EDITORS’ NOTE: The reviews presented in this article are Dr. Schuman’s and do not represent those of Contemporary Pediatrics or the editors.
It’s been an outstanding year for medical innovation—in fact, one of the best I can recall. If you want to improve the capabilities of your “high-tech office,” consider the following gadgets and gizmos that are sure to impress.
1. New stethoscopes from Ekohealth
No doubt you’ve seen advertisements from an innovative company called Ekohealth (Berkeley, California). Over the past year, Ekohealth has promoted not just 1, but 2 affordable digital stethoscopes that will improve a pediatrician’s ability to identify heart murmurs as well as detect subtle pneumonias. The $299 CORE Stethoscope gives one the ability to auscultate with a traditional analog stethoscope, or switch to digital mode with 40x amplification. If you want to keep your favorite Littman, ADC, Welch Allyn, MDF, or Medline stethoscope and want to enjoy the benefits of digital auscultation, you can just purchase the CORE Digital Attachment for $199.
The CORE system has a 9-hour rechargeable battery and connects via Bluetooth to an iOS, Android, or Windows application that displays and records a phonocardiogram. Ekohealth’s $349 DUO ECG + Digital Stethoscope produces crisp, clear heart and lung sounds with up to 60x auscultation while switching easily between 4 audio filter modes: diaphragm, bell, midrange, and extended. Users of the DUO can record and display a simultaneous electrocardiogram and phonocardiogram on a mobile device or Windows computer. Upcoming algorithms (not yet cleared by the US Food and Drug Administration [FDA] as of this writing) will provide an analysis of recordings to detect rhythm abnormalities and murmurs while reporting heart rate, QRS duration, and electromechanical activation time (EAT).
2. A better way to dispose of medical sharps
Disposing of medical sharps in a pediatric practice is a very expensive proposition. Needle bins fill up quickly and as there is little competition in the sharps disposal industry, your monthly costs of sharps removal may be considerable. Medical Innovations (Framingham, Massachusetts) produced the first (and still only) in-office medical sharps disposal system based on a device called the Medical Waste Machine 25 years ago, and it continues to be a great alternative to utilizing a sharps removal service.
To implement the system, a practice purchases a number of locking sharps disposal metal bins that are placed in examination rooms and anywhere one needs to dispose of medical sharps. Once filled, 2 plastic discs are placed in the bin, which is then inserted into the Medical Waste Machine. The device is then locked and turned on, heating the container to 380°F, melting the plastic discs, sterilizing the sharps, and encapsulating the waste in a plastic block during a 4-hour process. This plastic block is then placed in your regular trash.
In a small practice you may need to perform this process once per week. The machine and containers are a one-time purchase, and a practice usually orders the plastic discs 2 to 3 times per year.
3. mehealth for ADHD is now free
I’ve been using mehealth for ADHD (attention-deficit/hyperactivity disorder) for several years and have been extremely pleased with this practice tool. It facilitates diagnosis of ADHD by having parents and teachers fill out online Vanderbilt forms that are scored automatically. Consequently, evaluations are completed in just a few days rather than weeks or months. Additionally, it allows pediatricians to monitor a child’s school performance, while on medication or receiving behavior therapy, by requesting periodic follow-up Vanderbilt forms from parents and teachers. The system generates assessment reports and treatment graphs that one can share with parents and integrate into the patient’s electronic health record (EHR). It also facilitates e-mail communication with parents and teachers.
The online tool was developed by the Cincinnati Children’s Hospital Medical Center (CCHMC) in order to improve ADHD screening and management among community pediatricians. A randomized clinical trial showed dramatic improvements in ADHD care among practices using mehealth for ADHD compared with control practices.1 In addition, a recent study demonstrated that practices treating children with medications who used mehealth for ADHD had greater ADHD symptom reduction compared with controls.2
The CCHMC has secured funding from the National Institutes of Health (NIH) to recruit 5000 community pediatricians to adopt mehealth for ADHD to study how a variety of factors influence its use and utility. One simply goes to mehealth. com and enrolls. In addition to free access, users benefit by receiving 20 category 4 Maintenance of Certification (MOC) credits for using the tool. The tool now integrates a medication choice decision aid, and a management tool for parents and teachers that enables selection of daily and weekly rewards for achieving behavioral goals.
4. New ear irrigation system
Bionix (Toledo, Ohio) has been marketing cerumen removal products since 1984, and most pediatricians use its curettes and cerumen spoons routinely. This year, Bionix has released the OtoClear AquaBot device for ear canal irrigation. The AquaBot system provides a continuous stream of water to facilitate cerumen removal when used with OtoClear irrigation tips. Users “pump” the AquaBot container several times and a button press activates the water flow.
Bionix is also marketing the After-Swim water removal system for consumers—sculpted handheld sponges that help remove water from the ear canal to prevent otitis externa.
1. Epstein JN, Langberg JM, Lichenstein PK, Kolb R, Altaye M, Simon JO. Use of an internet portal to improve community-based pediatric ADHD care: a cluster randomized trial. Pediatrics. 2011;128(5):e1201-e1208.
2. Epstein JN, Kelleher KJ, Baum R, et al. Impact of a web-portal intervention on community ADHD care and outcomes. Pediatrics. 2016;138(2):e20154240.