28

April
2011

DIY (Diagnose It Yourself) Medicine Begins with an Open Source Reinvention of the Stethoscope

Open Source Stethoscope

The stethoscope... one of the most iconic tools used by physicians… a barrier patient-centered care. There is definitely nothing patient-centered about a clinician putting a stethoscope in his or her ears and proceeding to command a patient through a series of position changes and deep breaths only to conclude with “everything sounds fine” or “hmmm”. For patients to become truly active participants in their care, we not only need to rethink our communication and educational tools but also every medication instrument that we use. Sure, there are some patient-friendly versions of pedometers, sphygmomanometers, and glucometers coming to market, but what about the time-honored clinician tools like the otoscope, ophthalmoscope, and stethoscope. The patient should be able to hear everything that the clinician hears and see everything that the clinician sees. The instruments should be in every patient home as well. They should be inexpensive and easy to use. Even more important, they need to be reinvented so that they will fit into a modern model of healthcare delivery. They need to be networked with the ability to remotely control them and for them to stream data securely over the web. Patient and coach should be able to explore the data together and make comparisons not only over time but also across populations.

Yadid Ayzenberg of the New Media Medicine group has started this endeavor with the stethoscope. He is building a new tool that will not only meet the goals described but that will also be completely open source. Everything about the device from the shell to the electronics to the software will be fully documented and shared openly with the world. Each of the components is being specifically chosen so that the entire device can be fabricated at an extremely low cost with tools that are already available in fab-labs around the world and that you may soon have in your garage. Your next DIY project might be to build your own stethoscope (of course one that only faintly resembles the one that your pediatrician used to use… you know, the one with a fuzzy little animal glued to it so that it would appear more “patient-friendly”).

Narration Transcript:

Jim wakes up feeling ill, so he decides to give his doctor a call.

Over the phone, the doctor asks him for his vital signs: his temperature, his blood pressure and also his heartbeat.

Jim is able to relay this information to his doctor by using the IDA Digital Auscultation device that he purchased over-the-counter for only $10. This inexpensive alternative to digital stethoscopes saves Jim a visit to the doctor’s office and allows him to maintain his daily routine.

The device is easy to operate, and does not require any prior experience to use. To activate the device, Jim simply places it on his chest—the device will guide him and indicate when it’s in the proper position.

When the device is in place, it transmits the auscultation data via Bluetooth to an application running on his computer. After digital filtering and encoding, the audio and waveform is transmitted over the internet to the doctor’s computer. The doctor can hear Jim’s heartbeat the same as if he was performing the examination in person. Seeing the waveform of Jim’s heartbeat also gives the doctor much more information regarding the heart’s activity.

Jim can hear his heartbeat throughout the entire examination. A recording of the examination is stored in Jim’s personal health record, enabling him to easily share the results with other physicians.

IDA could have a major impact in developing countries, where the physician-patient ratio averages 1 to 200,000. The implementation of IDA makes it easier for physicians to monitor patient symptoms and provide effective treatments.