I use one all the time. I am a pulmonologist.
I would have to say it does not make or break anything. The amplified lung sounds help a bit and helps me clearly distinguish fine velcro rales of IPF versus the wet rales of CHF. Recording it compare later on might be helpful (though I do lung U/S for B lines and a focused subcostal echo and IVC so that's better anyway)
But I like the recording of sounds and that little rhythm strip (as I do not do 12 leads routinely in the office unless I am concerned about PE, PH, monitoring QTc when placing someone on longer term macrolides for NTM or bronchietasis etc.. which is not a common outpatient presentation) . But it's nice to see a rhythm.
If I hear a whopping classic AS murmur and play around with hand grip and valsalva and whatever, then I know "this is not someone I am doing CPET on."
bottom line the patients like it in that I am using "the newest technology" and I let them see the tablet screen with the phonocardiogram and little EKG tracing
if you have the money to splurge go for it. the battery lasts quite a while per charge.
in the hospital you might be pick up someone with AFib on a non-telemetry floor i guess and change their room assignment or something
of note these recordings do not qualify for 93000 (as it is not 12 leads) and the old phonocardiogram CPT code was deleted in the 2000s.
but perhaps you can use it to justify billing one higher level of office visit if you document you spent itme reviewing these reports on the EKO portal later on
I wil also say this takes quite a bit of time to do
If you utlize the "full exam" feature in which you put the stethoscope in the four regions of the heart you auscultate and that is 30 seconds per recording, this is a two minute cardiac auscultation.
I'm certain this benefits an interested non-cardiologist more so than an experienced cardiologist who has a stethoscope for an ear and can hear all 1/6 murmurs and extra heart sounds and also has easy access to TTE.
as soon as you record the sounds/EKG rhythm strip, it goes to the online portal. i hae a staff member input name and demographics and save.
then you can review on your computer screen right away with patient (if the patient cares) and play the sounds (if the patient cares)
then after work (if you care and have the time), you can plaky these over and over again and pontificate (hmm now that the stethoscope amplifies the sound, is this a 2/6 or 3/6? i believe it is CD SEM best heard at the R2ICS with radiation to the carotids.
That extra heart sound occurred around the P wave so must be an S4 (i think). oh there's a PVC there. that's what that was. whew I thought I was in trouble for a moment with a new AFib diagnosis! and so on so forth
ultimtaely this seems more useful for a non-cardiologist. usually an interested internist. a cardiologist probably does not even need these things and would find these things to occupy time.
would be a great learning teaching tool for med students, residents, fellows though.
play a game of guess the cardiac diagnosis based on the cardiac auscultation the various valvulopathies / cardiomyopathies / congenital heart diseases etc... something a cardiologist would see all the time
