In what they say is a first, a group of technology vendors has teamed up to add heart and lung sounds to an EMR. The current effort extends only to the drchrono EHR, but if this rollout works, it seems likely that other vendors will follow, as adding multimedia content to patient medical records is a very logical step.
Urgent care provider Direct Urgent Care, a Berkeley, CA-based urgent care provider with 30,000 patients, is rolling out the Eko Core Digital Stethoscope for use by physicians. The heart and lung sounds will be recorded by the digital stethoscope, then transmitted wirelessly to a phone- or tablet-based mobile app. The app, in turn, uploads the audio files to the drchrono HR.
Ordinarily, I’d see this as an early experiment in managing multimedia health data and leave it at that. But two things make it more interesting.
One is that the Eko Core sells for a relatively modest $299, which is not bad for an FDA-cleared device. (Eko also sells an attachment for $199 which digitizes and records sounds captured by traditional analog stethoscopes, as well as streaming those files to the Eko app.) The other is that the recorded sounds can be shared with remote specialists such as cardiologists and pulmonologists, which seems valuable on its face even if the data doesn’t get stored within an EMR.
Not only that, this rollout underscores a problem just been given too little attention. At present, what I’ve seen, few EMRs incorporated anything beyond text. Even radiology images, which have been digital for ages (and managed by sophisticated PACS platforms) typically aren’t accessible to the EMR interface. In fact, my understanding is that PACS data is another silo that needs to be broken down.
Meanwhile, medical practices and hospitals are increasingly generating data that doesn’t fit into the existing EMR template, from sources such as wearables, health apps and video consults. Neither EMR developers nor standards organizations seem to have kept up with the influx of emerging non-text data, so virtually none of it is being integrated into patient records yet.
In other words, not only is it interesting to note that an EMR vendor is incorporating audio into medical records, at a modest cost, it’s worth taking stock of what it can teach us about enriching digital patient records overall.
Eventually, after all, patients will be able to capture — with some degree of accuracy — multimedia content that includes not only audio, but also ultrasound recordings, EKG charts and more. Of course, these self-administered tests and will never replace a consult by a skilled clinician, but there certainly are situations in which this data will be relevant.
When you also bear in mind that the number of telemedicine consults being conducted is growing dramatically, and that these, too, offer insights that could become part of a patient’s chart, the need to go beyond text-based EMRs becomes even more evident.
So maybe the Eko/drchrono partnership will work out, and maybe it won’t. But what they’re doing matters nonetheless.