Editor’s Note: Each month, physician reviewers will evaluate a particular app or category of apps that provide some functionality for medical practices and/or patients.
In 2017, I had the opportunity to review the Core stethoscope. This stethoscope from Eko Health is designed to increase a physician’s ability to understand auscultated sounds by way of providing visual waveforms for both cardiac and pulmonary sounds. I found the stethoscope to be an intriguing approach to taking traditional data and making it more useful for both point-of-care utilization and teaching purposes.
The Core quickly became my default stethoscope because of its audio and digital amplification quality as well as its ability to record waveforms. It wasn’t perfect—its main problem is a heavy digital head that kept falling off the tubing—but it was a promising start.
Read more: App review of Eko Stethoscope
Now, early adopter physicians around the country are getting their hands on the company’s latest model, the Duo. As its name suggests, the Duo focuses on two things in addition to traditional auscultation: the ability to record audio waveforms of cardiopulmonary sounds AND capture electrical activity in the form of a single-lead EKG. This is amazing and adds a whole new dimension to the traditional art of auscultation.
Jason Bellet, one of Eko Health’s co-founders and current vice president of provider solutions, told me they started the company back in 2013 at University of California, Berkeley because they wanted to develop a tool that could augment cardiopulmonary assessment. They spent a long time working with established cardiologists to understand what was needed.
Ultimately, they decided modifying the stethoscope was an ideal way to bridge the gap between traditional auscultation and data analysis and evaluation. They wanted to ensure that their device could be used in a fully digital fashion complete with excellent fidelity and also capture data in an interactive way to make the findings actionable. With the Duo, the company is one step closer to its vision of a product that can gather, analyze, and interpret traditional physical findings.
The Duo brings together multiple pieces of information. There is traditional auscultation of the heart and lungs combined with audio waveforms of the sounds, a phonocardiogram, and a single-lead EKG that, depending on chest placement, can act as different leads from a traditional 12-lead EKG.
The Duo will definitely cause providers to do a double take. At first glance, the Duo looks like a stethoscope earpiece/tube combo connected to a long silver box as opposed to the traditional bell/diaphragm combo. The box is where all the magic is housed, as it connects to stainless steel leads as well as the audio transducer. The Duo’s tubing actually screws into the box. This is a godsend modification for anyone who encountered the frustration of the original Core’s transducer, which constantly slid off the tubing because of its weight.
In practice, the Duo can fairly easily be used as a traditional stethoscope. There are some issues when using it for cardiac auscultation with women because of anatomic considerations, but a bit of careful maneuvering makes the process easier. Excessive body hair also makes it difficult to get an accurate EKG, but this was not a consistent issue. The tubing connecting the earpieces to the transducer is a little short, but any longer and the transducer’s oblong shape would probably make it awkward to carry. Last, the tubing cannot be swapped for another tube, such as with the Core, because of the proprietary connection to the transducer.