Product Review: CodeHeart Video App Could Revolutionize Prehospital Medicine

CodeHeart is the name of a wireless app that allows physicians to see ECG and other EMS instrument read-outs in real-time, using live video transmitted over secure cellular telephone channels. The app, which was developed by cardiologists at Washington Hospital Center working with AT&T, is designed to improve heart attack diagnoses in the field. But the technology that underlies could be adapted to serve all aspects of medical treatment by EMS providers on location and experts in remote locations. In fact, such is the scope of CodeHeart, that it literally could revolutionize the administration of first response medical care.

Genesis

CodeHeart was borne out of a desire to get ECG and other readings to physicians quickly says Dr. Lowell Satler, director of interventional cardiology at Washington Hospital Center, and one of the driving forces behind the app’s development.

“It has been the practice to fax ECG readouts to remote specialists from ER rooms,” Satler told EMS World during an online Webex videoconference, during which he demonstrated the CodeHeart app. “The trouble is that this can take up to 10 minutes to send. Given that camera-equipped mobile phones are everywhere, it made sense to see if such information could be sent live by cameraphone: Just hold it up, shoot the chart and then send it in for quicker diagnosis and response.”

On paper, this sounds simple, but there were a number of hurdles that had to be cleared to make CodeHeart possible. The first was the technology: It has taken a while for cellular data rates to achieve the necessary speeds to send high resolution video in real-time. As well, older smartphones didn’t provide enough visual resolution to make their charts easy to read.

The second hurdle was security: Sending patient records by wireless video is not secure in itself, and is by no means HIPAA compliant. (The HIPAA Act of 1996 lays out privacy standards for protecting patient medical information. Sending it by conventional cellular channels is not allowed.)

Finally, just getting the CodeHeart concept to work was a challenge in itself. “This is why we joined with AT&T, who helped us tremendously in meeting the various challenges encountered,” says Satler.

Today’s Version, and What It Means for EMS

Today, the CodeHeart app meets all necessary speed and privacy standards. Whether used on a smartphone or loaded onto a tablet or personal computer, the app allows users to shoot high-quality video of charts, instruments, patients or indeed anything else that is relevant to a medical diagnosis. Moreover, people at both ends of the transmission can consult in real-time about what is being sent. Finally, the CodeHeart content is automatically archived by the system, so that the video can be reviewed after the fact as required for follow-up and training purposes.

Based on the examples Dr. Satler showed to EMS World, the CodeHeart video app is robust, highly detailed and extremely flexible. Meanwhile, the system’s automatic archiving function is both medically and legally useful.

“Currently we are just starting to get CodeHeart into the field,” says Satler. “There’s still some reluctance by some EMS organizations to use it, simply because they are leery of how new it is. But I have no doubt that, in a few short years, CodeHeart apps will be in widespread use across North America, if not the world.”

In saying this, Dr. Satler is vastly understating CodeHeart’s possibilities. The reason: CodeHeart is a video app that turns every smartphone, wireless-connected tablet and laptop (CodeHeart works over WiFi as well as cellular) into a real-time telemedicine terminal.

Consider the possibilities: With this app installed, every first responder will be able to link medical experts to emergency cases anywhere in the world, using real-time voice, video and data. Members of the public providing first aid will be able to provide this service as well.