Stethoscopes to the Recycle Bin? Hold on Just a Heartbeat!

The development of new, more accurate and compact devices could soon consign the iconic Victorian stethoscope to the vault of medical history. Accompanying the stethoscope into the vault are the analog versions of the ophthalmoscope, the ECG machine, glucose monitor and even the brain scanner. This bold new digital health industry looks set to disrupt healthcare much as digital music finished off the LP. But disruption is trickier in practice than merely tweeting about it.

Here, we bring you some of the newest, shiniest devices looking to take their place in the doctor’s bag and the reasons they may take a little longer to get there than the hype would suggest:

The Not-So-Humble Stethoscope

Pocket-sized ultrasound probes are proving to be invaluable in hospital emergency rooms and cardiology departments. But that’s not all. Cheaper, digital stethoscopes are evolving in an exciting way. These hybrid gadgets can convert the analog sound of heart or lungs to a digital audio file, amplify it, and filter out noise. Eko Devices, out of Stanford’s StartX accelerator program, use a cloud-based analytics system to analyze recordings that are captured via an attachment gadget that clips onto a standard stethoscope and sends the file via Bluetooth to a smartphone.

Eko is not the only company to turn heart sounds into visual images that appear on a mobile device. Rijuven’s CardioSleeve does roughly the same thing. What’s more, it has FDA approval, which Eko doesn’t as of yet.

Sensi is already commercially available. It’s an analysis app that requires a separate electronic stethoscope. The makers of the ThinkLabs One digital stethoscope urge doctors in no uncertain terms: “Time to put your old stethoscope where it belongs – in a museum”.

Brain in the Palm of Your Hand

Milab, at the University of Denmark, has developed a prototype portable brain scanner. The team converted a simple gaming headset and attached it to a mobile phone or tablet, to create a 14-channel EEG scanner. In the US, nineteen months since the launch of Obama’s Brain Initiative , the NIH has announced $46 million in grant awards to more than 100 researchers, most of whom are working on tools that will map the brain. These include teams at West Virginia University who are engineering a mobile PET scanner, while a team at MIT are adapting MRI to show the activity of individual brain cells.

“Instagram for the Eye”

Dr. Robert Chang, assistant professor of ophthalmology, and his team at Stanford Engineering, have developed a smart opthalmoscope – a smartphone add-on that allows physicians to carry out eye examinations in the field. The phone’s camera takes diagnostic images of the retina, optic nerve and other tissues in the eye via a magnification lens. Ordinary medics will be able to capture the digital images and send them to specialists for diagnosis.

Another team member, Dr. David Myung, outlines the gadget’s potential in emergency situations. “Imagine a car accident victim arriving in the emergency department with an eye injury resulting in a hyphema – blood inside the front of her eye,” Myung says. “Normally the physician would have to describe this finding in her electronic record with words alone. Smartphones today not only have the camera resolution to supplement those words with a high-resolution photo but also the data-transfer capability to upload that photo securely to the medical record in a matter of seconds.”

Ultrasound that’s an iPad

Oscardi showed off their Oscult this week at London’s Disrupt Europe 2014. Its hardware allows doctors to perform an ultrasound by simply plugging the device into an iPad. According to the company, more than 60% of the world does not have access to ultrasound machines, which are expensive and complicated to use. Oscardi says over 80 million ultrasound scans are conducted each year in the US. In developing countries, many urgently-needed scans cannot be carried out. In other words, the potential market is huge for this technology.  So far, Oscult is being tested in veterinary medicine.

Now What?

It’s a brave, new world and there’s a lot to be excited about. Akhil Saklecha, Professor in Emergency Medicine at Northeastern Ohio Universities College of Medicine, says smart technology is the key to decentralizing medicine. “Imagine a physician assistant who is in a rural part of India or China or Africa using this technology. It can have a huge impact on quality of life.”

But before we give a group cheer, there are some hurdles to climb. Firstly, the costs. Good-quality, hand-held ultrasound probes cost up to $60,000. The hybrid stethoscopes, which use mobile phone technology, sell for around $400, not including fees for cloud usage and specific tests; however, that’s still three times the cost of a regular, old-fashioned one.

Additionally, there’s the threat of hacking. Hackers have never maliciously altered data on a medical device, as far as anyone knows, but the FDA and others have flagged this up as a frightening possibility. The FDA’s new guidelines encourage manufacturers to identify any threats and vulnerabilities of a new medical device.

Drowning in Data

Perhaps the biggest hurdle is the lack of integration between gadgets-generated data and healthcare system information. Dr. Paul Abramson, a primary care physician in San Francisco, interviewed on KQED, says he is definitely not a technophobe, but cautions that there needs to be better ways of analyzing the mass of data for it to be truly useful to him.

“One recent patient came in with twenty years of data in Excel spreadsheets, and several other formats – everything from heart rate to symptoms and medications.” Abramson says even the patient wasn’t sure what to make of it all. “The thought of going through it and trying to put it into a format where you could then analyze it or extract meaning from it was not really feasible.”

The upside is that once the hurdle of loading such data originating from patients’ gadgets is surpassed, there are smart analytic applications in place to leverage Enterprise- wide healthcare data in order to provide organizations with the best analytic insights to boost their performance and further spread these gadgets use.

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