How We Built Our ‘World-First’ Invention Into A Successful Global Health Startup

Updated on 17 May 2017

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Pretoria-based HearScreen has developed what it hopes is a product that will improve the lives of millions of people across the globe. The e-health startup has developed a smartphone app that accurately detects hearing loss and links patients to health services.

Not only is this app the first of its kind, according to co-founder, Dr Herman Myburgh, it is used in 25 countries worldwide, including Ethiopia, Australia and Guatemala.

Validation Helped Us Avoid One Of The Biggest Mistakes

To develop a clinically valid product that is calibrated to international standards, and most importantly that customers would want, they had to conduct intensive product validation, says Myburgh, a computer engineering specialist who developed the app together with Prof De Wet Swanepoel who is lead-inventor and professor of audiology at the University of Pretoria.

What the team uncovered through product validation was not only what customers really want, but also how to improve on it to meet stringent international standards.

“Validation was important because we wanted to offer this solution as a comparable test to existing hearing screening technologies, while optimising the screening process and reducing costs,” says Myburgh.

In this way they were able to avoid one of the biggest mistakes that many new businesses make, developing products that customers don’t want.

In the end they created an app that provides a step-by-step guide for conducting a screening test as well as an explanation of the results. The complete device includes the app, a smartphone and a set of headphones.

The hearing test itself requires users to identify simple digits in the presence of background noise and then gives a score. The app also records the patient’s location during the assessment using Geotagging and patients with low scores are referred to the closest hearing health providers. According to Myburgh, HearScreen boasts an accuracy rate exceeding 90% for correctly identifying hearing loss.

Serving a Greater Need

The rewards have been significant, says Myburgh, the team plans to expand to 40 countries by the end of this year to meet the demand for the product. According to the HearScreen website, 360 million people globally have permanent disabling hearing loss, and unidentified hearing loss has far reaching consequences including communication difficulties, reduced energy and a higher risk of depression and dementia.

Myburgh says they are also motivated by the desire to ensure hearing healthcare for everyone, particularly in poor communities.

“At present, hearing test equipment is prohibitively expensive and inaccessible to the vast majority of South Africans,” says HearScreen chief executive Nic Klopper in an interview with The Guardian.

“We’ve improved the solution tremendously by being responsive to customer feedback from the field”

Myburgh says, “We measure our impact on the number of people our innovation can help. Social impact is therefore what drives the business, and is partly responsible for our success to date. Our partners love to know that together we are making a lasting impact that is measurable, and that enables people to get assistance to fulfill a basic human need. There is a great need to identify hearing loss early in life. If identified early, many interventions can be performed to improve learning and socialising. If identified too late, or not at all, it could lead to school failures and inhibit a person’s development to their full potential.”

SME South Africa speaks with Myburgh about what the validation process taught them about their app and customers.


The HearScreen team.

The Success Indicators Came Down To Reliability and Ease of Use
After development of the concept application, various experiments were performed in the laboratory to ensure that the device could be calibrated according to international standards. We also performed experiments to ensure the noise monitoring function was able to truthfully detect ambient noise levels during testing.

The user interface was also designed to be easy to use, with no prior training required. Experiments in the laboratory confirmed the accuracy of the device, but validation studies had to be performed to compare it against the current gold standard in terms of accuracy and sensitivity. The initial study included approximately 300 people, while a larger study was later performed on more than 1000 people.

These studies confirmed that the device was as accurate as current screening audiometry. Subsequent studies were done in various contexts and published in international journals.

The App Had To Provide A Complete Solution
We wanted to see that the device was easy to use, that it produced accurate and valid results and was at least comparable to existing screening audiometry. We also had to ensure that the app empowered community health workers to test people’s hearing with minimal training and that it could be used as a solution to connect patients to healthcare providers to address their hearing health concerns.

We Learnt That Simplicity Was King
Firstly, [we learnt] that the user interface is very important, and that it had to be adapted/optimised to be simple and intuitive. We aimed for it to be operated by someone who’s illiterate.

Secondly, the screening environment has to be meticulously controlled to ensure ambient noise levels are sufficiently low to allow for screening. Too loud ambient noise could result in false referrals. However, our noise monitoring function ensured that we could retest those patients who failed due to high ambient noise levels.

Thirdly, the screeners had to understand the importance of hearing screening, and had to buy into the programme. They felt empowered and knew they were making a difference.

The Early Customer Feedback Was Invaluable 
The importance of being flexible and adaptable to the needs and requirements of customers [was one of the biggest lessons in terms of our customers]. We’ve improved the solution tremendously by being responsive to customer feedback from the field.

Breaking New Ground Came With Its Own Set Of Challenges
[The most difficult aspect to validating the app was] making sure that it adheres to the stringent international standards for audiometric equipment in every respect. Since it’s the first of its kind it really has been breaking some new ground in this area which has meant lots of hard work and perseverance.

You Never Stop Trying To Improve Your Product
While offering an affordable alternative, you have to keep innovating to improve your products and develop new products – this requires business growth and substantial capital outlay. Our focus has always been on hearing healthcare, but we’re also partnering with other companies to expand our offering to enable screening and testing of other important health parameters.

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