You know the drill: Baby’s crying and can’t be consoled. He’s tugging at his ear and can’t fall asleep. Once again, it’s time for a trip to the pediatrician…or is it?
San Francisco-based mobile health startup, Cellscope, is offering pre-orders of its first product for home use, the Oto HOME, starting today—just in time for cold and flu season—the time of peak incidence of ear infections. According to Co-Founder and CEO Erik Douglas, the Oto HOME lets you bring the doctor into the home instead of the patient and parents into the doctor’s office. This is much “the same way that banking has moved from the branch office to the mobile phone.” What a good idea. It is not only more convenient, but it also means you don’t have to sit in your doctor’s waiting room exposed to the sniffles and sneezes of all the other infected kids.
Now, CellScope isn’t asking parents to make the diagnosis. Rather their device lets you take a video recording of the inside of the ear and connect with a physician for a remote clinical assessment and prescription, if indicated. The CellScope app includes Eardrum Finder, their proprietary software that shows the user, in real-time, how to navigate to the eardrum. Here is a short demo of how it works in the context of the mobile app. The user is given instructions on how to conduct the exam and led to the right place with a series of arrows and a congratulatory message. There are also tutorial videos on the CellScope website that can be seen here.
This is not to say that visualizing the eardrum of a crying toddler or infant is easy—it’s not. In fact, it may require two people: One to hold the child still and the other to properly insert the scope. However, it is a skill that motivated parents should be able to learn. And, what could be more motivating than not having to schlep to the ER or doctor’s office?
But, does it work?
An abstract presented at the October 2013 American Academy of Pediatrics Experience Conference compared the use of CellScope Oto to traditional ear exams concluded:
Image quality and diagnostic confidence from images captured by the CellScope-oto and a conventional device were comparable. Acceptability, image-capture, transmission, and parental involvement through sharing of images care were rated highly. The CellScope-oto has the potential to improve diagnosis and management and reduce expenditures related to AOM in children.
We should see more outcomes reported in the future as CellScope supports a variety of studies at academic institutions throughout the country, both for in-clinic use of the Oto PRO and at-home monitoring or follow up using the Oto HOME.
How can I get one?
If you live in California, you can purchase the Oto HOME online for $79. Pre-ordered devices will start shipping in late December. If you are outside of California, you can sign up on CellScope’s website to be notified when it is available in your state (anticipated mid-2015). It comes with a supply of soft reusable tips, a video to help you learn how to visualize the eardrum, and the Eardrum Finder. You can send the video recording to your own doctor for review (if he or she is willing and able to do this) or you can pay a per-use charge to submit the ear exams for tele-review by a board-certified physician—CellScope is working with a number of vetted physicians, experienced in telemedicine, who receive financial compensation for the remote assessments
One of the main drawbacks of the Oto HOME is that, right now, it is only compatible with iPhone 5 or 5S. Since many of us have already upgraded from the 5 to the 6 or are Android users, we will have to await the release of the phone-independent version of the Oto promised on CellScope’s website. The company tells me the iPhone 6 version is coming in January.
The pro version
There is also a pro version of the CellScope for physicians, the Oto PRO. Like the Oto HOME, it is a device that works via the mobile phone. The higher price of the pro version ($299) gets you an insufflator port for pneumatic otoscopy, still frame capture, PDF export for integration with the EMR, a tool for longitudinal image data tracking, HIPAA compliant storage of data, and 1 year of free software service. You also get a reference image library for patient and trainee education.