Logging in and Pairing (Android/iOS):
- Login to the Eko app and use the credentials provided. At the login screen, tap “clinicians” to use your own login or a designated site login provided by the Eko administrator at your institution. Tap “Telemedicine” if you have been issued an 8 digit number and 4 digit pin.
- Ensure that the bluetooth is active on your device, then turn on your Eko device.
DUO (left): Turn on by pressing and holding the action button for two seconds, the LED will blink which means that the device is searching for a Bluetooth Connection.
CORE (right): Turn on by moving the toggle to ON- the light will flash WHITE
Once the device you want to use appears in the menu, tap it to pair. After a successful connection The DUO LED will turn from flashing to solid and the light on the CORE will turn solid WHITE
Activating Live Playback
Live Playback allows you to listen to the stethoscope audio using standard headphones connected to your mobile device.
- After logging in and pairing your Eko device, access your settings panel by tapping the two lines (Settings Menu icon) in the upper left corner
- Look for the toggle switch labeled ‘Play from iPhone’ or ‘Play from Phone’ and toggle the switch to the right (to activate it)
- Once the switch is toggled on, the sounds will play from your headphones connected to your mobile device.
- For best sound quality, we recommend using wired headphones plugged into your phone
You can playback a recording that you have made using either your stethoscope earpieces or using headphones plugged into your iOS. When your CORE/DUO is ON and paired, your mobile app will default to playing back your recording through the stethoscope. When the CORE/DUO is OFF, your mobile app will default to playing back your recording through the iOS device.
If using CORE, an Android device will work as outlined above. If using DUO, your playback output will always default to the Android device. *Note: Please disable this feature to reduce noise from coming out of your phone/tablet if the same device is being used as the originating device.
Initiating a Live stream
(if applicable to your plan) *iOS screenshots below, names and direction same for Android
- Navigate to your settings panel and scroll to the “Live Stream” section.
- Tap the “Live Stream” toggle to ON. The button will change from gray to green (or pink on android).
- The blue dot and message at the top of the screen indicates that Live Streaming is active.
Sharing a Live Stream Session
You can share a Live Stream URL by selecting:
- “Share live stream link” or “Copy live stream link” (on android) which allows the URL to be sent via a preferred app or pasted into another app (such as the chat feature in your video application, if present).
- “Email live stream link” to input and send to a recipient's email address.
Ending a Live Stream Session
Simply turn your Eko device off or navigate back to the settings panel and switch the Live Stream toggle ‘OFF’. The Live Stream can be left ON if several patients are scheduled to be seen throughout the day. Collaborators will be able to use the same URL you shared previously, which can be saved as a “favorite” within their internet browser.
*NOTE: If you select “Reset live stream link,” this will deactivate the URL you shared and you will need to re-share the new URL to have collaborators tune in.
To run AI, you must pair your Eko device with your Eko app and initiate a recording by pressing the blue circle at the bottom of the screen for iOS users or the coral circle for Android users. The recording button will turn into a stop button, and a countdown will occur at the top of the screen with the word “Recording” appearing above the countdown timer.
Once the recording is complete, the AI analysis will appear after a few seconds at the bottom of the screen. If you have the CORE- the algorithm will screen for the presence or absence of heart murmurs, and if you have the DUO, the algorithm will screen for murmurs in addition to the presence or absence of Atrial Fibrillation, as well as the QRS duration. Both devices will calculate heart rate as well.
Saving a Recording
iOS - You have the option to playback the recording (selecting the blue “Play” button to the left), save the recording to a Patient (green “SAVE” button in the middle), or delete the recording (the red “DELETE” button to the right).
When the “SAVE” button is selected, you will be cued to enter your PIN to access your saved Patients (if a PIN has been set up). Then you can select from one of the Patients in your list or create a new Patient to save the recording to.
Android - You have the option to playback the recording (selecting the coral “Play” button to the left) or assign the recording to a Patient (green “Assign” button to the right). To create a new recording without assigning to a patient, select the “New” button to return to the main recording screen. Unassigned recordings can be accessed later from the patient recordings screen.
When the “Assign” button is selected, you may select from one of the Patients in your list or create a new Patient to save the recording to.
For recordings longer than 15 seconds (up to 120 seconds), Eko AI will only analyze the first 15 seconds of data. Ensuring that signal quality is optimal is needed before a recording is initiated in order to return the best analysis results. Follow the steps outlined in Capturing Good Quality Data to ensure optimal data quality.
Annotating anatomical locations on recordings
Eko’s mobile software includes an annotation feature allowing users to tag anatomical positions to preserve that location when saving a recording. Review the workflow below for annotating the auscultation position for a recording:
Eko recommends that users of the Eko AI software annotate their recordings to provide better guidance for which valve or area of the heart is exhibiting a murmur.
Tap the person icon in the top right to view your Patients. If you choose to enable “Enhanced Security”(iOS Only), you will be required to enter your PIN to access patient data.
Forgot your PIN? On iOS, user Touch ID or Face ID (if your device accommodates this functionality) or enter your Eko account login credentials.
Once you’ve entered your PIN (or valid login credentials) you will be brought to your Patients screen (with list of patients). Eko includes three Sample Patients for reference. By tapping on the blue plus symbol (+) you can create additional patients.
Adding new Patients
The only information needed to create a new Patient is the Patient ID. You will not be allowed to save a new Patient without inputting information into that field. Once you’ve created a Patient you can add recordings to that Patient, share via a PHI protected email, alter that Patient’s information, and delete that Patient’s profile.
Note on sharing patients: A patient’s profile may only be shared or deleted if that patient has been created under your username, patients that you may have access to through your institution or have been shared with you may not be shared or deleted.
Bluetooth Range / Connection
Bluetooth connection: The Eko CORE and DUO all connect to compatible software programs via Bluetooth and are subject to the limitations of most other Bluetooth devices. If users are experiencing poor connectivity (frequent disconnections, latency, or disruptions in transmission of the wave forms) attempt the following:
- Check that Bluetooth has been turned On for that device.
- Ensure that there is a clear line of sight between the stethoscope and the device the user is attempting to connect and stream from.
- Even a human hand or body may disrupt the connection
- Limit the physical distance between the stethoscope and the device the user is attempting to connect and stream from.
Poor waveforms: If users are experiencing waveforms within the app that have artifact or are smaller than desired, Eko advises:
- Alter the positioning of the device. Certain anatomical locations or positioning may provide better waveforms and ECG tracings.
- Follow the steps to improve Bluetooth connectivity. If the Bluetooth connection is disrupted that will affect graphing of the waveforms.
- When the clinician is performing auscultation on the patient, they may want to mute their microphone to prevent feedback for the receiver (consulting MD or clinician). Be sure to unmute if needing to engage the provider again.
- Altering the volume on the Eko stethoscope or in the iOS/Android app does not affect what the receiver hears.
- If using the Eko app on iOS or Android, the clinician may send the app to the background and continue the live streaming session while utilizing another video conference app.
- Be advised that choosing to 'Reset live stream link' will provide a new URL for the Live Stream link and the old link will no longer be accessible.
- The provider conducts the assessment. They can turn OFF the Eko stethoscope during the assessment as needed to confer with the MD. Turning the Eko stethoscope OFF ends data transmission; if the device is turned ON it should auto-pair with the Eko app and resume the Live Stream session.
- Once the assessment is concluded the provider can turn the Eko stethoscope OFF and close the Eko app until the next visit.
LBL 270, Rev A, April 30, 2021