The idea first came to Dr. Matthew Bromwich while on his annual visit to treat children in Iqaluit.
Many of the patients the CHEO ear, nose and throat specialist and surgeon saw in the North — where children suffer hearing loss at three times the national average — needed hearing tests. That often meant flying them and their families down to Ottawa because no audiologist was available in Iqaluit.
To 44-year-old Bromwich, who has been described as an “ideas factory,” it was a problem begging for a solution.
“I said: ‘Why can’t we fit something in a shoebox and send it up and do testing there?’”
That was a decade ago. At the time, the only option for hearing testing meant visiting an audiologist at a special site equipped with a booth and specially designed equipment. The system created bottlenecks and tended to isolate hearing testing from the overall health system, says Bromwich, although hearing loss is a massive and growing problem.
Today, Bromwich’s concept has blossomed into a thriving high-tech business that is changing the way hearing testing is done around the world. The tablet-based audiometer he created and first tested on his three-year-old son not only fits into a shoebox, but is easy to use.
So far, 350,000 people around the world have had their hearing tested using the technology, which represents the first real innovation in hearing testing in decades. It is now being used in 60 countries and the company has 54 so-called outreach projects, which help bring hearing testing to poorer communities at lower or no cost.
Bromwich calls it the democratization of hearing testing and Shoebox Audiometry is doing that in ways that he likely could not have imagined while working on the concept in his basement between shifts at CHEO and work on a handful of other medical inventions.
On Wednesday, at Shoebox’s busy offices off Preston Street, Bromwich and the company he founded gave back to CHEO with a $150,000 donation — a thank you for the innovation grant and the support the Ottawa-based children’s hospital gave Bromwich that helped him develop the idea.
“We are enormously proud of Matt’s innovation and leadership,” said CHEO CEO Alex Munter. “Our goal is to create a community of problem solvers at CHEO.”
Munter said Bromwich embodies that ethos. Among other things, it was Bromwich who proposed the hospital create a healing garden.
Bromwich initially worked on the Shoebox concept with his brother Julian, a programmer. They looked at how they could use the newly released iPad technology to “gamify” hearing testing to make it more accessible while still getting medical quality results.
Five years ago Bromwich, whose day job is as a pediatric airways surgeon — saving the lives of children with blocked airways — weighed leaving medicine to run the company. Instead, he stepped down as CEO and became the company’s chief medical officer while continuing to work full-time as a surgeon — a job he loves. His brother Julian is the company’s chief technology officer.
The company hired high-tech entrepreneur Michael Weider as CEO. When he first met with Bromwich, Weider said he was intrigued.
“My background is in technology, not medical devices. I have been involved for many years in tech businesses that have had commercial success, but one thing that was missing was the human element.
“I saw the business potential of what Matt was working on, but also the potential to impact people on a global basis in our health care system in a way that was never possible in anything else that I had worked on.”
Hearing loss, he noted, affects an estimated 466 million people around the world and that number is expected to grow to 900 million in coming years.
“We are almost all testing our eyes on a yearly basis but hearing is the neglected problem that doesn’t get the same level of attention.”
That is changing.
Weider said someone around the world is being tested every three minutes with Shoebox technology.
“We have impacted hundreds of thousands of people around the world and we feel like this is just the beginning.”
The United States is the company’s biggest market. Occupation safety is also a major focus, as is working in low-income countries.
Recently, Shoebox worked with an NGO in the Democratic Republic of Congo bringing the technology to health workers treating people for drug resistant tuberculosis. One side-effect of treatment can be deafness, but in order to prevent it, patients had to be sent by ambulance across the city to an audiologist which meant delays and that often patients lost their hearing.
The use of the tablet-based hearing test means drug-related deafness can be prevented in most cases. It also has freed up ambulances for other pressing needs.
The company is also working with Bruyère Hospital to screen patients for hearing loss using Shoebox technology as soon as they walk into the hospital. The project is aimed at making sure undetected hearing loss is discovered and that, using a portable amplifier, patients can hear the instructions they receive from health professionals.
“It is remarkable how much of a difference it makes,” said Bromwich.
He said bringing hearing testing to people who would not have had access to it is amazing. “I love it.”
Recently, Bromwich travelled to rural Peru where there is a shortage of audiologists. Representatives from Shoebox trained volunteers who screened more than 3,000 children for hearing loss.
“Seeing the impact globally, a world away in Peru, is amazing.”
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