The Longevity

Digital Stethoscope Startup Has Finger on Pulse of Health Tech

What started as a spring break project for a UC Berkeley student has turned into a successful startup for the three young founders. Carol Pogash at the New York Times reported on digital stethoscope company Eko Devices:

[The company] raised nearly $5 million and sold 6,000 digital stethoscopes, used in 700 hospitals. The wireless stethoscopes can transfer a patient’s heart rate and other vital signs directly to Eko’s secure portal, where it can, among other things, be shared with other doctors for a second opinion.

Now they have built something with a potentially larger market: It is the Duo, a digital stethoscope for home use, which could change how heart patients are monitored, the entrepreneurs say. It is scheduled to become available by prescription in the fall.

The product, which fits in your hand, combines electrocardiogram, or E.K.G., readings and heart sounds into a device that allows patients to monitor their health at home and send data to their physicians.

None of the founders have a medical background, but they consult with doctors in the development of their products:

The Eko team relies on cardiologists at the Mayo Clinic, Stanford University’s School of Medicine, Massachusetts General Hospital and the University of California, San Francisco, School of Medicine.

The Duo gives at-home heart patients “a cardiology-level exam” said Dr. Ami B. Bhatt, director of outpatient cardiology at MGH and an assistant professor of medicine at Harvard University.

Dr. Bhatt, who is a scientific adviser to Eko and will be compensated with a small stock option for her work, said that tracking patients, wherever they live, will allow cardiologists to intervene “before a crisis.”

Not all doctors are enthusiastic about emerging health technology:

Other doctors say that it is too soon to tell how helpful telemedicine devices — which include home monitoring devices for diabetesasthma and sleep disorders — will be, given the many obstacles. For one, patients can’t always be relied on to use them consistently or correctly.

“Medicine is experiencing a potentially tectonic shift,” said Dr. Jeffrey Olgin, professor and chief of cardiology at the U.C. San Francisco School of Medicine, who conducts research into mobile and digital health. “There is a huge amount of venture investment in these kinds of things. People are betting this is going to happen — but it hasn’t happened yet.”

The Duo and other telemedicine devices address a common medical problem. “There is a black space,” said Dr. Robert Pearl, a lecturer on health care policy at Stanford University’s medical and business schools and, until recently, the chief executive of Kaiser Permanente Medical Group, which represents 10,000 physicians.

Many small companies are developing devices for home monitoring, he said, “but doctors do not want continuous information.” They only want to know when there’s a problem, Dr. Pearl said.

Physicians tend to want more time talking to patients and less time scanning screens — and some of them are tech averse. “Some doctors are still faxing prescriptions,” [founder Jason] Bellet said. Telemedicine data must seamlessly reach patients’ records, which is something he and his partners are working on, he said. And insurance companies must agree to reimbursement, another work-in-progress.

Dr. Olgin, the U.C. San Francisco cardiologist, said he believed “very strongly that it’s not enough to do consumer-grade evaluations of telemedicine devices.”

“They should be held up to the same level as drugs, because there are always unintended consequences,” he said.

Some doctors may not be ready, but the market seems to be:

Telemedicine is a $9.2 billion business, said Bruce Carlson, publisher of Kalorama Information, a health care market-research firm in New York. The field is growing at 8 percent annually, nearly three times as fast as other medical devices.

The Duo enters a competitive field. The more established Kardia Mobile, which is the size of a stick of gum and attaches to the back of a smartphone, takes an E.K.G. reading in 30 seconds. It sells on Amazon for $99. This spring, AliveCor, the maker of the device, received over $30 million in funding, including an undisclosed amount from the Mayo Clinic, which is collaborating with the company on development of its devices.

The market potential for products that address heart failure is great. The Centers for Disease Control and Prevention estimates that 610,000 people die of heart failure in the United States every year, making it the leading cause of death. Half of heart-failure patients who leave a hospital return within six months. They keep tabs on themselves by weighing themselves daily, looking for sudden weight gain that can mean water retention — a sign the heart is not functioning properly.

According to the founders, developing products for the digital health market is all about perspective:

“If you compare Eko to Uber, it looks like we’re moving at a snail’s pace,” Mr. Bellet said. “But if you look at health care as a whole, we’re actually making quite a splash.”

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