benefits of hearing aids before having to make a purchase decision.

The device borrows from the unique “open platform” concept of Sona hearing aids—a Sonova company that was integrated into the Unitron brand about 2 years ago. Flex:trial allows clinicians to choose 1 of 5 possible technology levels to be used in a single trial device. Through simple software adjustments, Flex:trial can be worn for a trial period (defined by the clinician) before a patient decides on the purchase of a device. It is thought that this type of hearing aid—a low-risk at-home trial device before purchase—will serve as an effective complement to motivational interviewing techniques.

One of its primary goals is to improve the conversion rate for those patients who would benefit from amplification. With Flex:trial, patients who are resistant to trying hearing aids or nervous about the financial commitment can be fit with a device with the right technology level for them to try at home with no cost and no obligation, and test-drive it in all their listening environments.

Flex:trial units are not conventional demonstration models. Using Unitron’s TrueFit™ software, providers program a single hearing instrument to higher or lower levels of technology as many times as needed, for the time period they choose, in order to provide a trial solution to a patient. The result: those people newly diagnosed with hearing loss get immediate access to a product with the technology level best suited to their needs—focusing their attention on the benefits of better hearing rather than cost.

The Flex:upgrade solution provides an option for patients who would like to increase the level of technology on their current hearing instrument—perhaps due to changes in preferences or lifestyle—but don’t want to invest in an entirely new hearing aid.

HR caught up with Unitron President Jan Metzdorff, US President Rodney Schutt, and Global Marketing VP Bruce Brown during the recent AudiologyNOW! Convention in Anaheim, Calif, to learn more.

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  Jan Metzdorff   Rodney Schutt   Bruce Brown


HR: You initially launched Flex:trial in a recent US pilot study. So what’s the verdict?

Metzdorff: At EUHA, we launched Flex:trial worldwide while launching Flex:upgrade in a handful of countries, including Germany, France, Australia, with a limited number of dispensing offices in the United States. This pilot has been very successful, and we will be launching the upgrade concept soon to many more countries.

From an overall point of view, the Flex solution has been a tremendous success. This is a new way of utilizing open-platform hearing aids and a new way of giving both hearing healthcare providers and consumers unique access to various technology levels.

The response has been overwhelming. We have sold many, many more trial aids into those [pilot launch] markets than we had expected. We’ve also seen a lot of excitement from some [unexpected] major accounts. There have been a lot of dispensing offices that want to meet with us in order to find out how this can help build their business.

Flex does a lot of things not just from a technology point of view, but also from a branding point of view. It really provides something different to the market.

HR: Do you think this concept can grow market penetration?

Schutt: Yes, that is the overall premise of Flex. If you look at the industry during the last 20 years, the innovation in hearing aids is remarkable from the standpoint of size and cosmetics, the ability to do more in terms of improving comfort and speech intelligibility, and reducing major problems like feedback and occlusion. Hearing aids have gotten exponentially better at addressing all these issues.

But the reality is that our industry’s market penetration has remained static. Basically, over the last 20 years, we’ve been stuck between 20% and 25% market penetration. In other words, the technology is wonderful but it’s doing relatively little to increase the adoption of hearing aids. So the question becomes: How do we move toward increasing awareness; to lead-generation; to improving the processes inside a practice; to better sales; and culminating in more satisfied users?

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Flex:trial starter kit and Flex:trial Moxi Kiss RIC  


Flex was purposely designed to address these very questions. From a Unitron perspective, we recognized that there was an opportunity to address some of the barriers to adoption. We wanted to focus on helping hearing healthcare practices grow their businesses, by ultimately helping more patients experience the benefits of amplification.

This is the reason we did a “soft launch” with Flex in a pilot study [see the article by Brian Taylor, AuD, in the May 2013 HR]. When I was talking with all our different customers—single-owner practices, ENT-based clinics, hospitals, etc—I put on my “Six-Sigma hat” and started asking them how patients flow through their respective practices. I came to the conclusion that we needed to conduct a pilot study of Flex in order to understand the entire situation. In this way, we’ve launched Flex with a firm idea of recommended best practices. For example, if you operate a single-owner dispensing practice, we have developed some great strategies that really work when using Flex.

Ultimately, what we have developed is something of an A-to-Z approach to marketing and dispensing Flex:trial. The risk-free aspect is so appealing to consumers from the awareness standpoint. And it’s certainly backed by the best marketing I’ve seen in my 4 years at Unitron in terms of phones ringing, lead generation, customer appointments made, and orders received.

HR: So how exactly are dispensing professionals using the device?

Schutt: Single-practice hearing care professionals need help. They need help getting people in their practice, and they need help with conversion because they often have a very clinical focus. Flex helps top-line growth because their conversion rates increase, and it reduces their cost-of-goods because their return-for-credit rates go down. And the overwhelming response in the pilot has been, on aggregate, about 70% of the people receiving the Flex:trial end up purchasing hearing instruments. Plus, of those who buy, about 70% of them actually upgrade two technology levels.

I think we’re pretty well aware of all the barriers of entry: stigma and cosmetic issues, concerns about product performance, and price in an economy that has been struggling recently. People who don’t have a lot of disposable income can come into a practice that offers Flex:trial, and the clinician can say, “Okay, here are the results of your evaluation, this is a summary of your hearing loss, and here is the type of device that I would suggest you consider.” At that point, the consumer—with help from the professional—settles on a particular hearing aid style and color. And, importantly, when they get to that point where price and affordability are discussed, the dispensing professional can say something like, “Good, that indicates you might do well with [for example] a Moxi 6. This meets all the basic needs and parameters that you need. I would prefer to fit you with a higher-level hearing aid, but all the information we’ve gathered strongly suggests you will do very well with these hearing aids.” The patient is fitted, in this example, with the Moxi 6 technology and they are sent home to see how they like it.

From almost 30 years of data, we know that only about 50% of all patients who receive a recommendation for a hearing aid and who make an appointment to get their hearing aids 2 weeks later don’t come back. So now, as indicated by our pilot sites, the clinician isn’t focused on selling; they’re focused on the right solution for that individual patient—today. Similarly, the patients leave and they’re immediately listening to new sounds in all their lifestyle’s environments. Their focus isn’t on worrying if they can afford hearing aids or if they should return for an appointment, and they’re not thinking up all kinds of excuses why they shouldn’t come back.

During the return visit, the clinician also has the opportunity to upgrade the patient to a higher technology level, such as a Moxi 20, which is two technology levels higher than Moxi 6. The new hearing aid also remembers the patient’s preferences from its self-learning algorithm. The patient tries out this new performance level for another 5 to 10 days, and our pilot study results show that about 70% of the patients return with a clear preference for higher technology level.

This Flex:trial method of dispensing has produced results that are far better than we’d initially hoped. The bottom line is we’re helping people. We’re getting more people to try hearing aids, and then—once they’ve acknowledged the need for the devices—many will select a higher technology level once they understand why it can serve them better than the comparatively basic, but still good, technology that serves their basic hearing needs.

We’re certainly proud of our technology and things like our new Moxi Kiss design. But, frankly, the technology is simply an enabler to an overall solution that helps the practice better serve the patient.

HR: So this might be a new method for increasing the number of first-time users?

Brown: Absolutely. One of the interesting things we did was the controlled roll-out in which approximately 100 professionals participated in the pilot study. This included quite a few who were very unsure of how something like Flex:trial would work within their practices. And, perhaps, the most rewarding part of the study was that many of them became huge promoters of the Flex:trial solution. The fundamental thing that it does for the first-time user is it allows them to ease their way into amplification; they get to experience the benefit of both the basic and higher-level technologies before having to make a firm commitment—it’s a low-risk, low-stress test-drive of advanced hearing aid technology.

During the pilot, we were tracking how this promotion was working against traditional promotions—specifically how many patients were coming into the office and how the conversion from a visit to a hearing aid sale was going. On both measures, we saw a significant uptick. And, by having the practice owners actually doing the tracking, they were also seeing this for themselves. We have a video of some of these customers commenting on their experiences, and I think it’s a worthwhile film clip for clinicians to see.

As we get better algorithms, faster chips, better looking designs, and smaller hearing aids, I think the industry will see incremental growth in sales [on the range of the traditional 2% to 4%], but I think it’s interesting that a product and concept like Flex:trial could really improve sales and increase both the number of people who are interested in addressing their hearing loss and the number of first-time users. This really is a new direction for practice-building that addresses a consumer need that has not been adequately addressed before.

HR: How do you promote the fact that Flex is an upgradable hearing aid?

Brown: We’ve left it up to the professional how they wish to promote the upgradability feature. Some use it as a service bridge. So, if someone comes in with a Moxi 6 for a routine hearing aid check, they might be given a Moxi 20 to try out or use while waiting for their device to come back. We have many practices that see it as a low-cost method of database mining. So, every patient with an Era-platform hearing aid [except the high-end Moxi Pro] could be invited to an “Upgrade Day” where they’d try a risk-free upgrade. For example, they could be sent home with a 2-week risk-free upgrade of two performance levels. They can try it themselves in real-life situations. This is a new way of generating sales.

So, ultimately, Flex:upgrade is a solution that is left up to the dispenser to decide how they wish to use it.

Metzdorff: I think it’s important that we leave it up to the dispenser to judge what best suits them and their business relative to the upgrade. It may be that they decide to use it as a separate campaign to pull people in. Others will prefer to use it more subtly, offering upgrades during cleanings, the purchase of batteries, or hearing aid check-ups in which the customer is asked how they like the aids and address possible new hearing needs and desires using the upgradable features. —Karl Strom