Distant Site Guidance - Without Eko Dashboard

If the distant/consulting provider is not using the dashboard to listen to the Live Stream auscultation, the Telepresenter can share the Live Stream link via the Chat feature on the Video platform, text, or email the link directly to the consulting provider. 

Windows Link Sharing Instructions

If the Telepresenter is using a Windows based laptop and has installed the Windows Eko App Eko Windows App, Telepresenters can follow the instructions below to share the livestream link:

1. Open the App from the desktop
2. Sign-in and connect the Eko device
3. Toggle Live Stream “On”.
4. Click “Copy live stream link” to copy the live stream URL and paste it into a text or chat function of the video application used for the video visit.
   • Alternatively, click “Email live stream link” to type in the email address of the consulting clinician you are meeting with.

iOS/Android Instructions

If the telepresenter is using an Eko mobile app for the Eko live stream, Telepresenters can follow the instructions below to share the livestream link:

1. Log into the Eko app, pair the Eko device
2. From the home screen, tap on “Quick Record”
3. Once you are on the Quick Record home page, Tap on “Live stream”
   
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4. When live stream is toggled on, you will see the options to: “share livestream link” and “email livestream link” 
5. By clicking “Share livestream link”, you will be prompted to either copy the livestream link or share it via text, airdrop. The most common workflow is to copy the livestream URL and paste it into the video conferencing chat box used for the video portion of the virtual encounter.  Alternatively, select “Email live stream link” where you will then be prompted to type in the  email address of the consulting provider.
   
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   • Once the Teleconsultant has received the Live Stream link, clicking on it will launch the live stream. Note: Eko will work on Chrome, FireFox or Safari browsers but will not work on Internet Explorer.

Saving the Live Stream URL For Future Visits

To streamline future visits, the telehealth consultant located remotely can save the Live Stream URL as a bookmark in their internet browser or as a desktop icon. Ask your Eko representative about the best method of managing multiple Live Stream accounts and URLs.

*Note that the Live Stream URL can be reset between visits at the discretion of the institution or telehealth provider at patient location, in which case it would need to be re-shared with the telehealth consultant located remotely. Resetting the Live Stream URL will end any Live Stream in session.

Eko’s Live Stream service transmits de-identified patient heart, lung, and bodily sounds. No data is stored during these sessions and no identifying information is displayed to the telehealth consultant.

Best Practices / Troubleshooting

Audio:

• The consulting provider should always use plug-in headphones in order to receive the best audio quality during the auscultation portion of the visit; it may be advisable to wear headphones throughout the visit to ease the workflow.
• Hardwired headphones that connect to a computer via 3.5mm aux jack may be preferred as they typically have less configuration needs than a USB headset, but either should work well.
• If performing the consultation using a Windows PC, audio settings may need to be adjusted to prevent Windows from reducing the Live Stream volume.
• The originating site will not be able to adjust your listening volume, only their own. Be sure to use any local controls on your computer, as well as the built in volume adjustment located on the livestream URL page.
• From within your web-browser you can view the wave forms, monitor heart beat, and review any AI results (if applicable to plan). You can also mute your livestream audio as needed via the play/pause button. If auscultation is required again during your session, be sure that you have your volume properly adjusted.
• If you are experiencing audio feedback, it could be helpful to suggest to your originating site to briefly mute their microphone during your remote listening. That way, the listening provider can continue to instruct on stethoscope placement as needed. When bi-directional conversation is needed again, remember to unmute.

Additional Troubleshooting:

• Please be advised that Internet Explorer does not support the Eko Live Stream. Compatible web browsers include Chrome, Safari, Firefox and Microsoft Edge.
  • If Internet Explorer is your default browser, simply launch a compatible browser and copy/paste the Livestream URL link into the search bar.
• If experiencing an issue in the stability of your connection and waveforms, instruct the patient/provider with the patient to move closer to the device that the stethoscope is paired with. Note the Connection status in the top left corner of your waveform view for real time feedback, which corresponds to your overall connection across Bluetooth and your network. Additionally, it is recommended to quit any applications you have running on your computer that you don’t need during your visit to ensure adequate bandwidth for your telemedicine visit + Eko livestream.
• If the originating site resets the livestream link and no waveform is displayed in your browser, simply request that they share the livestream link with you again.
  • If your waveform is still not displaying despite a successful connection and active livestream from your originating site, then you may need to have your IT/IS group check that the appropriate URLs and ports have been whitelisted.
• When the session is complete they can close the browser window and return to the video conference.

LBL 271, Rev F, May, 2022