This is an amazing story. Not just because the Eko (pronounced echo) Core should make plain analog stethoscopes obsolete within a few years, but also because it was conceived and brought to market (with FDA approval) in just two years.

Co-founder and CEO, Connor Landgraf, was a senior studying bioengineering at the University of California Berkeley (my alma mater – Go Bears!) when he attended a panel discussion on technological shortcomings in current medical practice. One technical laggard that caught his attention was the stethoscope.

Because of his own personal history of cardiac problems, Connor was determined to bring this venerable diagnostic tool into the modern age. Together with two friends, mechanical engineering grad and CTO, Tyler Crouch, and Haas Business School grad and COO, Jason Bellet, the team set out to reimagine the stethoscope.


A brief history of the stethoscope

Laennec's stethoscope, circa 1820 (photo credit: Wikipedia)
Rene Theophile Laennec’s (1781-1826) stethoscope | by Mrjohncummings | via Wikipedia | CC BY-SA 2.0

The first stethoscope, a simple monaural (one ear) device, was invented in France by René Laennec in 1816. Prior to this time, physicians just placed their ears on the patient’s chest to listen to heart or breath sounds. So, this was quite a breakthrough.

Variations of Laennec’s stethoscope, albeit now binaural (two-eared) and two-headed (one head for low frequency and the other for higher frequency sounds), have been in use ever since. It was clearly time for another leap forward.


What’s different about the Eko Core?

Although electronic stethoscopes, recording stethoscopes, and even early versions of a digital stethoscope have already been developed, there is really nothing quite like the Eko Core. It not only allows users to easily convert their existing stethoscopes from analog to digital, it also amplifies the sound. And, via Bluetooth, with the use of an accompanying iOS app, it can record not only the auditory heart sounds, but also a visual recording—a phonocardiogram—of them as well.

eko mobile app
Eko Mobile App for the iPhone and iPad

So why do we need all this stuff? Haven’t cardiologists been doing just fine up until now? Well, sure, more or less. But it isn’t the cardiologists who will benefit the most from the advances of the Eko Core, it is the rest of us who struggle to hear that soft S3 that signifies heart failure or the even softer S4 that suggests a stiff ventricle. It is the pediatrician who would like to better characterize a toddler’s murmur, the nurse practitioner that wants a second opinion on the unusual heart sounds of her elderly patient, or the busy emergency physician who can barely hear the heart at all over the din of a crowded ER.

Eko Core is going to help them hear heart sounds better and it is going to let them see what they are hearing. Best of all, they can share, in a HIPAA compliant fashion, what they are seeing with other clinician’s to help with the diagnosis.

Because the Eko phonocardiograms are visual, they can be placed in the patient’s electronic health record (EHR) or (heaven forbid) in the paper chart. This allows the clinician to record changes in heart sounds over time.

Eko has partnered with drchrono, an EHR used by 85,000 physicians and 5.5 million patients, that enables mobile medical records (some of its functionality is even available on the Apple Watch). Daniel Kivatinos, COO and Co-founder of drchrono says that the two companies are working together to “create the mobile medical toolkit of the future.”


FDA approval

doctor using CORE by Eko
Doctor using Eko’s CORE with child patient

A lot of young companies in the digital health space seem to shake in their boots when the topic of FDA approval is brought up. It seems too complex, too time-consuming, and too expensive to undertake. Not for Eko, though. Conner tells me right from the beginning, the team knew FDA approval was a critical step if they were to successfully commercialize the product. And, of course, they are right. Clinicians have to trust their medical devices work as specified. Going through the FDA approval process is one way of proving your device does what it says it is going to do.

The device was tested at another of my alma mater’s, University of California San Francisco, as a part of a clinical trial in conjunction with the echocardiography lab. Other physicians, more than 20 of them across the U.S., have also participated in Eko Core’s usability study. And, Stanford University’s Department of Medicine will be the first institution in the country to deploy the device to its internal medicine residents as part of an ongoing institutional pilot.

The Eko team learned their device had been FDA cleared under FDA’s 510(K) process just last week. Join me in congratulating them on a job well done.


Watch the video (above):

To learn more about the Eko Core, please watch this video interview with CEO Conner Landgraf, recorded on 9/1/2015.


How can you get one?

The Eko Core goes on sale today (September 2, 2015). It costs $199 for the digital device, the Core, alone or you can purchase a bundle (the device plus an Eko Core Stethoscope) for $270. Click here to check it out.


Full disclosure

If you check out the Eko website, you will see that I am one of the company’s Medical Advisors. That is because, if you haven’t already figured it out, I am wildly enthusiastic about the device. That being said, I also want to share that, unfortunately, I do not have any financial stake in the company, although I most certainly wish that I did.



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