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I am testing the master Elite Stethoscope by Welch Allyn and I should say technology have improved. Took me 2 days to get the hang of it, but indeed as soon as I learned how to handle it like a Doppler probe, I started to hear sounds I never heard before. Lungs can be heard even with a jacket on clear as a bell. Looks cool and patient notices it. But ambient and extraneous noise are also heard.
I will demo the 3200 3 M product soon and this is Bluetooth equipped with optional software. I can now share heart sounds, I believe or even compare prior murmurs. Any EMR capable of archiving such within the EMR? - http://multimedia.3m.com/mws/mediawebserver?SSSSSu7zK1fslxtUOx2v58_vev7qe17zHvTSevTSeSSSSSS--
I can imagine 10 years from now documenting directly all findings, can you?
Can't any of you guys see the potential of this? Bluetooth, able to record and create tracings, minimizing more work up? Can you imagine monitoring like eICU satellite clinics and uncertain heart sounds and or lung sounds transmitted by nurses? And I thought you guys love toys that has potential
Of course, device interfaces are easy enough once you have the specs and resolve the workflow of when to pick the patient as typically the device does not provide that information.
We did a Tahita Scale interface for a clinic once reading from a serial port the device provides to capture BMI, Weight, % Fat and other stats.
Greg--Principal at PatientOS Inc. (888)-NBR1-EMR
My son was a battlefield medic in Iraq. He didn't bother to carry a stethoscope on patrol because when they came under fire and men were wounded, they couldn't hear anything over the gunfire. I'm not sure an electronic stethoscope would work. They had to become much more tactile and visual.
A major part of PE is eye balling your patient. I would first like to express my gratitude and deepest respect for your son, Matt who is serving in Iraq.
I will demo the system hopefully next week for 2 weeks and see the free software how it helps looking at auscultograms we were mandated in Med school back in the Phil, as patients in our charity ward, can not afford test. So we have to hone our skills and clinical eye to a cheaper older technology the stethoscope. I found it a shocker that our attendings here in USA can not teach me much about auscultation, and only to find out I knew more. Their response was to order and Echo or an Xray.
I would think if voice recognition software are being utilized why not check patterns of transmitting sounds by the valves and lungs can not do the same. It may alleviate use of expensive testing. This technology may extend what the EICU is doing, similar to monitoring the heart tracing.
As you are well aware, Primary care Internal Medicine will be the thing of the past, yet the demand may continue to rise. Extenders may be critical, and our job description may be that of a commander of a control center. Perhaps dealing with 5 to 10 NP's, ANP's or PA's in the clinic seeing 10 to 15 patients a day. Hope it makes sense
They should make a stethoscope gadget for the iPhone. You place it on the patient and it displays the sounds graphically on the screen. It should work on battle fields and it can be transmitted from the patient's iPhone to the doctor's iPhone on 3G and even stored in an EMR. In short - a Tricorder
Margalit Gur-Arie
My brand new Blog: On Healthcare Technology
"A major part of PE is eye balling your patient. I would first like to express my gratitude and deepest respect for your son, Matt who is serving in Iraq."
Roger, thanks kindly. He's back in the States and had his first interview for medical school admission yesterday. He's very hopeful.
I like Maralit's idea of a visual display. Out in the field, it's 90% boredom/10% terror -- machine guns, rocket propelled grenades, chaos -- without benefit of a basic physician tool.
Be sure to fill us in on extraneous noise and how it affects it.
I've been using a Thinklabs electronic stethoscope for about a year.
http://www.thinklabsmedical.com/
I got one for my wife, (a gyn), too.
She loves it....
It comes with a cable that plugs into our tablets. You can analyze the sounds with the free software (see the site) and we can save the sound file in eClinicalWorks as a document.
http://www.thinklabsmedical.com/electronic-stethoscope/products/thinklabs-phonocardiography-software-161.html
Reddy
William "Reddy" Biggs, MD
Managing Partner, 22 physician Internal Medicine group
"Live on eClinicalWorks since 2/1/2007" http://tinyurl.com/reddybiggs
Reddy 3 COm has bluetooth so it intrigued me and the sleek design is much better than the older verison I demoed about 8 years ago. I think the newer technology is much better. I did not like the design of thinklabs.
I will see how the free software is. There is another software but too expensive just as expensive as the stethoscope. I will keep you guys posted.
Just received the demo of 3M Littman. This thing is turbo charge. Simulates a real stethoscope feel and is automatic- turns on on its on and off when not in use.
The claim of 24 times louder is indeed real. I thought I would lose my hearing when I pressed the max volume before listening to the heart. At 1/3 bar level it simulates the cardiac stethoscope. At half is more than loud. Background noise is minimized.
Have not tried the software yet while I await my Vaio lap top. The software is impractical and I am not sure if that is networked. Let me see this 2 weeks if the software is practical. I adjusted to it instantly while it took e 2 days with Welch Allyn's Elite. Either ways I am not going back to the traditional scope. So exciting. Body habitus does not affect my hearing capabilities now. All I need is 3 cardiac cycle or even 2 per valve area as oppose to 5 to 10
I work as a cardiologist and am intrigued with the Littman 3com stethoscope...not so much for me but for the ability to download and save the sounds...it seems to me that it would be a great teaching tool...I always have residents working with me...I'm never sure how much they hear or comprehend.-actually, I think they don't pick up that much. It really is an art that requires practice and repetition until it gets burned into the association neuron synapses.
Give us an update when you have worked the software.
fran403:Give us an update when you have worked the software.
Will try this weekend. I think the software is overkill in real life practice, but may potentially be important when primary care will be run by Extenders and perhaps a ratio of one supervising MD to 4 to 6 extenders.Though ANP's and NP's I heard can establish their own practices.
Regarding heart sounds, I always emphasize to students (seniors) and even NP's to understand the heart cycle first before they even bother to discuss murmurs with me. The beauty of the 3 M 3200 product aside from the software is the ability to pick different frequencies. It delivers the 24 times amplification of the best cardiac stethoscope it claims. I did not believe it till I crank up before even listening to my first case, and I thought I would go deaf! LOL. It reminded of the heart sounds I was listening to in med school crank up on my boom box.
I do not believe the software is networked. That is the drawback unless I decide to use a lap top and go back to resetting my office to wireless. I will download it on my just recently acquired Sony Vaio SR series. I will see the quality of the recorded sound and report back this weekend.
The 3100 without the bluetooth capability is just a few bucks cheaper than a regular cardiac steth. Suggested price is almost $500 but it is about 368 to 378. Steth assist software is free, and the more sophisticated Cardioscan is close to $400. Not sure if that is worth it with the dropping reimbursement. They claim you can potentially reduce the tests saving the 3rd party payor money, but does not reward you back. If the software is free would be worth the purchase. I suppose it is a great tool for Concierge practices, for patients to have a visual and audio of their lungs and heart
elidan: They should make a stethoscope gadget for the iPhone. You place it on the patient and it displays the sounds graphically on the screen. It should work on battle fields and it can be transmitted from the patient's iPhone to the doctor's iPhone on 3G and even stored in an EMR. In short - a Tricorder
There are several handheld ultrasound devices coming on the market this year. GE has announced and demoed one already. They will record and graph sounds and images for computer importation.
Medscribbler is exploring interfaces to these devices with some reservation as there have been stethoscopes on the market for years that can graph and record sounds. we built interfaces for them but physicians did not take them up like we thought. GE is a bigger player and ultra sound is much more valuable so maybe this is a go this time !!!
Medscribbler Getting you there sooner!
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I think that the price for the Cardioscan is ludicrous. I really can't see why anyone would spend an additional $400 for the software...The justification that it saves money is suspect. The patient's with a murmur and symptoms are going to go to echocardiograms. I'd really love to know how many programs are sold at that price. I really can't imagine any significant sales volume.
If I get the stethoscope...I may convert some good murmurs into ringtones...
As far as portable echocardiography...the equipment is incredible considering what was available 10 years ago and the equipment that was needed to produce the recordings. My office echo machine from 1995 weighed about 500 pounds. My biggest concern about portable devices is the ability for something so small (and so expensive) to walk away from my office. I work in a good area...I have a pretty broad spectrum of patients. I have had the strangest things "disappear" from my office. I don't think I would ever purchase a portable echo unit at $20,000...I don't know what the street value is, but I'm sure its more than an iphone, itouch,or laptop!
CEOMike, you are probably thinking of the GE Vscan.
http://www.engadget.com/2009/10/22/ge-vscan-portable-ultrasound-earns-the-leonard-mccoy-seal-of-app/
I haven't seen availability on this unit yet, OR a price.
It looks easy to use, BUT there are a few caveats.
1) Will the use of these devices be covered by the current ultrasound CPT codes? Will this service be reimbursable? Will it need preauthorization?
2) Who is obtaining the image? Who is reading the image? Most primary care docs have a little training, but it is nowhere near what a radiologist or cardiologist has. Furthermore, the acquisition of the study makes a HUGE difference in the ability to spot pathology. These devices will require some ultrasound training to be used to their best advantage.
3) Price?
4) How are the images stored? I would hope they are DICOM, or at least be DICOM compatible. JPG would be easier for EHR use, but the EHR would need to provide a viewer that allows adjustment of the images like DICOM viewers do.
This could be a useful unit for thyroid US if the resolution is good enough, the Doppler is good enough, and the images can be stored.
I wish my EHR had a full PACS built into it, but having a separate PACS is really not a problem. I simply launch the PACS program on my tablet, and I can review the studies with my patient in the exam room in a matter of seconds.