Listening to your favorite music for at least 90 minutes a day and treating your tinnitus with it? Almost sounds too good to be true. Yet more and more German statutory health insurance providers pay for this treatment. We wanted to know more about it and spoke with Jörg Land, the CEO of Sonormed GmbH, about Tinnitracks.
Mr. Land, how did you come up with the idea of developing the Tinnitracks app to treat tinnitus with music?
Jörg Land: We did not come up with the idea of bringing tinnitus and music together, but we developed the respective research product. At the time, the subject was actually brought up to a colleague and that gave us the idea – in other words, the subject found us. You subsequently have several discussions and contemplate whether there are any technical solutions available.
What technical requirements need to be met for this app?
Land: You simply need an Apple or Android device as well as your own music files. Having said that, before you can use the app, you also need an accurate diagnosis by an ENT doctor. That’s all a patient needs and what determines the treatment. The complexity remains with the system. After all, the patients administer the therapy at home. The app is deliberately simple. Users see a music player with which they can play their tracks. We don’t want to leave anyone behind because of bad usability.
Can I convert any music file with this app?
Land: You can convert any music track. However, we check whether it is suitable for the therapy. This is indicated via a signal that indicates either red or green since not every music file is appropriate for everyone. For example, if a patient suffers from very high-frequency tinnitus and wants to use classical music – that being music with very dynamic sound patterns and many quiet sections – it won’t work. People also like to try audio books. However, human voices display narrowband speech signals and are therefore also not suitable for this purpose.
Why is it presently not possible to use streamed pieces of music?
Land: We are moving step by step. The age profile of our users suggests that they still use their own music tracks and don’t stream music. However, we monitor our user feedback very closely and consider user suggestions and requests.
How long should people use the app?
Land: That depends on how long it takes for the treatment to work. We recommend administering the therapy for at least 12 months. That seems like a long time but we assume good compliance since we are combining an existing behavior pattern – listening to music – with traditional hardware. The best treatment is ineffective if patients don’t want it.
The app has been certified as a medical device. What were the required qualifications?
Land: We had to and still must document and safeguard everything. That is to say, we created the app to meet the requirements for a digital medical device. For example, every update cycle is being documented and also includes CE testing with every update. All processes have been developed to comply with legal requirements. Even though this sometimes makes things more complicated, it is crucial for our product. What’s more, it is unlikely that these processes will become any easier in the future. We are only able to collaborate with healthcare players, such as the German Technician Health Insurance (German: Techniker Krankenkasse) for example if we provide a medical device.
You just mentioned that you are also collaborating with statutory health insurance companies. Why are not all statutory health insurance providers covering the costs of this app?
Land: As is the case with every market, there are early and late market participants. Some health insurance providers want to be involved and help shape the process very early on. Others take more time. Having said that, if you compare Tinnitracks with other digital solutions on the market, we have already come a long way. Even though a great product is a prerequisite in the healthcare market, it isn’t always critical to success. Success comes with gaining market access and when physicians understand the product and want to use and prescribe it, respectively.
You also offer subscriptions paid out of pocket. Do you check whether tinnitus frequency has also been accurately determined in these cases?
Land: Things are clear with patients whose health insurance provider covers the costs. Only the physician can provide the activation code for the app. This is also where patients received their diagnosis and frequency determination. Needless to say, we are not fully in control in the case of users who choose to utilize the app on their own. However, they also need to know their tinnitus frequency to be able to properly use the app. This generally requires a visit to an ENT physician or audiologist.