Cellscope announced today the launch of an iPhone otoscope attachment for parents to use at home. The Oto HOME attachment will allow parents to capture video of an ear exam on their kids and connect with a physician for remote assessment and treatment.
Cellscope’s iPhone attachment sits over the device’s camera and inserts into the ear canal to capture images of the ear drum. For parents worried about an ear infection, they simply open the app, attach the device to their iPhone, and insert the ear piece into the ear canal to begin capturing images. These images are then shared with a physician along with a history questionnaire via the Oto CONNECT service. The consulting physician can review all of that information and then call the parents within two hours to discuss next steps.
Cellscope’s Oto HOME follows a growing line of direct-to-consumer diagnostic health devices like the AliveCor Heart Monitor and iSonea’s AirSonea device. These devices are enabling patients to capture an ever increasing amount of data ranging from standard ECG tracings to more novel items like the “wheeze rate.”
In the case of Oto HOME, the obvious question is whether the device is really worth it for any parent. The Oto HOME is $79 and comes with one Oto CONNECT session; subsequent sessions cost $49. For most parents, there seem to be two potential benefits. The first is that they may get their kids more expeditiously treated, thereby shortening illness duration, reducing complications, or otherwise improving outcomes. As of now, there’s really no data either way related to those outcomes.
The second is the time and inconvenience of getting to the pediatrician; that benefit comes at the expense of having a physician actually see and examine their child. It’s also worth noting that the pricing for each virtual evaluation seems higher than most co-pays would be. Here, it really comes down to the preferences of the parent and the relative pluses & minuses of virtual versus in person evaluation.
In addition, one unique challenge here will be how to prevent overuse of antibiotics by the consulting physicians. For both the physician and the patient, simply prescribing an antibiotic means a short visit where the physician feels like they did something and the patient feels like they got something. For parents who spend $130 to get this device and a consultation, I suspect a similar expectation will often come in to play. It will be important for Cellscope to implement quality control measures to help prevent overuse of antibiotics, a major problem in the management of otitis media.
On the flip side, pediatricians could use the Oto HOME to monitor kids in whom conservative therapy is initially recommended. It may be far more reassuring to a parent to accept symptomatic care over antibiotics if they knew they could easily have a physician take look again if things didn’t improve. That, however, will generally be up to the parents who will have to buy the device; telehealth reimbursement rules will not allow most pediatricians to use this device with their own patients.
That being said, there are certainly subsets of kids who may derive particular benefit from having access to this device and service. Certainly, there are plenty of kids out there who get frequent ear infections. For their parents, having this device at home and the ability to quickly triage symptoms could be really useful. It may also save a lot of trips to the pediatrician. And for kids who have ear tubes, this could be a useful way to monitor them after insertion.
We’ve been fans of what Cellscope has designed for some time. It’s a clever device that is elegantly designed. For physicians, the Oto PRO, which we did not discuss here, certainly offers many advantages over the traditional otoscope. For parents, the Oto HOME is a really interesting idea that I suspect has a niche out there where it will actually enable kids to get better care.