Expert Newborn Screenings A Heartbeat Away!

jimmy-kimmel-baby-billy2-1This week, Jimmy Kimmel shared the emotional story of his beautiful newborn son’s heart surgery.  He and his wife Molly welcomed their second child, William “Billy” Kimmel.

At three days old, Billy had successful open heart surgery at Children’s Hospital Los Angeles and is now home with his family.  On his show, Jimmy opened up about his son’s birth and health complications. He also underscored the need for the accurate and timely screening of congenital heart disease (CHD).

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Essential to early CHD diagnosis is the detection of a murmur using a stethoscope during a newborn’s first physical exam.

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But routine neonatal examination without specialist consults fail to detect more than half of babies with heart disease.

Approximately 160 infants pass away from undetected Congenital Heart Defects each year in the United States.

William “Billy” Kimmel, who is absolutely adorable below is one of the lucky ones; looks like he’s already laughing at Dad’s jokes too.

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Billy thankfully had the condition detected early, but many children with CHD get discharged with undetected or misdiagnosed conditions.

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After the events of this week, expecting parents have every right to question if their child is being screened appropriately or if clinicians known to misinterpret heart sounds are interpreting their child’s heart sounds accurately.

Kimmel’s story is really a wake-up call that we need more nurses like the wonderful ones who treated his baby boy.

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Now, there’s a device that will make sure congenital heart screenings more effective for infants.

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And it’s not just infants. Over 1.3 million adults live with congenital heart disease in the U.S, which now surpasses the number of children with congenital heart disease.

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Three entrepreneurs are well on their way to making sure accurate screenings are a heartbeat away. Their innovation paves the way for a new era of cardiac screenings.

They want to do what Shazam did for music, only for heartbeats.

Their new device called Eko [pronounced like Echo, as in a heart echo] offers the potential to dramatically improve the efficacy of newborn screenings, especially for newborns far from a pediatric cardiology center.

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The San Francisco based digital medical device company, launched Eko, an FDA-cleared digital stethoscope that enables ANY clinician, regardless of their training level, to secure a virtual pediatric cardiology opinion on heart sounds recorded with their FDA-cleared digital stethoscope.

It was a pleasure interviewing one of the founders, Jason Bellet.

Bellet says, “The silver lining in Jimmy Kimmel’s story is that the congenital heart failure was detected early through a murmur using a stethoscope and could be treated, but very often these murmurs go undiagnosed and undetected and infants leave the hospital with potentially life threatening situations.” [:27]

“Eko Devices would enable nurses and clinicians to get Cardiologist’s second opinion to immediately decrease the number of missed cases.” [:12]

Bellet is the co-founder and a brilliant former student from the University of Berkley.  He graduated in 2014 and founded Eko Devices with two fellow students, Connor Landgraf and Tyler Crouch out of the Start-up accelerator at Berkley.

The three founders successfully pitched their idea and raised $5M to bring it to market quickly and bring it to as many clinicians as they can.  It received FDA approval in September of 2015.

QUESTION: WHAT IS EKO?

ANSWER:  It’s basically a Smart Stethoscope that can bring the sounds to a trained ear immediately.

The vision is to bring machine learning and physician support tools to every clinicians stethoscope to make their screening process as easy as Shazaming a song.

QUESTION:  HOW DID YOU COME UP WITH THE IDEA FOR EKO?

ANSWER:  The idea stemmed from the fact that we realized the stethoscope is used as the primary screening tool for cardiac health, including for newborn babies.

But, it’s extremely outdated and ultimately leading to misdiagnosis and lack of cardiac conditions because you hear the heart sounds, but don’t understand what you’re hearing.

Cardiologists are the ones who can differentiate what is normal and what is not.

So, what we wanted to do was make it easy for clinicians to modernize their own stethoscopes to bring it into the modern era and send concerning or confusing heart sounds immediately to cardiologists in real time using this platform or capture it to send it to a specialist.

QUESTION:  There are other digital stethoscopes out there. Why is this one unique?

Bellet says, “Our digital stethoscope is the first to allow clinicians to stream sounds wirelessly from the stethoscope to a smartphone and to a cardiologist anywhere in the world.”  [:15]

QUESTION: Is it HIPPA compliant?

ANSWER:  It’s the ONLY digital stethoscope on the market that has built a HIPPA compliant software platform to stream heart sounds from any clinician to any specialist anywhere in the world.

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QUESTION: THAT’S GROUNDBREAKING. WHERE IS IT CURRENTLY BEING USED?

ANSWER:  Eko is now used at over 700 institutions across the country and has been adopted by pediatric cardiology programs.

QUESTION: WHO NEEDS EKO?

The technology is applicable in many aspects of patient care, but especially in newborns.

QUESTION:  WHAT IS YOUR ULTIMATE GOAL WITH EKO?

ANSWER: The ultimate goal is bringing it even one step further.  Our idea is have machine learning tied directly into the stethoscope itself, so one day clinicians can be as accurate as cardiologists in their initial interpretation of what they hear.

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Next, I spoke with renown adult congenital heart disease specialist Ami Bhatt, M.D. F.A.C.C. who says identifying congenital heart disease in the community can be challenging at any age whether we are trying to identify a high risk newborn like Jimmy Kimmel’s or catching congenital heart disease in a school age student or adulthood.

Ami Bhatt, M.D. F.A.C.C.  is director of outpatient cardiology at the Massachusetts General Hospital in Boston as well as a renown adult congenital heart disease specialist.  She innovates with the Healthcare Transformation Lab, serves as a scientific advisor for Eko Devises and runs a telemedicine practice.  She can be reached at mghachd@partners.org

Bhatt says,  “Because congenital heart disease is relatively rare it’s difficult for clinicians to identify it. The use of digital stethoscopes and other telemedicine technology which can connect the patient and caregiver in the community with experts at academic centers can improve initial diagnosis AND longterm followup.”

QUESTION:  WHAT HAPPENS WHEN KIDS WITH CONGENITAL HEART DISEASE AGE?

ANSWER:   Two things. One, as kids with congenital heart disease age, we know there are complications that may arise. Technologies like digital stethoscopes and the use of algorithms can help monitor their progression and track changes in disease BEFORE they progress too far.

And two, lack of follow-up is a persistent problem with children with congenital heart disease become adults. One of the main drivers is the challenge of access to subspecialty care.

Additionally, distance from medical centers, along with the time it takes and sometimes the cost of being away from work and family drives young adults to ignore their own healthcare needs.

The advent of digital health in congenital heart disease care empowers the patient to engage in a partnership to their health without taking away from their ability to live a full and active life.

QUESTION:  DO YOU THINK TECHNOLOGY HELPS OR HINDERS DOCTOR-PATIENT RELATIONS?

ANSWER: As the delivery of healthcare changes, caregivers are desperate to return to the ideal  doctor patient relationship, which is based on a human connection. As we build digital technology, and use machine learning to support our physicians at at time when there are so many diagnosis to be made, it allows us to concentrate on a shared patient and provider centered experience.

QUESTION:  HOW DOES AN ADULT KNOW WHEN TO GET THEIR HEART CHECKED?

ANSWER: If they had heart disease or heart surgery as a child, they should check in with their cardiologist to find out if they need any longterm care.

QUESTION: HOW DO THEY FIND A SPECIALIST?

There are advocacy websites, such http://www.ACHAheart.org which report self-identified Specialists in congenital heart disease or they can call a major center like Massachusetts General who can find a local center that can partner in their care.

QUESTION: HOW CAN THEY FIND OUT WHO USES THE EKO DEVICE?

ANSWER: If they want to find a specialist using the Eko Device people can contact Massachusetts General http://www.massgeneral.org\adultcongenitalheart for more information and ask about centers near them. They can also contact any hospital and ask for their telemedicine department and inquire if they use Eko.

QUESTION: HOW DO CLINICANS FIND EKO IF THEY’RE INTERESTED IN USING IT?

ANSWER:  Clinicians are able to access the device by going to the Eko Devices website at http://www.ekodevices.com and then if they’re interested in testing it they can purchase a unit directly from the website and send it back if they don’t like it. But that’s a rarity as the success rate has been high with over 5,000 clinicians across the country using it.

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This truly is a hot technology that will save kids like Jimmy’s, as well as those who aren’t at top hospitals in the country.

Billy will have another open-heart surgery within six months to repair the hole, and Our thoughts, well wishes and prayers are with him and his family.

“As a cardiologist, we sometimes worry about technology interfering with the doctor patient relationship. However, in these cases, it is technology that brings us to meet the patient where they live. Technology is finally bringing us home.” 

-Ami Bhatt, M.D. F.A.C.C.

If you haven’t seen Jimmy Kimmel’s story see it on Emmy-award-winning @GMA:

WATCH: @jimmykimmel shares emotional news about newborn son’s emergency heart surgery; son now at home recovering. http://abcn.ws/2pSPakE

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QUICK FACTS:

According to the CDC, 40,000 babies in the U.S. are born each year with congenital heart disease.

Recent studies estimate approximately 160 infants or 1 in 25,000 live births die per year from unrecognized CHD.

The reported sensitivity for detection of a pathologic heart murmur in newborns ranges from 80.5 to 94.9 percent among pediatric cardiologists, with specificity ranging from 25 to 92 percent.

A study in the American Journal of Medicine discovered internal medicine residents misdiagnose as many as 75% of murmurs with a stethoscope.

Routine neonatal examination fails to detect more than half of babies with heart disease; examination at 6 weeks misses one third.

A normal examination does not exclude heart disease.

Babies with murmurs at neonatal or 6 week examinations should be referred for early pediatric cardiological evaluation which will result either in a definitive diagnosis of congenital heart disease or in authoritative reassurance of normal cardiac anatomy and function.

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Take care of your heart everyone!

 

For more on Eko visit: http://www.ekodevices.com

UPDATES:

Good Morning America
ABC NEWS
May 9, 2017
Jimmy Kimmel returns to TV with update on his son’s health, defends his call for children’s health care coverage

One week after Jimmy Kimmel revealed that his son, Billy, had been born with a heart defect, the comedian returned to host his late night show with an emotional update on his son’s health and a defense of his foray into the country’s heated debate on health care.

The “Jimmy Kimmel Live!” also thanked his fans for their “humbling outpouring of support” and said that he and his wire “very grateful” for the multitude of donations made to the Children’s Hospital of Los Angeles, where his son was treated.

“First I want to tell you because so many people have asked: Our son Billy is doing very well,” Kimmel said. “He’s eating. He is getting bigger. He is sleeping well. He can read now — which they say is unusual [for a child his age].”

Kimmel, 49, revealed last Monday that his son underwent surgery on his heart three days after he was born, and will require another procedure when he’s a little bigger in three to six months.

During his monologue, Kimmel asked all politicians to come together to ensure healthcare for all Americans, especially those who have pre-existing health conditions.

Though there were many who supported Kimmel’s point of view, he noted that there were many others who called him an “out of touch Hollywood elitist.” To those critics, the late night host offered a sarcastic apology.

“I’d like to apologize for saying that children in America should have health care,” he joked. “It was insensitive – it was offensive – and I hope you can find it in your heart to forgive me.”

To further the conversation, he interviewed Bill Cassidy, a Republican senator from Louisiana who last week tweeted that there should be a “Kimmel Test” for any healthcare bill passed.

The Jimmy Kimmel Test, he noted, would be in place to ensure that any healthcare plan would adequately cover pre-existing conditions “but in a fiscally conservative way that lowers cost.”

“I happen to like [it] a lot,” Kimmel said. “He is a doctor – a gastroenterologist. He is married to a retired doctor — his wife Laura, was a surgeon. And he co-founded the Greater Baton Rouge Community Clinic, which provides free dental care and health care to the working uninsured. So obviously – this is someone who cares about people’s health.”

 

 

New Study: High Tech Baby Monitors

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SO MANY NEW SMART PHONE MONITORS AIM TO GIVE PARENTS PEACE OF MIND.

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BUT A RECENT STUDY LOOKS AT THEIR REAL SAFETY AND EFFECTIVENESS.

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DOCTOR KIMBERLY GIULIANO OF CLEVELAND CLINIC CHILDREN’ S DID NOT TAKE PART IN THE STUDY, BUT SAYS ONE OF THE BIGGEST CONCERNS DOCTORS HAVE ABOUT THESE MONITORS IS THEY’ RE NOT REGULATED.

CG: Dr. Kimberly Giuliano/Cleveland Clinic Children’s [19:10:35-19:10:47] “They are not tested and regulated by the FDA, so they don’ t have to go through the same rigors that medical equipment would. So it’ s quite possible that something could happen to a child that the monitors wouldn’ t necessarily pick up on.”  [00:12]

THE TYPE OF MONITORS STUDIED ARE THOSE WITH SPECIAL SENSORS TO ALERT PARENTS WHEN THERE IS A PROTBLEM WITH A BABY’ S PULSE OR HEART RATE.

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STUDY AUTHORS EXPRESS CONCERN OVER THESE MONITORS TRIGGERING FALSE ALARMS, WHICH CAN CAUSE UNNECESSARY STRESS TO PARENTS AND BABIES.

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DOCTOR GIULIANO SAYS WHEN IT COMES TO MONITORING A HEALTHY BABY, A DEVICE THAT WILL AID YOUR ABILITY TO HEAR OR SEE THE BABY IS ENOUGH.

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SHE SAYS VIDEO MONITORS HELP BECAUSE WHEN YOU CAN SEE THE BABY ON YOUR SMART PHONE SCREEN, YOU CAN SEE IF THEY’ RE JUST CRYING BECAUSE THEY WANT TO BE HELD, OR BECAUSE SOMETHING HAPPENED AND YOU NEED TO GO IN AND HELP.

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WHAT MOST PARENTS AND DOCTORS WORRY ABOUT IN THE FIRST YEAR OF LIFE IS ‘ SUDDEN INFANT DEATH SYNDROME,’ WHICH IS AN UNEXPLAINED DEATH OF A SEEMINGLY HEALTHY BABY DURING THEIR SLEEP.

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DOCTOR GIULIANO CAUTIONS PARENTS FROM ALLOWING ANY MONITOR TO GIVE THEM A FALSE SENSE OF SECURITY.

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CG: Dr. Kimberly Giuliano/Cleveland Clinic Children’s [19:08:41-19:08:57] “The biggest thing that we’ re concerned about when babies are sleeping at night is SIDS, is ‘ Sudden Infant Death Syndrome,’ and that’ s silent. There’ s nothing that’ s going to show up on a monitor that’ s necessarily going to tell us that. So just because you’ re not hearing anything, doesn’ t always mean that everything is one hundred percent okay.”  [00:16]

DOCTOR GIULIANO SAYS THE MOST VITAL THING WHEN IT COMES TO LAYING BABY DOWN TO SLEEP IS TO RECALL WHAT DOCTORS CALL THE
‘ A-B-C’ S’ OF SLEEP.

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THIS MEANS A BABY MUST SLEEP ALONE, ON THEIR BACK, AND IN A CRIB, TO MINIMIZE THE RISK FOR ACCIDENTAL SUFFOCATION.  AGAIN, THAT’S:

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COMPLETE RESULTS OF THE STUDY CAN BE FOUND IN JAMA.

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(Media:  Cleveland Clinic News Service 9500 Euclid Ave. / JJN4-01Cleveland, OH 44195 Phone: 216.444.0141 “Study Looks at Safety, Effectiveness of High Tech Baby Monitors”April 26, 2017 Sound Bites/Voice Over Pathfire#: A)

It begs the question why a sensor product for newborns was able to raise $25M with no proof that sensors keep babies safe.  In fact, $3M of that funding came from the National Institutes of Health (NIH) –the government.

If the National Institutes of Health wants to conduct a study on how to prevent Sudden Infant Death Syndrome (SIDS) or how to keep newborns safe –why wouldn’t it perform an independent study.

In 2013, a Baby Monitor Sensor pad product was recalled after two babies died. The cord attached to the baby monitor’s sensor pad, which was placed under the crib mattress caused strangulation. There have been 7 reports of strangulation by baby monitor cords since 2002.

According to the CDC, almost 2000 babies die each year under SIDS circumstances.

Placing a foreign object inside the crib or worse on your baby with a sensor is not the answer.

Remember, the most effective thing you can do to help reduce your baby’s risk of SIDS, say pediatricians, is to maintain a safe sleep environment—and not one that involves complicated home monitoring devices.

“If sleep position and infant bedding are appropriate, there shouldn’t be much SIDS left to try to prevent with home monitors,” Dr. Alan Jobe of the Cincinnati Children’s Hospital wrote in an op-ed for the Journal of the American Medical Association in 2001.

Sixteen years later, the thinking remains the same. The American Academy of Pediatrics revised and expanded its SIDS prevention recommendations.

In addition to putting your baby to sleep on his or her back, APA recommendations include sharing a room with your infant but, crucially, not a bed; keeping baby’s sleeping area clear of any loose bedding, pillows, toys, or cords; and making sure your baby isn’t too warm when sleeping.

Nos. 12 and 13 on the APA’s list of guidelines?

“Avoid commercial devices marketed to reduce the risk of SIDS. … There is no evidence that these devices reduce the risk of SIDS or suffocation or that they are safe.”

And:

“Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS. … They might be of value for selected infants but should not be used routinely.”

(In fact, there’s some evidence that they might not be safe: In November, monitor behemoth Angelcare voluntarily recalled 600,000 under-mattress sensor pads after two infants died of strangulation when the cord attached to the pad wrapped around their necks.)

The point is clear: Infant monitors, even the newest generation of smartphone-friendly wearable tech, do not reduce the risk of SIDS.

Bottom line:  Exposing your newborn or infant to an unregulated sensor gadget placed so close to their tiny body isn’t deemed safe or advisable by physicians.

Safewise rates 10 Best Baby Video Monitors for 2017 here:
http://www.safewise.com/resources/baby-monitor-buyers-guide

 

Summer Safety by Water

TO MINIMIZE  RISK YOU SHOULD NEVER SWIM ALONE.

ALSO, NEVER DIVE INTO A LAKE OR RIVER BECAUSE WATER LEVELS FLUCTUATE.

CHILDREN AND NON-SWIMMERS SHOULD ALWAYS WEAR A LIFEJACKET.

DON’T OVERESTIMATE YOUR SWIMMING ABILITY.

AND IF YOU’RE PLANNING TO SPEND YOUR HOLIDAY POOLSIDE, DR. TALLMAN AT THE CLEVELAND CLINIC HAS A MESSAGE FOR PARENTS.

CG: Dr. Tom Tallman/Cleveland Clinic
“When parents are taking young children to swimming pools don’t rely on just the lifeguards who are there to save them. They still need to keep an eye on the kids and watch them very carefully.”

 

 

DR. TOM TALLMAN IS AN EMERGENCY ROOM PHYSICIAN AT CLEVELAND CLINIC.
HE SAYS THERE IS ONE THING ALMOST EVERYONE SHOULD KNOW BEFORE GETTING IN THE WATER.

CG: Dr. Tom Tallman/Cleveland Clinic
“Everybody should know basic CPR because when someone has had a water-related injury, such as that, resuscitation can be rather simple.

CLICK ON PHOTOS TO ENLARGE

LEARN CPR

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STAY OUT OF WATER WITH ANY DANGER OR WARNING SIGNS.

GET OUT OF WATER IMMEDIATELY IF IT MAY RAIN.

DROWNING IS SECOND LEADING CAUSE OF ACCIDENTAL DEATHS FOR
15 – 44 YEAR OLDS.

 

MOST PEOPLE DROWN WITHIN 10 – 30 FEET OF SAFETY.

BOATERS SHOULD ALSO BE ON HIGH ALERT.  COAST GUARD RESEARCHERS SAY DROWNING WAS THE REPORTED CAUSE OF DEATH IN ALMOST THREE-FOURTHS OF RECREATIONAL BOATING FATALITIES LAST.