Imagine a clinician using the same technology as the Shazam music-identifying app to determine if your heart beat is normal or exhibiting a murmur. That’s just one of the things the makers of Eko Devices hope you’ll be able to do with their digital stethoscope in the near future, elevating the traditional sound medicine to a new level. Named one of TIME’s Best Inventions of 2015, the Eko Core digital stethoscope was developed by three undergrads at UC Berkeley with a unique combination of backgrounds in business, bioengineering, mechanical engineering, and computer science.
So how does it work? As TIME describes, it, “Once the smart adapter is attached to a stethoscope, it streams heartbeat data to the cloud so physicians can download it to a smartphone. From there, a companion app (iOS or Android) can analyze the audio and compare it to previous recordings, which may help doctors detect murmurs, heart-valve abnormalities and other conditions” not discernible to the human ear.
The founders started to question why something as universally used and fundamental to healthcare as a stethoscope lacked innovation, especially at a time when care is trending to value-based. A smart tool, already being worn by healthcare professionals both in and outside of a hospital, could help them to do their jobs better. It seems like a simple idea—but other digital stethoscopes had struggled with adoption and failed.
The San Francisco-based Eko team see their electronic stethoscope as just the beginning of its journey as a brand committed to building the future of cardiovascular care through a platform of non-invasive devices and revolutionary algorithms. Nicole Diamant and Jane Parker of InterbrandHealth sat down with COO and Co-Founder Jason Bellet to talk about its vision for the future of healthcare, and how Eko is making that happen.
InterbrandHealth: Why develop a new stethoscope? What about this ubiquitous tool intrigued you, and what’s the role of sound in health care?
Jason Bellet: One of my co-founders had been working with cardiologists at UCSF to try to understand the technical gaps in cardiology. One of the cardiologists took his stethoscope off his neck and said, “This is a tool that’s worn around the necks of 30 million clinicians around the world. It’s prevalent in every country, from the developing world to UCSF, from fresh-out-of-med-school students to pediatric cardiologists—they’re all using the same tool, yet it’s incredibly inefficient.” This is really astounding when you consider that sound is the frontline. It’s the indicator. It’s the alarm.
Think about when you go to the doctor. They see you, they take your temperature, they take your weight, and then they listen to you. What they’re listening for are sounds that are an indication of something else—whether it’s a wheeze or a murmur or tightness or a rub. They’re listening for all these different sounds that can be indicative of an issue. The sound is the medical justification for a scan, for an ECG—it’s the gatekeeper. And the spokes are the screenings they can do to find out what’s wrong. If the first line of defense isn’t as efficient as possible, you’re either paying for unnecessary testing or missing something entirely.
Heart conditions often present with sounds through a murmur. A lot of kids present with a heart murmur as they grow. What was happening was that pediatricians and nurse practitioners would hear these murmurs, and they wouldn’t know if they were innocent or pathologic. So they were telling people to get checked by a cardiologist. Clinicians have a hard time differentiating between normal and abnormal heart murmurs. And so our concept was, we have the stethoscope. Now, how do we make it digital, and how do we find a way to actually capture a recording of the sounds? And can we tie in machine learning to actually give point of care decision support for these physicians?
InterbrandHealth: How did you develop the product? And why is it different than both a traditional stethoscope and the other digital options that came before you?
Bellet: Stethoscopes are an extension of the doctors themselves, frequently staying around the neck for years and years like an old friend. We wanted to respect this relationship while making it work harder. The key is to fit into the physician’s existing routine. We had really good mentors at institutions across the country, and we started with more than 100 physician interviews in our design phase. The interviews gave us these pain points that we had to hit in order to ensure success.
We built the first digital stethoscope, to not only amplify heart and lung sounds—it amplifies them 40x -, but to actually stream the sounds via Bluetooth to a HIPAA-compliant app such that it can be used in a hospital setting. Whether it’s a physician’s phone or a hospital mobile talent, the device can capture heart and lung sounds, visualize them in waveform, save them and allow the physician to add a note, such as, sounds like a murmur. Then, the data can be shared securely with a cardiologist or consultant in a store-and-forward capacity; they can live stream it for real time telemedicine visits. The ability to do live consultation is essential and to do it you need to hear heart and lung sounds.
InterbrandHealth: You raise the topic of telemedicine. What role does Eko play in that space?
Bellet: We are in the digital medical device space. In order for telehealth to be effective you need to have digital medical devices. And we bridge that gap. From a device perspective, we want this to be in the hands of every clinician. If you’re using a stethoscope, you can benefit from our product, and that’s something that we take very seriously. From the software side, we want to power the telemedicine of the future. So we want this to be part of at-home kits; we want it to be clinic-to-clinic. Clinic-to-clinic is really the sweet spot for us right now as there are geographic limitations that can inhibit care. Rural telemedicine centers can now access major academic and thought leaders with detailed data in seconds.
InterbrandHealth: What’s your relationship like with health systems and the systems they are currently using, like EHRs?
Bellet: We’ve gotten a really great reception from health systems, open to integrating heart and lung sounds for the first time in history into their EHRs (electronic health records). Getting our first partner, Dr. Chrono, to step up and say, “we’re in” was an incentive to others to step up as well. It’s indicative that there is innovation in the EHR space, driven primarily by providers and secondly by what the most competitive EHR is doing. Ultimately, it’s really the individual caregiver’s prerogative to use the tool that he or she believes can help them do the best job. Some choose to integrate with EHRs; some do not.
InterbrandHealth: You thought a lot about UX during the development of the product, but what’s the experience that a customer has with you after purchasing the device?
Bellet: Our primary customer is the individual physician, and we had to focus on those pain points first. We have a direct to clinician (B2C) model, and that’s why our brand is almost as consumer-ish as medtech gets because we have to sell to individuals. That said, introducing software into the stethoscope space also compels us to have a B2B vertical so where we sell our software into health systems and focus on telemedicine.
While the device is intuitive and easy to use, we’re super hands-on with our customers in terms of supporting them. Where we assist from the onboarding side is instructing them on how to use our telehealth service, from basic use to expansion. A lot of health systems start off with a small pilot, and once they’ve proven that it’s a sustainable solution then they expand.
Our hope is that our customers say interacting with our products helps them do their job better. They already have a stethoscope—they’re already using it on every single patient that they see, and we help improve efficiencies, increase their confidence with diagnosing the patients, and, while we aren’t a diagnostic tool, we help make better diagnosis possible. And, perhaps most importantly, where there is uncertainty around a patient’s health, there’s a communication tool for the care teams to rally around to better assess and help that patient.