Whether diagnosing a heart defect in a newborn or discovering a life-threatening rumble in a elderly man’s abdomen, I think all clinicians can relate to that surge of excitement we feel when we discover something that we could use to help a patient. But as I’ve progressed through my training, I’ve also observed how these findings inevitably lead to confirmatory tests – echocardiograms, ultrasounds, and so on. Our clinical acumen is simply not good enough. I’ve often heard the argument that, for this reason, the stethoscope is an outdated tool. Perhaps it almost was. Companies like Thinklabs, however, feel very differently and are reinventing the stethoscope to meet the needs of modern medicine. Meet Thinklabs’ ds32a digital stethoscope with the Stethoscope Medical App for the iPhone. Together, they not only improve the clinician’s ability to hear sounds, but also to review and share the audio and waveforms – all on the iPhone.

Thinklab’s stethoscope/iPhone app combination certainly isn’t the first recent leap forward for the stethoscope. We’ve talked before about 3M’s digital stethoscope with Zargis Cardioscan software. The 3M/Zargis package pairs a cutting edge stethoscope with ground-breaking analytics. Having had the opportunity to use digital stethoscopes before, I can attest to the fact these devices vastly improve on our ability to hear heart sounds. On top of that, the audio is transmitted via Bluetooth to a computer running Cardioscan, which helps analyze the waveform and make a diagnosis. In its “Innovation of the Year” article, Popular Science estimates that this technology could save nearly $10 billion/year in unnecessary tests (I suspect this is a huge overstatement, but the cost-saving opportunities are real). Thinklabs has upped the ante by adding portability, a proven user interface, and adaptability to the stethoscope with its digital stethoscope/iPhone medical app combination. As the manual describes, the stethoscope pairs with the iPhone via an adapter cable. The software on the iPhone then allows viewing of the waveform and frequency data, with editing functionality including trimming the audio and annotation. It does not, however, allow for the kind of analysis that Cardioscan performs.

And therein lies perhaps one of the biggest challenges for Thinklabs. I suspect their software will exhibit all the things we’ve come to love about many iPhone apps, generally centering on an easy and fun user interface. And taken alone, the ability to record, review, transmit heart sounds from the bedside is revolutionary. Thinklabs, however, isn’t the only manufacturer that thinks so. Zargis was approved all way back in October, 2009 as an iPhone medical app developer, and their press release certainly suggests that they view the mobile platform as an enormous opportunity. So while Thinklabs’ stethoscope/iPhone medical app pair are bound to be impressive, I suspect that the behemoths of 3M and Zargis are not far behind – and are likely to bring their analytic software to a mobile platform.

The stethoscope has been a clinician’s best friend since the advent of modern medicine in the 19th century, with the first stethoscope being introduced in 1816 by Rene Laennec in Paris. The stethoscope reached its current form, more or less, in the 1960’s, courtesy of Dr. David Littmann. Based on what we know so far, Thinklabs is certainly among the innovators ushering in the next iteration of the stethoscope.

Related Posts:

1. Diagnose a Heart Murmur with a Stethoscope? There’s an App for that…in the Future?
2. iMurmur App Helps You Learn Heart Sounds Via Your iPhone [App Review]
3. Health Canada approves iPhone medical app for diagnostic imaging use – FDA to follow suit? [Resolution MD Mobile]

This past week Reuters reported on how Zargis Medical(auscultation software) was cleared as a developer for iPhone apps and more importantly, peripherals for the iPhone.

The following is a quote from Zargis Medical in the article:

The future of healthcare delivery is about connectivity and mobility. Zargis’ expertise in computer-aided auscultation and our advanced medical software platform positions us perfectly to create diagnostic software and peripherals that are a natural fit for smartphones. We intend to improve healthcare efficiency by helping clinicians bring medical technology to the patient, rather than the other way around,” stated Zargis CEO John Kallassy.

If you delve deeper into Zargis Medical, you see how they are heavily vested in diagnostic cardiology software. They have created the worlds first FDA-cleared medial software to identify and classify suspected systolic and diastolic heart murmurs. Of particular interest is how they have integrated their software with the Littmann Bluetooth Electronic Stethoscope Model 3200. In their setup, the stethoscope communicates via bluetooth to a laptop with the Zargis auscultation software.

Continue on for the rest of the story.

Some of the features of this pairing are described in detail at MarketWatch.com. Noteable features mentioned by MarketWatch are:

-Zargis StethAssist(TM) software, included with the Littmann Electronic Stethoscope Model 3200, allows clinicians to visualize heart, lung and other body sounds, play recordings at slow speeds to hear more clearly, and save recordings for comparison to future auscultations.

-StethAssist and Cardioscan recordings and related patient notes are stored electronically and can also be sent to colleagues for a second opinion.

This pairing between Zargis and Littmann happened pretty recently, in late August. You can check out the pairing in more detail on the Zargis website. Right now the pairing of Zargis’ software with Littmann’s bluetooth stethoscope requires a laptop, but with news of Zargis being approved to develop peripherals for the iPhone, one would only think they would take this pairing to the iPhone, bypassing the need for a laptop or PC.

There are a few possible mobile scenarios I can see happening:

1) The bluetooth Littmann stethoscope pairs with the iPhone via bluetooth. Zargis develops an auscultation app for the iPhone that is able to access this connection and use the information to implement the same auscultation capabilities their PC software provides. Basically, the app could enable you to diagnose certain heart murmurs, enhance heart sounds, store murmurs, store other sounds(lungs), and send them to your colleagues.

2) Zargis develops a peripheral stethoscope that connects directly to the iPhone. No bluetooth involved here, and they have an App on the iPhone that works as described in the above scenario.

Either way, if they are able to bring their auscultation software to the iPhone there could be interesting benefits. Some of the different ways I could see this used in the clinic setting are the following:

-This would make their software more mobile and significantly easier to use in a hospital room. -Imagine pre-rounding and being able to save interesting heart sounds you hear to your iPhone, then playing them during rounds for all to hear. This could be great for teaching purposes. -Cardiologists could even save a patients heart sound at every check up, then compare the heart sounds over time.

-Remote clinics could save worrisome heart sounds or lung sounds and email them to cardiologists to get diagnostic results (if the auscultation software isn’t able to identify the heart pathology first)

-EMT or other first responders could use this mobile set up during the ambulance ride to the hospital to send heart sounds or lung sounds to the ED or cardiologist on call.

Will any of this actually play out? I have no clue. But am I hoping it does? Absolutely.

Related Posts:

1. Connect Your Stethoscope to Your iPhone, Thinklabs’s Stethoscope Medical App – 3M/Zargis Not Far Behind
2. iMurmur App Helps You Learn Heart Sounds Via Your iPhone [App Review]
3. iStetho Adaptor and iStethoscope app are Making Some Sound Waves, but Digital Connectivity is Still Lacking