Take a full cardiac exam on the Eko App February 27, 2023 21:16 Updated Who is this for? ✓ Plan: SENSORA™ platform with Structural Murmur Detection ✓ Role: Program Admin, Clinician You use the full cardiac exam to perform a comprehensive cardiac assessment. The cardiac exam guides you through a four-point examination in the following areas of the chest: Right Upper Sternal Border (RUSB) Left Upper Sternal Border (LUSB) Left Lower Sternal Border (LLSB) APEX The Eko analysis automatically checks for potential murmurs at every position. Results populate on the cardiac exam summary screen when all four positions are complete. From this screen, you can manage the exam by sharing it, adding notes, assigning it to a patient profile, and so on. Here's how: 1. Pair the Eko device 2. Assign a patient profile 3. Start the cardiac exam 4. Manage the exam Watch the video 1. Pair the Eko device Pair the Eko device with the Eko App. See instructions here. 2. Assign a patient profile On the Eko App, tap Exam in the bottom toolbar. Tap Full Cardiac Exam. The Assign to a Patient screen opens. Watch a video Assign an existing patient Search for the patient in the Existing Patients tab by typing the patient’s name or MRN into the search field. Tap the patient’s name. The patient is now assigned to the recording, and the cardiac exam opens. Create a new patient To create a new patient profile, tap New Patient. Enter the patient’s information. Either the first OR last name, OR the MRN number is required. Tap Start Exam. The new patient is now assigned to the recording, and the cardiac exam opens. 3. Start the cardiac exam The Eko app guides you through each auscultation position starting with the Right Upper Sternal Border (RUSB). Use the included visual as a placement reference. If you need to skip a position, tap Skip Position. Hold the chestpiece in position as you normally would. Place the chestpiece on the patient. The CORE listens for a signal before it starts recording. On this screen, you can tap Audio to adjust the audio settings or Placement to see a placement visual. Recording begins when the CORE detects a signal for the RUSB position. Have your patient remain still and quiet to capture a high quality recording. The recording and analysis progress shows on the screen. If you need to restart the recording for the position, tap Restart. When the RUSB recording is complete, the exam automatically changes to the LUSB, then the LLSB, and finally, the APEX. When the recording is complete, the analysis results display on the cardiac exam summary screen. 4. Manage the exam The cardiac exam summary screen shows the results for each recorded position. Tap a recording to expand its results. Tap it again to collapse it. If a recording was not successful, a Retry button appears that can be used to retake a recording. For each recorded position, you can: View the analysis results for each recorded position Play back each position’s recording Change the audio settings Share a position’s recording Delete a position’s recording from the exam For the entire exam, you can: Reassign the cardiac exam to a different patient profile Select the patient stance Add a note Share the recording summary for the entire exam Delete the cardiac exam End the exam Watch a video Individual recordings Tap a recording to expand it. View analysis results for a position The analysis results area of the screen displays: The position of the recording. The exam finding, such as if a structural murmur was detected or not. The heart rate in beats per minute (BPM). The visualization of the waveform. If no murmur is detected, it looks like this: If a structural murmur is detected for a position, an average waveform shows above the PCG tracing for that position. If no structural murmur is detected for a position, then only the PCG waveform shows. Note The average waveform highlights the location of a murmur within a heartbeat. The AI analyzes and averages the individual heartbeats with the PCG and creates the illustration. To the right of the average waveform is an illustration of a waveform with no murmur for comparison. Play back the recording Tap the blue play button to see the recorded phonocardiogram and hear the recorded sounds. The recording starts to play. You can pause it by tapping the button again. Change the audio settings Tap the audio settings button. The Audio Settings screen opens. Update the following settings as needed: Setting Description Play from Headphones Tap to turn on. You can listen to sounds on your headphones or earbuds that are connected to the iPad. Adjust the iPad’s volume if needed. If there are no headphones connected to the iPad, then the audio will play through the iPad’s speakers. Tip Use high-quality headphones for optimal heart sounds as audio may play back poorly on the iPad speakers. Volume Boost Activated when Play from Headphonesis turned on. Further amplifies the sounds through your headphones. Tap the scale to adjust the level. CORE Audio Filter Setting only shows when a CORE device is connected. Select an audio filter of Cardiac, Pulmonary, or Wide(for all use cases). Share the position’s recording This will only share the recording for the position you select. Tap the share icon to email the report for sharing or printing. The Share Summary screen appears. In the Email field, enter an email address. When you start entering an address, another email field appears below if you want to add multiple email addresses. Tap Send. An email is sent to every email address you entered. The person can click a link to open a screen in a web browser, where they can view or download the recording information. They can access the audio clip directly from the report without any sign-in. Warning 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 share patient records. Delete the position’s recording This will delete a position’s recording from the exam. It won’t delete the entire cardiac exam. Once a recording is deleted, it can’t be retrieved. You can take a new recording for a position after it’s deleted. Tap the delete icon. A confirmation message appears. Tap Delete. The recording is deleted, and a Take Recording button appears for the position if you want to retake the recording. Note 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. Entire exam You can manage aspects of the entire cardiac exam. Reassign the recording To reassign the exam to a different patient profile, tap Reassign on the top right corner. The Assign to a Patient screen opens. Search for or select an existing patient, or create a new patient profile. The recording is reassigned and the cardiac exam summary screen opens again. Select the patient stance In the Select Patient Stance section, tap the radio button for Standing, Sitting, or Supine. Add a note You can annotate the exam with freeform text. Warning We strongly recommend omitting any personally identifiable patient information or protected health information (PHI). Any notes will be included when sharing this recording with others. In the Add Note section, tap the plus icon on the right. The Summary Notes screen opens. Enter any information about the recording. Tap Done on the keyboard. The note is saved and appears on the Summary Notes screen. To add another note, tap Add Note at the bottom of the screen. To edit a note, swipe right on the note, and select Edit on the right. Note: Notes can’t be deleted once they’ve been assigned to a patient. To close the Summary Notes screen, swipe down from the gray bar at the top. The cardiac exam summary screen now shows the number of notes. Note Only the person who created the note can edit or delete it. You can’t edit notes added by another user. Share the recording summary This will share all recordings taken for the exam. Tap Share Summary to email the report for sharing or printing. The Share Summary screen appears. In the Email field, enter an email address. When you start entering an address, another email field appears below if you want to add multiple email addresses. Tap Send. An email is sent to every email address you entered. The recipient can click a link to open a screen in a web browser, where they can view or download the recording information for all four positions. They can access the audio clip directly from the report without any sign-in. Warning If this recording is assigned to a patient, any personally identifiable information (PII) and/or protected health information (PHI) from that patient will be pulled into the report. It is your responsibility to maintain HIPAA compliance and, if necessary, remove PII and PHI before report transmission. Delete the exam This will delete the entire cardiac exam, including all recordings. Once a recording is deleted, it can’t be retrieved. Tap Delete. A confirmation message appears. Tap Delete. The cardiac exam is deleted and the Exam screen opens. Note 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. End the exam Tap End Exam. The Exam screen opens. LBL: 406 Rev.2.0 Date of Issue: February 17, 2023
