An Israel-based startup is developing a handheld product for patients that enables a remote physical exam with an otosocope to examine the ear as well as the ability to auscultate heart & lung sounds.
Tytocare recently garnered a lot of attention after raising more than $10 million in their latest funding round. Interestingly, among the various venture capital firms of whom most clinicians have never heard, was a company we all know – Walgreens. Earlier this year, we highlighted Walgreen’s plans to become a hub for digital health tracking through partnerships with Qualcomm and WebMD – which makes their investment here a bit more interesting.
Tytocare’s handheld device is aimed at patients. The idea is basically to give them a tool that lets them perform a remote physical exam and then connect them with a physician for evaluation and recommendations. We’ve seen a number of novel patient-facing diagnostic tools come to market in the past few years. AliveCor’s Heart Monitor was one of the first and more recently we wrote about Cellscope’s home otoscope.
The device looks to include a number of different sensors & diagnostic tools. First, there is a camera that looks to be designed much like a traditional otoscope. With that, you can do an ear exam and throat exam; for the latter, there even appears to be a slot in the device to slide in a tongue depressor. Second, there is functionality to auscultate heart and lung sounds. We’d imagine the technology here involves something similar to what 15-year old whiz kid Suman Mulumudi put together for his iPhone stethoscope device Steth IO. Finally, there is a built in temporal thermometer.
According to Tytocare’s website, they are currently working through the FDA clearance process. As each functionality of the device already exists, they will almost certainly only have to demonstrate equivalency of each function to existing FDA-cleared devices. What’s novel and interesting here though is rolling in all of these devices into one simple handheld device.
I’ll make a leap of faith here and assume that the device will be able to capture high quality images, heart & lung recordings, and accurate temperatures. Let’s also assume it will be relatively low cost, especially if fashioned as a smartphone attachment, in comparison to buying a stethoscope/otoscope/thermometer. If that all happens, I could see a lot of physicians and healthcare professionals being interested in this device. It would also have a lot of appeal for clinicians in resource limited settings, during home visits, or in disaster zones – places where the portability and connectivity of the device would be especially useful. As a cardiologist, one of the first things that came to my mind was screening for congenital heart disease in remote, resource-poor areas by community health workers.
As for home use, there’s clearly a demand for more accessible and lower cost healthcare. The recent successes of telemedicine companies are evidence of that. It’ll be interesting to see how these types of devices fit into that care model. For example, could a patient with COPD or asthma be spared an in-person visit if their doctor not only hears their story but also the diffuse wheezes in their lungs during a video-chat visit? Practically, one concern here would be the quality of that data – not only technically, but whether the patient actually put it in the right spots. It’s also important to remember that this is a limited exam in comparison to what patients (should) get in clinic – in the context of a little abdominal distension, edema, and elevated JVP, those wheezes mean something very different.
Of course, the potential of this device (including the uses I speculated about) are highly dependent on the ability of Tytocare to prove to clinicians that the data they capture is high quality and equivalent to standard exam techniques. It will also be important and useful to evaluate the device in the context of specific use cases, such as part of an asthma management program or in the diagnosis of ear infections, so that we understand how to appropriately incorporate it into care. And doing that kind of clinical research is possible, as AliveCor, one of the first and most prominent companies in this space, has shown us.