Hello, and welcome to this IHS training on Rexton's latest platform, REACH. My name is Jill Bombacci, and I'm part of Rexton's clinical development team. Today, we're going to talk about the form factors available in the REACH platform and we'll discuss how our proven technology is easy for you to fit and easy for your patients to wear. Here are our learning objectives for today. Upon completion of this course, you will be able to describe the features and benefits of the newest form factors in the REACH platform, describe automatically and manually activated features that can improve hearing performance in situations with multiple speakers in challenging acoustic environments, and identify programming tools that can be used to address issues that may be brought up during follow-up visits. I always like to start out with our brand promise, and our brand promise is rely on Rexton. This is a reassurance to people with hearing loss that no matter what life throws at them, we won't let them down and they can always rely on Rexton. And our core idea is that our products are life-proof. This simple yet powerful message truly sets us apart from competitors. It's a takeaway we want you to remember, a compelling reason to choose and trust our products. It's more than just a purchase, it's a meaningful choice. Rexton REACH offers a solution that enables patients to keep track of multiple voices simultaneously, reaching out for the speech of each person in the conversation. Voice focus scans the surrounding environment 1,000 times per second with four independent focus beams. This is directionality reimagined in a way that was previously not possible in hearing aids. Multi-voice focus enables REACH to constantly adapt to the changing dynamics of the people speaking, drastically improving the hearing experience. REACH is based on four pillars. The first is multi-track processing, which enables us to use separate processors, assigning one for speech and one for background sounds. The second is multi-voice focus, which allows for four independent directional focus areas to engage simultaneously. Next we have voice stabilizer, which controls the compression for each of the four focus areas. And finally, connectivity, keeping the wearer engaged with their world through media devices like cell phones. Let's first take a closer look at multi-track processing. With single-track processing, one band or processor handles both speech and noise, so compromises need to be made. There's always going to be a time when speech is overlapped with noise, so the hearing aids need to decide, do I enhance speech or do I lower background noise? With our multi-track processing, there is no compromise. Multi-track processing targets speech sounds and processes them separately from background sounds. Each input receives a separate and dedicated sound processing strategy, meaning we have 48 processing channels for speech and an additional 48 for background sounds. Speech is processed in one track, where the compression ratios are kept low, and background sounds are processed in a separate track and receive a level of compression that keeps them comfortable while retaining their natural qualities. This ensures that gain and compression algorithms are applied for better speech and background sound processing. Then they're mixed back together, after all parameters are set properly to each of the signals. The result? Target speech sounds are processed without the interference of surrounding noises, so the patient is able to hear the speaker with ease. Rexton REACH is able to take this technology to the next level with the introduction of multi-voice focus. The new multi-voice focus adds an additional layer of speech enhancement for challenging situations with multiple speakers, and it does this by analyzing and steering multiple directional beams at the same time. Multi-voice focus is a completely new and stronger microphone steering system that can track and detect multiple voices and enhances each individual speaker. It analyzes the acoustic scene 1,000 times per second and is optimized to pick up voices even in the most complex situations. It includes a proximity analysis to identify the voices of the wearer's conversational patterns. It focuses on dominant speakers within normal conversational distance of 2 meters or a little over 6 feet. The benefit for the wearer is to be able to hear all conversation partners easily and maintain the natural quality of every sound around. Think about narrow directionality. Other manufacturers have recently added narrow directionality, which has actually been a feature in our hearing aids for years, but we took a leap further with multi-voice focus. Now, as you know, with narrow directionality, you need to face the speaker. So conversing with multiple speakers can be extremely challenging. Well, we are the only ones who now can actually track and follow multiple voices. With multi-voice focus, we make hearing easy. We do the work for you so the wearer is never left out of the conversation. Now let's take a look at another feature designed to enhance speech, voice stabilizer. When in an environment where background noise gets louder, the signal-to-noise ratio is compromised. It's harder to hear speech over that loud surrounding sound. So what voice stabilizer does is it controls the compression knee points to ensure that all voices within the focus beams are amplified in the very best way. It allows the wearer to maintain focus on target voices when the noise in the environment gets louder. Now the separate processing of speech and noise in two different tracks, our multi-track processing, allows for more aggressive compression of the noise and more linear and stable processing of the speech signal. So it ensures a strong contrast between speech and noise so that background noise is never going to overpower speech. Now let's take a look at a study that was performed to determine how Rexton Reach performs in real-life situations. So a study was performed using 78 experienced hearing aid wearers. 31 participants were female and 47 participants were male, and they all had mild to moderate sensorineural hearing losses. They were all fitted bilaterally with different makes and models of hearing aids. The participants were asked to complete a questionnaire based on the performance of their own hearing aids. The participants were then fitted bilaterally with ReachLIT hearing aids with M receivers and appropriate sleeves and were asked to wear the Rexton ReachLITs for two weeks, then alternate back to wearing their own hearing aids for two weeks, and then again wearing the Rexton ReachLIT hearing aids for two weeks. And they were asked to fill out a questionnaire at the end of each of those two-week wearing periods. Questions were related to their listening experience and satisfaction and response options were based on a seven-point scale. Participants were asked about their conversation experience. For example, are they able to contribute to a conversation? Do they feel included? Do they feel frustrated? And are they able to stay involved in a conversation and not have to withdraw from groups? As you can see in this slide, Reach rated higher than the participants' own devices in all situations. As part of the final questionnaire, participants were asked if they would recommend Reach and whether they would choose to keep Reach. 81% of participants would recommend the ReachLIT hearing aids and 78% of participants would keep them. The final questionnaire also asked participants whether they preferred their own hearing aids or the ReachLIT hearing aids for certain listening situations like better speech understanding, increased listening effort, feeling more confident, and overall preference. They rated the ReachLIT hearing aids better than their own hearing aids in all listening situations. If you would like further information regarding this study, please feel free to scan the QR code you see on this slide. Connectivity is another important focus of the new Reach platform, as we know that connectivity really is an important feature for your patient. Reach uses made-for-iPhone and ASHA protocols to connect seamlessly with smartphones. The ReachLITs are Bluetooth LE audio ready due to our latest firmware update. Please note that this firmware update is not required. It is an option for those patients that purchase new Android smartphones that are equipped with LE audio. So here you see our current Bluetooth protocols made for iPhone, ASHA, and LE audio. Made-for-iPhone allows for phone call and audio streaming, and when using it for phone calls, the patient may use hands-free mode, needing only to push the rocker switch to accept a phone call. The patient's voice will be picked up by the hearing aids' microphones. The ASHA protocol used in Android phones allows for the same streaming of phone and audio, but without the hands-free mode. And if your patient does have an Android phone that's equipped with LE audio, they will have that hands-free calling feature. So how do we know if a phone is compatible? It's so hard to keep track as new phones come out often. And then you have that patient that comes in with a phone that's so old you've never even seen it before, and there are so many different Android phones, it's so hard to keep track of which ones are compatible. Well now we have an easy way to determine if your patient's phone is compatible. We have our device compatibility QR code that you'll see here on the screen. Simply scan that QR code with your patient's phone to determine if that phone is compatible. All you need to do is open up the phone's camera, focus on the QR code and tap the link. The phone will then display if it's compatible with the Rexton app, if it's capable of streaming calls and audio, and if it's capable of hands-free use. It even reports the model of the phone and the operating system version. It's so quick and easy. So let's talk a little bit more about the Rexton Reach RLIT. The small Reach LIT is available in three performance levels, 80, 60, and 40. It features our top audiology and connectivity features and comes with redesigned housing. The newly designed rocker switch has rugged bumps that makes it easier to feel and use. Like all of our other RIC devices, the Reach LITs are IP68 rated and have a water and oil repelling coating and a new anti-capillary housing design. Our Reach RICs are also ATEX certified, making them suitable for use in combustible environments. Reach uses our current Earware 3.0 and you have the option to choose between four receiver powers covering over 90% of hearing losses. The new Reach is packed with features that are sure to make wearer's listening experience a more satisfying endeavor. Besides multi-track processing, multi-voice focus, voice stabilizer and the connectivity features we've already discussed, there are many other features designed to improve the wearer's hearing experience. My Voice 2.0 is designed to automatically improve the wearer's own voice perception. It allows for the use of more closed fittings that make better use of noise reduction and directionality. Sound Pro 3.0 is the brain that controls and integrates features to influence the hearing aid's performance. It allows you to customize the hearing aid's response to meet the wearer's needs and preferences. The motion sensors are also used to modify the hearing aid's response by changing noise reduction and directionality based on the motion of the wearer. Headset mode and hands-free mode allow for easy use of iPhones when taking phone calls. Rexton Assist provides wearers with full control of the hearing aid's response using artificial intelligence and the input of the hearing aids. The hearing aids are built with a telecoil for use in looped environments like airports and theaters and for use with landline phones. For those environments with high reverberation, we have our unique auto-echo reducer. Our wind noise canceler is especially tailored to reduce wind noise and improve speech understanding in the presence of wind. The music enhancer provides the wearer with a more natural music listening experience. And telecare so you can easily support the wearer's needs without them having to visit the hearing center. The Reach RLIT is available in four colors, rose gold, dark champagne, sandy brown, and black. The Reach LIT is rechargeable and provides up to 34 hours of runtime on a single charge and that's including 5 hours of streaming. If the wearer is not streaming, the hearing aids will provide up to 39 hours of runtime on a single charge. So wearers are sure to get a full day or two of use from a single charge. The hearing aids come with the charging station R as a standard offering, but wearers have the option to opt for the universal cable charger or upgrade to the travel charger or the charging plus station. The charging plus station is a charger that also functions as a hearing aid dryer and sanitizer. Connectivity goes beyond connecting to your phones. It also includes connecting to other devices like the smart key, the smart mic, and the smart transmitter 2.4. The smart key acts as a remote control for volume control and programming changes. The smart mic allows for connection to devices that do not feature made for iPhone or Asha protocols and can also be used as a microphone during a lecture. The smart transmitter 2.4 allows for streaming of the TV signal to the hearing aids in surround sound. In addition, we offer the smart demo as well as the cross RLI. Connecting for the REACH RLIT is via the NOAA link wireless. To ensure we meet the needs of every patient, Rexton offers Rexton Assist, which can be accessed from the Rexton app. This feature, completely powered by artificial intelligence, allows wearers to take control of their own hearing performance to tailor the sound to their needs and preferences anytime, anywhere. The patient just needs to answer a few simple, plain language, straightforward questions and the AI using this input and the environment analysis will provide a solution to any issues faced by the wearer. Rexton Assist also provides instructions on how to handle the hearing aids and offers tips and solutions on how to overcome issues that may arise. It even adjusts the hearing aids, if needed, based on input from the member in real time. Changes performed on the hearing aids by the patient may be seen in Connects, whether it's an in-person visit or via Telecare. The Rexton Assist platform is simple to use and it has a fresh new look and more user-friendly attributes. Wearers can download and activate it at their convenience, giving them greater control over their hearing aids performance with instant hearing solutions. Let's talk a little bit about performance level differentiation. On this slide, you'll see the differences between the 80, 60, and 40 performance levels of the Reach LIT. The 80 performance level tracks multiple voices across four focus beams, so there's no need to look at each target speaker. The 60 performance level tracks multiple voices across two focus beams, so there isn't as much support for lateral voices and therefore requires some more head steering. And the 40 performance level tracks multiple voices in front focus, so voices are still analyzed, but with less contrast. Let's take a look at the latest form factor in the Reach platform, the Reach Inox CICLI. This is the first invisible hearing aid with rechargeability from the Rexton portfolio. It's an instant fit hearing aid that is still small and discreet, but is now rechargeable. Your patient will get up to 28 hours of runtime on a single charge. It's offered in the 80 and 40 performance level, is IP68 rated, and is ATEx certified. The black shell reduces complexity for both the user and the hearing care provider. The hearing aids are clearly marked with a white R and L side indicator. There is a sleeve position indicator to assure your patient attaches the sleeve properly. Color options for the faceplate are black or mocha. When choosing the faceplate color, consider that the black does create a shadow effect and can become even more discreet. The Reach Inox CICLI fits from a mild to moderate hearing loss and again is offered in performance levels 80 and 40. Reach Inox CICLI uses 3.0 earwear. Both sleeves or domes can be used. There is also an option for a custom earmold, which of course will require an earmold impression. Let's talk about the Reach Instant Fit CIC Travel Charger. The charger for the Reach Inox CICLI has L and R indicators that are strategically placed to the left and right accordingly, making it easy for your patient to know which ear to put the devices in. Your patient will get up to 28 hours of runtime on a single charge. It will take about 4 hours for a full charge, but there is also a quick charge feature. Placing the hearing aids in the charger for 30 minutes will add about 6 hours of runtime. The charger does have a built-in power bank for convenient charging on the go. The charger will provide up to 4 charges on the go. The charger uses a USB-C cord and can also be charged using a Qi wireless charging pad. The Reach Inox CICLI hearing aids are optimized for size. There is no Bluetooth, no motion sensors, and no MyVoice. However, the hearing aids include Voice Stabilizer, SoundPro 3.0, and have binaural 1-mic directionality. With binaural 1-mic directionality, the microphones from each of the hearing aids work together to create a directional listening pattern. This amplifies speech from the front to help wearers hear speech better when in noisy environments. This offers unmatched conversation support in noisy environments. In addition, the hearing aids offer telecare via the Rexton portal. Programming for the Reach Inox CICLI hearing aids is done via the Connex Air. The devices can be paired to the Rexton app via acoustic pairing. Performance levels of 80 and 40 are offered and a cross is available and is compatible with both the 80 and 40 performance levels. In addition, a smart demo is available for purchase. Voice Stabilizer is one of the main features of the Inox CICLI. It provides the contrast needed to reliably distinguish speech. We talked about Voice Stabilizer earlier when discussing the RLIT hearing aids, but I'll mention it again as a reminder. When background noise gets louder, the signal-to-noise ratio is compromised. With Voice Stabilizer, it's controlling the compression knee points to secure that speech is amplified in the best linear way. Because we have our multi-track processing and have that separate processing of speech and noise in two separate tracks, it allows for more aggressive compression of the noise and more linear and stable processing of the speech. And what that's going to do is create that strong contrast between speech and noise so that background noise is not going to overpower the speech. Now let's talk about the differences between the two performance levels offered for the Inox CICLI. So this chart shows the different features according to performance level. As you can see, Voice Stabilizer is offered in both the 80 and 40 performance levels. Wind Noise Reducer reduces the interference of wind noise when outdoors. It is offered in both performance levels, but there is more aggressive wind noise reduction in the 80 level. In terms of Music Enhancer, there are three music programs offered in the 80 performance level, Playing an Instrument, Live Music, and Recorded, as opposed to one music level in the 40 performance level, Recorded Music. And Auto Echo Reducer and Bandwidth Extender are offered in the 80 performance level only. They are not offered in the 40 performance levels. So let's talk about who a candidate is for the REACH Inox CICLIs. So a person who typically resists wearing hearing aids due to their strong preference for a discreet solution, would be a great candidate for this form factor. First-time hearing aid wearers, experienced hearing aid wearers, experienced in-the-ear users who really want to avoid that everyday hassle of having to change batteries, younger users, people with mild hearing losses that maybe want to wear hearing aids for occasional use, and people with active lifestyles that maybe want small hearing aids and want to have a portable charger. Rexton hearing aids are easy to fit and easy to adjust. I always like to go back and go through the steps of a first fit. So first, you'll want to prepare for your fitting by charging the hearing aids prior to connecting. They will arrive to you with 30% charge, but it is best practice to place them in the charger for at least 15 minutes before programming. The hearing aids are going to turn off when placed in the charger, and they will turn on when removed from the charger. Once the hearing aids are removed from the charger, they're going to remain in discovery mode for three minutes. Another way of turning off the RIC hearing aids is by pressing the lower part of the rocker switch for five to six seconds. That's going to turn off the hearing aids, and pressing that bottom part of the rocker switch again for five to six seconds is going to turn those hearing aids back on. The RIC hearing aids are programmed using the NOAA Link Wireless, and the INOX CICLIs are programmed using the Connects Air. You can perform a first fit in just a few simple steps. First, you're going to select your acoustical parameters for each ear. If using an ear tip, please be sure you're actually using the same style ear tip you choose here in acoustical parameters. If using an ear mold, be sure to change the coupling type to ear mold and select the vent size. The choices you make here are going to affect the response of the hearing aids. So if after you fit the hearing aids, you decide that you want to change maybe to a different ear tip, for example, you want to change from a vented sleeve to a closed sleeve, be sure to come back here and select the correct ear tip and then recalculate the fit. And remember, we always do recommend fitting as closed as possible. Next, you'll select your fitting formula and experience level. You can choose between the different fitting formulas. We do recommend fitting to Smart Fit, which is our proprietary formula. And it's specifically designed for our hearing aids and is based on NALNL2. We also recommend fitting your patient to Experienced, even if they are a new user. If you choose New, keep in mind that you'll be at about 70% of target. So we want you to fit them to Target, fit them to Experienced. Now, if you do fit to Experienced and the amplification at this level is too much for the patient, you can always use automatic acclimatization to make the hearing aids more comfortable for your patient. The hearing aids will then return to full target over time on their own without the need for future visits. Next, you're going to click on that First Fit button on the bottom right of the screen. And of course, be sure to always run MyVoice 2.0 as part of your First Fit to reduce the occlusion sensation. To end your fitting session, click the Disconnect button, then click the X on the upper right corner and select Yes to save the hearing aids settings. Automatic acclimatization is a great feature that allows the user to leave their fitting appointment with their hearing aids set at a comfortable level for them while ensuring that the gain will automatically reach the desired target over a specified period. So after performing the First Fit and running MyVoice, you're going to go to Automatic Optimization and then Automatic Acclimatization. Now, you'll first need to choose a fitting strategy. We recommend using Current Gain We recommend using Current Gain as endpoint. So if you first fit your patient, they're at target and it just seems uncomfortably loud to them, they just can't tolerate that loudness, using the Current Gain as endpoint strategy will assure that the wearer will gradually return to this target. Now, there is an option to use a feature called Smart Acclimatization. You'll see it right there in that strategy box. And checking the box for Smart Acclimatization will allow the wearer to reach the endpoint more quickly or slowly. And this is based on the wearer's volume adjustments. Next, you'll choose the settings. Flat is going to reduce the gain across all frequencies by six decibels. This is a good option for patients maybe that state that all sounds are uncomfortably loud. Speech is a good option when there's a sibilance or harshness to the sound of the hearing aids. And high frequencies is used when all sounds, especially soft sounds, sound too tinny or metallic, or even just too loud. Then you can select the length of time that Automatic Acclimatization will run for. So I would say most of your patients coming in have a sensorineural hearing loss. So for that type of loss, we would recommend choosing four weeks or two months. Finally, you're going to make sure that you press that Start button. This is going to begin the process of slowly returning the hearing aids to full target. This step is extremely important. If you don't press that Start button, the hearing aids are going to remain under target indefinitely. So please make sure that you press that Start button. If for some reason you need to stop the process, for example, maybe you're making changes to the receiver or the earwear or other gain changes, pressing that Stop button halts the process and leaves the hearing aids where they are. There is a button below that, that arrow bent to the left. That's the Reset button. Hitting that Reset button is going to not only stop the process, but it's going to take the hearing aids back to the gain settings obtained before automatic acclimatization was activated. So be sure if you are stopping the process that you hit that Reset button. So let's talk a little bit about our SoundPro 3.0. In SoundPro 3.0, slow acting compression is addressed among other processing parameters in this screen with the simple movement of a slider. Now to get to SoundPro 3.0, you just need to click it. It's in that left-hand gray panel on your screen. And it is defaulted to balanced focus. However, if your patient feels they need more support in noisy environments, you can move this slider toward speech focus because we want to focus more on speech, right? We want to try to get rid of some of that background sound. So one step towards speech focus, a little goes a long way if they need more support when they're in noise. Now, if your patient maybe is used to having more awareness of their surroundings, you could always move that slider in the opposite direction one step toward natural focus. Now, we really don't recommend making changes here unless it comes up in a follow-up visit because most people do well in balanced focus. So after your first fit, your patient leaves, wears the hearing aids for a few weeks and then comes back for a follow-up. If they need more support in noisy situations at that point, then you would make those changes here. You also have the option to customize the hearing aids with some of our offsets that you'll see here. We have noise, music, car, audio, TV, and headset mode. So let's say your patient comes back and is having some issues when they're in the car. Let's say they're complaining that road noise just seems uncomfortably loud. So you would click on that car offset and here you'll be able to make adjustments to the hearing aids. Now, these adjustments are going to happen automatically whenever your patient is in a car. So if they're having issues with road noise, you could come here and make a change. Road noise is a very low frequency, so you can just drop the gain down two to three steps in those first three handles. These frequencies are outside of the speech frequency range, so dropping the gain in these three handles is really going to help this patient get rid of some of that road noise when they're in a car. You also have the option to customize the hearing aids when your patient is streaming. Now, we have the audio and the headset mode here in our offsets. Audio is for streaming and headset mode is for phone calls. So let's say your patient is having some issues hearing when they're talking on the telephone. You would click that headset mode offset. And let's say your patient says that, you know, they're just hearing too much surrounding sound when they're on the telephone. Well, there's this mix with microphone level. This is set at 70% by default. What that means is the microphone of the hearing aids is still on, but it's at 70%. The microphone level is dropped down, so that surrounding sound is still on. If they're having difficulty when they're at 70%, you can move that slider down. You could drop it to 55%, 45% just to make the microphones not as sensitive and not picking up that surrounding noise while the patient is on the telephone. There's also an option to set the volume to a different level. So let's say we're on the phone, there's also an option here for auto volume. Checking that auto volume box is going to improve the streaming signal because it's going to adjust the loudness of the streaming depending on how loud or quiet that environmental noise is. So if the environmental noise is loud, the streaming signal is gonna be increased so you could hear it better over that environmental noise. This is a really, really great feature. I like using it for everybody. It is an option here. It's defaulted off. So if it's something that you wanna add for your patient, just remember to check that auto volume box. So before we end, I just wanna give you all some key takeaways. First for the REACH RLIT. So the REACH RLIT powered by multi-track processing separates speech and background sounds into two completely independent tracks. This is hearing aid innovation exclusive to REXTIN. Our multi-voice focus in our REACH RLIT, another first in hearing technology, allows wearers to track and focus on multiple speakers individually. This is a huge step forward from what was already our impressive narrow directionality technology. And as we all know, now connectivity is even more important for wearers. That's why we have developed a device that is upgradable with a simple firmware update to take full advantage of Bluetooth LE audio. And some key takeaways on our REACH INOX CICLI. This product features voice stabilizer, which provides the contrast needed to reliably distinguish speech. It is the most discreet and easy to fit solution and is now rechargeable and provides up to 28 hours of runtime on a single charge and can be charged up to four times on the go. And finally, life is unpredictable and hearing aids may be subject to environments that are not ideal. That's why REACH is life-proof. So wearers can always rely on REXTIN and go on with their lives without having to worry about their hearing aids. Thank you so much for taking the time to attend this webinar on our newest platform, the REXTIN REACH, and to learn about how our proven technology is easy for you to fit and easy for your patients to wear. We hope that the next time you're trying to decide which product to use, you'll REACH for REXTIN to help you and your patients engage better in their day-to-day conversations. We truly believe that every voice matters. And remember, no matter what life throws at you, you can always rely on REXTIN.

Rexton REACH

hearing solutions

multi-track processing

multi-voice focus

voice stabilizer

advanced connectivity

My Voice 2.0

Rexton Assist

life-proof promise