In 2015, Dr. Deven Unadkat and three of his emergency room colleagues started looking for an out-of-the-box solution to a persistent problem. Their ER operated next to a home for developmentally disabled individuals. On a near daily basis, patients from the home would end up in the ER, often times scared and confused.
"They would come for a rash or a bug bite and we would see how disruptive that was, " Dr. Unadkat explained. "We would think 'wow, if I could have seen this patient in their house, I could have saved the insurance company, the patient, and the ER time, money, and energy. And they would have gotten the same amount of treatment, the same level of care.' "
The seed of an idea for a unique telemedicine solution germinated and grew. Today, the four founders of StationMD have built an organization that provides remote health care to thousands of patients, many of them are people living with disabilities. It is staffed with board certified physicians, 24 hours a day, 365 days a year. The goal is to prevent unnecessary and traumatic trips to the hospital whenever possible. StationMD meets that goal with the help of Eko products and services.
Our population has a high probability for bowel obstructions. The Eko DUO allows us to listen to bowel sounds so we can gauge whether we need to do further imaging. Our population also has a higher likelihood of having aspiration pneumonia or pneumonia in general. By being able to listen to lung sounds, we're able to assess our patients for something we know they are high risk for. Those two things in particular are the most valuable, said Dr. Unadkat.
Eko DUO is a combination digital stethoscope plus handheld ECG. It wasn't the first diagnostic tool the company tried out, but it is now standard in every "station " StationMD sends to care facilities and even private homes.
"Before we decided on Eko, we trialed two other digital stethoscopes. One was Bluetooth. It only worked on Windows and every two or three months there was an update that needed to happen, and because of that update we would have significant delays. The connectivity wasn't as strong either. The next one was a USB, external microphone type of stethoscope. You had to change the microphone input on our video platform to auscultate. The downside was we stopped hearing the person doing the physical exam. That wasn't useful either, " explained Dr. Unadkat.
"When we saw the solution from Eko, it was relatively straightforward to connect, it used Bluetooth, and I was able to hear the patient and staff, as well as the heart and lung sounds at the same time. It solved all those problems. It's like you're seeing the patient in person, " he said.
With the DUO integrated into StationMD's workflow, clinicians are able to see patients and instruct a caregiver on how to place the stethoscope. Whether just a few miles away, or on the opposite side of the country, the DUO livestreams high quality heart, lung and bowel sounds, and can livestream ECG data as well.
"The ECG rhythm strip on the DUO is helpful especially when the heart rate is fast. It adds another piece of the puzzle of what this person is presenting with. The more pieces of information we can have, the higher the likelihood we can prevent this person from going to the hospital unnecessarily, " Dr. Unadkat said.
As Chief Medical Officer, Unadkat is acutely aware of what sending a patient for an X-ray means on multiple levels: emotionally, logistically, medically, and financially.
"If I ask that a patient to go get an x-ray, I know that it can be very disruptive for the patient and their caretakers. So that decision is taken very seriously, and any tool I can use to help make that decision is beneficial. Our patients sometimes have a hard time expressing themselves, hearing, and fully comprehending what is happening. The situation can be very traumatic for them. "
Each trip also comes with the risk of being exposed to dangerous infectious diseases at the hospital or imaging center, and runs the risk of patients missing their medications.
"Having a tool that allows us to reliably rule in or rule out a particular concern, without the need to transport a person, is key, " stressed Dr. Unadkat.
Another key for tools employed by StationMD is simplicity. The company's Chief Operating Officer, Meghan Calichman explained, "We need the product that is the easiest to use. With Eko, the staff just needs to move the stethoscope on the individual. "
As StationMD continues to meet the growing demand for this important and unique telehealth care, Eko is proud to be a part of its solution.