Echopen is an open hardware project for medical clinical examination. © Echopen
Connected to a tablet or a smartphone, the first open source echo-stethoscope was presented on March 24 at Hôtel-Dieu hospital in Paris. This prototype developed by Echopen fablab could transform diagnostics and democratize this type of instrument, thanks to its low cost.
It’s a stimulating precedent in the world of open hardware for medicine. Echopen, a nonprofit fablab dedicated to medical Open Hardware hosted by Hôtel-Dieu in Paris, presented on March 24 the first version of its open source ultrasound probe. This ultrasound echo-stethoscope prototype designed for health professionals is an innovation, two hundred years after the invention of the stethoscope by René Laennec.
Lowering costs
Settled into Hôtel-Dieu with support from APHP (Public assistance for Paris hospitals) and funded by Fondation Pierre Fabre, Echopen fablab was born from the necessity to design low-cost echography that could provide easy access to diagnostic guidelines. Generally, ultrasound equipment is expensive and imposing.
“Having a tool that could diagnose any type of medical pathology in order to offer rapid diagnostic guidelines would be a revolution,” says Nowami, the project’s coordinator and cofounder, whom Makery met, along with the ultrasound echo-stethoscope’s few core developers, ahead of the public presentation. The members of Echopen wished to remain anonymous, in order to “preserve its status as an open source collective”. Over the past year, the community has rallied almost 200 people around the project, including “about 20 very active individuals”, according to Nowami: doctors, acoustic engineers, electronic engineers, programmers, radiologists…
The open source ultrasound echo-stethoscope would save an incredible amount of time during emergencies, of course, but it would also open new perspectives to the profession, such as in medical deserts or during humanitarian missions. “This would allow us to quickly separate the figures between vital emergency, complementary examinations or false alerts,” Nowami explains. “The number of people with access to echographic examinations is very insufficient, as this resource is bulky, costly and largely reserved to radiologists. There exist ultra-portable devices, but they cost $8,000-15,000, which is still prohibitive.”
Philips is about to release a tool called Lumify, which can be rented for $199 per month. The advantage of Echopen’s probe is that “it can be directly connected to a smartphone, and its final cost would be less than $200,” says Nowami.
“Of course we want to crack the technology, but above all we want to put a tool in the doctor’s hand. We urgently need to liberate access to this type of tool.”
Nowami, coordinator of the open source echo-stethoscope
A prototype for medical deserts
The humanitarian field is also very interested, says Olivier, whose experience includes the scientific coordination of humanitarian missions in South-East Asia. “In Cambodia, for example, it’s complicated to use ultrasound in medically underserved areas. In obstetrics, this tool would be vital. In Morocco, a large number of women have no access to monitoring, and the mortality rate is very high.” Also, Nowami adds, “In cases of obstetrical anomalies, kidney stones, we could be more efficient with health care.”
Collaborative project
The project, entirely distributed, was spread out among a coordination and impulsion pole “here at Hôtel-Dieu”, a ENS Cachan pole “for the transducer design”, “an electronic pole analogue to Aforp, a training center for apprentices, and finally a signal processing pole at Telecom Paris Tech”.
After presenting version 1 of the prototype, the Echopen team still has development work to do. Echopen documented their process on a wiki that already counts several hundred pages. “But we really need to organize it, because we want to the project to spread,” says Émilie, buried in the mass of online documents.
Another challenge that remains is all the legal work. “We still have a lot to do before the device is approved,” Émilie adds. “People also need to be trained to use it. In this sense, training should probably be part of the kit.”