Using the Eko App for the Eko CORE Digital Stethoscope - 2nd Gen

Download the Eko App

All Eko stethoscopes come with the Essentials features of the Eko App. These features allow you to record, analyze, and securely share data between providers and patients. While it is not required that you use the Eko App, we highly encourage you to use it to get the most out of your Eko device. 

For iOS: Download the Eko App here.

For Android: Download the Eko App here. 

Create an Eko Account

To create an Eko Account from a web browser:

1. Open up the Eko Web Dashboard by clicking here. 
2. Click on “Create Account”
3. Fill out the Sign Up form and click “Create Account.”
4. Eko will send you a confirmation email after you submit the form. Click on the confirmation link in the email to confirm your Eko Account.

To create an Eko Account from the Eko App:

1. In the Login screen, lick on “Sign Up.”
2. Confirm you are a healthcare professional.
3. Enter in your full name, email address and then click “Sign Up.”
4. Eko will send you a confirmation email after you submit the form. Click on the confirmation link in the email to confirm your Eko Account.

Menu Walkthrough

The Menu is where you can go to update your settings and view information about your connected Eko stethoscope. You can navigate to the Menu by logging into the Eko App and tapping on the “Menu” icon on the bottom left of your screen. For the rest of this document we’re going to take you through the Menu and what it has to offer.

Editing Account Profile

Tap your username to edit your account profile including name and password.

You can edit your name, email, and password by tapping on the corresponding arrow-in-a-circle. If you’d like to enable enhanced security, tap the toggle. It will turn dark blue when enhanced security is enabled.

Select “Change Log In PIN” to set your 4 digit PIN.

Adjust Stethoscope Settings

If you’re connected to a stethoscope, you can tap the stethoscope settings (e.g., “CORE Settings”) to adjust settings for that specific stethoscope.

Toggle ON “Record from Device” to allow recordings to be initiated from your CORE (by pressing the “O” button between the “+” and “-” buttons on the CORE).  Toggle ON “Active Noise Cancellation” to filter out background noise while listening or recording. Select different audio filters by tapping on “CORE Audio Filter” and  selecting the appropriate audio filter:

When you return to the CORE Settings screen, you will see the filter you selected next to the CORE Audio Filter menu item (shown as “Pulmonary” here).

Tap “App Settings” to adjust background connection settings, patient assignment at start up, and recording length settings

Adjust background connection time: This feature allows you to set the number of minutes the Eko app remains connected to your stethoscope while the app is in the background. Tap on the arrow-in-a-circle to access the settings and choose among 1, 5, 15, 30 minutes connection time or no limit to connection time.

Turn ON/OFF “Assign Patient at Start” for Cardiac Exam: If ON (blue), then you will be prompted to select a patient prior to beginning the exam. If OFF (white), then you will not be asked to assign a patient at the beginning of an exam, but will have that option presented to you after a recording is taken.

 

Set recording length for Quick Record: Tap on the arrow-in-a-circle to access the settings submenu where you can adjust the amount of recording time to 15, 30, 60, 90, or 120 seconds. After you make your selection, the selected value will be shown next to “Recording Length” (15 seconds in this example).

Tap “Customer Support” to access Eko device user manuals, visit the Eko Support Center, or contact Eko’s Customer Support team.

Tap “Regulatory Information” to view the Instructions for Use and Certification of the Eko App.

Set Up Wireless Screening

Wireless screening allows for real-time streaming of stethoscope sounds to Bluetooth-enabled audio devices. This set up helps clinicians adapt to different environments and keep safe from infectious disease.

The following workflow is designed for the Eko CORE Digital Stethoscope (2nd Generation) and Eko CORE Attachment (2nd Generation).

User Manual and Indications for use can be found here. 

Please note: Make sure your preferred headphones are plugged into or paired with your phone. We recommend using wired headphones for best sound quality but have beta tested with Airpods and got good sound quality with the following devices:

iOS: 5s, 6, 6s, 8, X, XR, XS, XS Max, 11, 12

Note: If you choose to use Airpods, or other wireless headphones, we recommend testing the sound quality and having wired headphones as a backup. Please see more information on compatible phone and bluetooth headphone models for Wireless Auscultation Here.

1. Launch the Eko App and turn on Play from Headphones under the Settings panel of the App.
2. Plug your preferred headphones into your phone. If you are using bluetooth headphones, connect them to your mobile device. We recommend limiting to only 2 bluetooth devices connected simultaneously to ensure strongest wireless connectivity. 
3. (Optional): If you have a fully assembled stethoscope, start by removing your stethoscope ear tubing by either unscrewing the barb/tubing from the bottom of the CORE or pulling the ear tubing off of the barb.
   • https://www.youtube.com/watch?v=ebN2Gg402X0
   • https://www.youtube.com/watch?v=uaVtx9PMRSM
4. Turn on the Eko CORE and pair to the Eko App. Once the device is paired to the App, you can put your mobile device in your pocket or hold in your hand during auscultation. 
   • 
5. (Optional): Put a glove / cover / stethoscope sleeve of your choice on the Eko CORE so that the entire device is covered. This can be changed between patients and the device can also be cleaned with 70% isopropyl alcohol wipes (do not submerge device in liquid). 
   • Examples of covers: (you can also use surgical gloves)
   • Stethocap.com
   • Stethobarrier.com
6. Auscultate with the CORE. You should be hearing sounds through your headphones. 

Cardiac Exam Mode Walkthrough:

The Cardiac Exam mode helps you efficiently conduct a comprehensive cardiac assessment, turning any physical exam into a greater opportunity to catch cardiovascular disease. You will be guided through a 4-point examination process in the following areas of the chest: Right Upper Sternal Border (RUSB), Left Upper Sternal Border (LUSB), Left Lower Sternal Border (LLSB), and APEX. Eko will automatically check for potential murmurs or atrial fibrillation at every position. Results will populate on the Cardiac Exam Summary Page once all 4 positions are complete.

Step 1: Connecting device

Make sure Bluetooth is enabled on your mobile device. Log in to the Eko App and power on your digital stethoscope.

 

Select the stethoscope you want to set up from the screen.

 

If you’re using the same stethoscope from your last pairing, Eko will automatically reconnect with that stethoscope. The app will indicate when the stethoscope is paired successfully.

Step 2: Starting a cardiac exam

If it is your first time taking a recording, follow the prompts on the screen to be guided through the steps. If you’ve already completed your first recording, you’ll see the cardiac exam screen, and have the option to start a spot check or full cardiac exam. Tap “Full Cardiac Exam” to begin.

Step 3: Taking a recording

The Eko app will walk you through each auscultation position starting at the Right Upper Sternal Border (RUSB). Use the visual as a placement reference. You can skip recording from any position and move to the next by tapping “Skip Position.”

 

Hold the stethoscope in place and have your patient remain still and quiet. Recording will begin and end automatically once the Eko app detects a signal. Tap “Audio” to enable listening from your Bluetooth device and access Volume Boost. Tap “Placement” to enter the placement for this position.

 

Hold your stethoscope steady for the next 15 seconds. Eko will automatically check for heart murmurs and/or atrial fibrillation (when using DUO).

Step 4: Continuing exam

Once the RUSB is completed, the app will move continuously through the Left Upper Sternal Border (LUSB),

 

Then, to the Left Lower Sternal Border (LLSB),

 

and finally, the APEX.

Step 5: Assigning exam 

Once all 4 recordings are complete, results for all positions will populate on the Cardiac Exam Summary screen, including any murmurs or AFib detected. From here, you can assign the exam to a patient by clicking “Assign” on the top right corner.

 

If you’re assigning the recording to a patient you’ve already created, you can find and select them using the search bar or by scrolling through the patient list.

 

You can also create a new patient profile directly from the recording. If you close the “Assign Patient” tray or select “I’ll Assign Later,” your recording will be automatically saved under “Unassigned.”

Step 6: Selecting a stance

(Optional) Indicate the stance your patient was in during the recording by selecting: “Standing, Sitting, or Supine.”

Step 7:  Adding notes

Tap “Notes” to further annotate this exam with freeform text.

 

Fill in any additional detail by typing into the text field. Keep in mind that any notes or comments you add will be included when sharing this recording. Therefore, we strongly recommend omitting any personally identifiable patient information or protected health information. Select “Done” to save the note.

 

From the Summary Notes screen, you can edit or delete the note by swiping left on the note.

 

You can also add additional notes separate from the one previously created by tapping, “Add Note” at the bottom of the screen.

Step 8: Sharing a report

Tap “Share” to generate and share a report with the full waveforms, secure links to access the audio clips for each position, and any included annotations.

 

You’ll have the option to use a number of common mediums including text messaging, email, or any frequently used apps. Your recipient will be able to access the audio clip directly from the report without any login.

[Important] If this recording is assigned to a patient, any personally identifiable information (PII) from that patient will be present and visible on the report. This may violate HIPAA provisions; you are responsible for ensuring HIPAA compliance when you are sharing patient records.

 Step 9: Managing individual recordings

Back on the Cardiac Exam Summary screen, you can also tap on a position to review that recording in more detail.

 

From the selected position, you can replay the audio recording by tapping the playback button. Tap “Audio” to enable listening through your Bluetooth device.

 

Tap “Share” to generate a PDF and audio clip from this specific position.

 

Tap “Delete” to remove this position from the full exam.

 

You’ll have the option to re-record the deleted position before ending the exam. Once you end the exam, you won’t be able to delete or re-record any single position for this exam, or any previously completed exams.

Step 10: Ending exam

Tap “End Exam” to return to the Cardiac Exam home screen.

Spot Check Walkthrough

Spot Check lets you quickly check for signs of cardiovascular disease from a single recording. Eko’s FDA-cleared, clinically-validated, automated disease detection will automatically check for potential heart murmurs or atrial fibrillation with every Spot Check or full Cardiac Exam. If you are interested in walking through a full cardiac exam, please visit our Cardiac Exam Walkthrough to learn more.  

Step 1: Connecting your Eko stethoscope. 

Make sure Bluetooth is enabled on your mobile device. Log in to the Eko App and power on your digital stethoscope.

 

Select the stethoscope you want to set up from the screen. If you’re using the same stethoscope from your last pairing, Eko will automatically reconnect with that stethoscope.

 

The app will indicate when the stethoscope is paired successfully.

Step 2: Entering Spot Check

On the Cardiac Exam Home Screen, tap “Spot Check” to begin. (On your first visit to the new version of the clinic app, Spot Check will be the only selectable option, as shown on the left.

 

Once you complete your first recording, you’ll have the option to perform a Spot Check or Full Cardiac Exam for any future assessment, as shown on the right.)

Step 3: Learning about heart sound and ECG analysis

If this is your first time using the new Eko app, a series of screens explaining the possible results and indications for use of the Eko Analysis Software will automatically appear before starting your Spot Check.

 

Tap “Continue” to proceed through each screen.

 

Be sure to check the acknowledge box after reading the Indications for Use and before tapping “Continue.”

Step 4: Taking a recording

Spot Check mode is set to record at the Left Upper Sternal Border (LUSB) by default. Once the Eko app hears a sound, it will start recording automatically. You will see the recording and analysis progress on the mobile device screen, as shown on the screenshots below. Note that in Spot Check mode, only one recording will be taken. 

Use the included visual to help guide you through placement. If you’re using a CORE device, hold the chestpiece in position as you normally would.

 

If you’re using a DUO, we recommend positioning the device at an angle toward the left shoulder, ensuring both electrodes are in direct contact with the patient’s skin

 

Have your patient remain still and quiet to capture a high quality recording. The app will listen for a good signal.

 

When a good signal is found, a 15-second recording will start automatically.

 

Hold your stethoscope steady for the next 15 seconds. Eko will automatically check for heart murmurs and/or atrial fibrillation (when using DUO).

 

Tap on “Audio” on the lower left of the screen to enable audio playback through headphones. As shown below on the left, you can initiate headphone playback by sliding the toggle until it is blue. You can also engage Volume Boost by moving the slider right or left.

 

Tap on “Placement” on the lower right of the screen to pull up the placement reference image, as shown below on the right.

Step 5: Viewing the results

Once you have finished the recording, the algorithm analysis results will be displayed on the Spot Check Summary screen. From here, you can assign the recording to a patient by tapping “Assign” on the top right corner.

 

If you’re assigning the recording to a patient you’ve already created, you can find and select them using the search bar or by scrolling through the patient list.

 

You can also create a new patient profile directly from the recording. If you close the “Assign Patient” tray or select “I’ll Assign Later,” your recording will be automatically saved under “Unassigned.”

Tap “Share” in the lower left corner to generate and share a report with the full waveform, a secure link to access the audio clip, and any included annotations (this is explained in more detail below).  Tap “Notes” to enter freeform notes about this patient and/or recording (this is also explained in more detail below).

Tap “Playback” to see the recorded phonocardiogram and hear the recorded sounds.

 

Tap “Delete” to delete the recording; you will be asked for confirmation before deletion takes place.

Step 6: Select a stance

(Optional) Indicating the stance your patient was in during the recording by selecting: “Standing, Sitting, or Supine.”

Step 7: Entering notes and details

Tap “Notes” to further annotate this exam with freeform text.

 

Fill in any additional detail by typing into the text field. Keep in mind that any notes or comments you add will be included when sharing this recording. Therefore, we strongly recommend omitting any personally identifiable patient information or protected health information. Select “Done” to save the note.

 

From the Summary Notes screen, you can edit or delete the note by swiping left on the note and tapping on either “Edit” or “Delete”. You will be asked to confirm any deletion before the record is actually deleted.

 

You can also add separate, additional notes by tapping, “Add Note” at the bottom of the screen.

Step 8: Sharing a recording

After you tap “Share”, you’ll see a pop-up miniature version of the generated report.

 

You now have the option to use a number of common media including text messaging, email, or any frequently used messaging apps. Your recipient will be able to access the audio clip directly from the report without any login.

 

[Important] If this recording is assigned to a patient, any personally identifiable information (PII) from that patient will be present and visible on the report. This may violate HIPAA provisions if you are sharing. YOU ARE RESPONSIBLE FOR ENSURING HIPAA COMPLIANCE WHEN YOU ARE SHARING PATIENT RECORDS.

After you tap on your chosen method (medium) for sharing, tap “End Spot Check” to return to the Cardiac Exam Home Screen. You also have the option to add the three other cardiac recording positions to this Spot Check exam by tapping “Continue with Full Exam.” That will take you to Cardiac Exam Mode. For more information on Cardiac Exam Mode, visit here. 

Remember, once you’ve completed your first recording, you’ll be able to choose between performing a Spot Check or full Cardiac Exam on any future login.

Atrial fibrillation detection available when using DUO with the Eko app

Telehealth subscription required for live streaming

For healthcare professionals only

LBL 236, Rev C, March 16, 2021