In a frenzy of self-consciousness, the stethoscope was born in 1816. To avoid pressing his ear against a patient’s large chest, René Theophile Hyacinthe Laennec used a rolled-up sheet of paper on which to listen to an unwell woman’s Heart.
Laennec pioneered the method of listening to sounds produced by internal organs (also known as auscultation), and that foresight sparked a surge of innovation that continues today.
“The Physicians in New York City may now listen to their patients’ hearts in San Francisco,” according to an article in Popular Science’s July 1921 edition, would have delighted Laennec.
According to a tech Telephony magazine, a palm-sized transmitter was connected to a distant phonograph through vacuum tubes and telephone lines so that “the heartbeats of a patient may be loud enough to be heard across a huge auditorium.” It was first created by the US Army’s Signal Corps facility, probably to monitor soldiers. The PopSci covered a smaller, cart-contained “stethophone” at an American Medical Association meeting in Chicago in September 1924. These demonstrations claimed to broaden medicine’s reach by making vital equipment transportable and sending it to rural locations, democratizing cardiac healthcare. Progress toward that promise has been patchy over the previous century, but with recent advances—and the assistance of a pandemic—gaining its traction.
Despite the novelty of the stethophone in 1921, remote cardiac monitoring did not take off until the early 1960s, when the Holter monitor—a portable ECG—was widely produced. On the other hand, the Holter’s shape made it impractical to wear for more than a few days or anything rigorous. Patients would lose patience with the ungainly equipment due to tangled cables, taped electrodes, and a clunky card-sized recorder. Despite this, it has been the standard remote monitor for more than five decades.
“Medicine is sluggish to develop and adapt,” says Francoise Marvel, a Johns Hopkins Cardiology Fellow and the CEO of Corrie Health, a digital monitoring service. Even while patient privacy and health safety frequently influence the adoption curve, Marvel, a self-described digital health interventionalist, finds medicine’s glacial pace aggravating. “With remote cardiac monitoring, there has been a lot of stagnation,” she explains. “Then there was the smartphone,” says the narrator.
Three technology developments have collided in the last decade to restart efforts to hear faraway tickers: considerable advancements in wearable sensors, including longer-life batteries; increased availability of high-speed data networks; and the rise of cloud-based analytics; machine learning is frequently used, as it may provide fast findings and notifications (even from San Francisco to New York). Remote monitoring for heart problems, according to a paper published in the Journal of the American College of Cardiology in April 2020, “is showing considerable promise for the early detection of life-threatening illnesses and critical events by long-term continuous monitoring.”
There’s also emerging evidence that the practice leads to improved medical and financial outcomes. According to a 2015 Mayo Clinic article, released patients who participated in smartphone research that required daily blood pressure and weight measurements had a 20% hospital readmission rate compared to 60% for the control group. The Daily blood pressure monitoring as part of a complete program has shown similar outcomes in Marvel’s own Corrie Health studies, both published and ongoing.
Heart health may now be monitored remotely using everything from Apple Watches to brilliant patches, not only Holters and blood pressure cuffs. Puck-sized digital stethoscopes from StethoMe and ThinkLabs may be used at home to capture and share respiratory and Heart rhythm information. A smartphone cover is included with AliveCor’s KardiaMobile finger pad ECG scanner.
The rhythm patch is a pendant-sized patch that adheres to the breast and may be worn for 30 days. Even the US Army is on board, doing remote experiments on soldiers using the ruggedized tracker known as a Whoop strap, a century after the stethophone first debuted.
The monitoring options may be expanded even further shortly. According to Gartner, the intelligent apparel industry might be worth more than $2 billion next year. Hexoskin shirts, for example, monitor ECG and heart rate in real-time. Ambiotex, a German firm, makes an intelligent shirt that tracks your heart rate. In 2019, a Georgia Tech team created a flexible, stretchy electronic device that can measure various vitals such as ECG, heart rate, breathing rate, and motion while being thin enough to be implanted in clothing. Even though so many technology stars are supporting remote cardiac monitoring—and rising evidence that individuals who are younger or merely computer savvy are adopting smartwatches and other biosensors—doctors, seniors, and many insurance companies have opposed adoption because the technology can be too pricey, untested, or difficult to understand.
The epidemic has arrived.
Despite all of COVID-19’s losses, suffering, and defeats, physicians and patients have learned to rely on telemedicine. The American Medical Association stated that primary care telemedicine visits surged nearly tenfold from the previous year to 35 million in the second quarter of 2020, while office-based visits declined by 50%. According to a survey released in July 2020 by UK health information company IQVIA, clinicians intend to use telehealth for 25% of their patient visits after the pandemic, up from 6% now. In the aftermath of COVID-19, according to a Pew Research Center research from 2021, life will be “much more tech-driven.” “The rise of…an ‘Internet of Medical Things,’ with sensors and gadgets that enable new types of patient monitoring,” according to the report. Medland (physical examinations), Butterfly (ultrasounds), and PocDoc (blood tests) are just a few of the companies that already have digital tools that allow telehealth examinations to be done at home, at work, or in a distant care facility.
Remote heart monitoring looks a lot different now than it did a century ago when Popular Science recounted how the sound of human heartbeats could be sent across the nation to an eager gaggle of white-coated and be-stethoscoped men assembled in a concert hall to catch their first heart performance (not that Heart). “I believe COVID-19 stepped on the gas and shown very rapidly, in an emergency context, that telemedicine could be responsive and beneficial,” Marvel adds. “As a result, I believe the door is open, and we must step through it to fully use the advancement of technology.”