Why High Quality Audio Matters in Telemedicine

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Award-winning audio engineers from the music industry are making the case for higher fidelity audio in telemedicine. Here’s why.

Imagine settling into a luxurious reclining theater seat to view a widescreen HD premier movie while listening to the audio through your laptop speakers. The picture unfolds in detail so fine the star’s nose hairs can be counted, but the tension-building ominous music can barely be heard. That’s telemedicine without diagnostic quality audio.

The human ear is tuned to the high frequencies of the human voice by nature, however most of the thoracic and intestinal sounds essential to auscultatory diagnosis are low frequency and up to eight times more difficult to hear. Heart, lungs, or intestines may be playing that ominous soundtrack of disease outside the range of your hearing. Using high quality headphones and straining your auditory cortex until your head aches is only a partial solution.

Dynamic range control (which balances the volume of high and low frequencies) is the solution for making movies and music sound great, but those systems were not tuned for medical use. While they boost the volume of the low end, they may also create distortions, effectively making the audio unsuitable for telemedicine as well as teaching or lecture scenarios.

Recent advances in audio processing have addressed these issues. A prime example (and the only FDA listed post-processing algorithm) is Bongiovi’s MDPS™ system. The MDPS™ software interprets the sound just as your auditory cortex does, raising the low frequency sounds for consistent volume without unnatural artifacts, bringing the audio sharpness in line with the quality of the video on your existing equipment. Included profiles are tailored to types of input including speech intelligibility and heart/lung sounds. Several other post processing advances ensure that the resulting audio is accurate and free of distortion. This clarity is essential to “seeing” the whole picture.

Here’s what you might be missing:

1. Accurate representation of tone and demeanor. Weakness, slurring, nasal obstruction, mental status, and indicators of substance abuse are subtle and go beyond understanding the words the patient uses. Low quality audio may miss the influence put on a word or phrase that is key to accurate diagnosis and treatment. Advanced audio processing will equalize the volume without distortion.

2. Clear communication. A low quality audio recording can increase the likelihood of both obvious and insidious communication errors. If information is obviously inaudible, the process stops while the correct information is obtained, a frustrating experience and a waste of valuable time in critical situations. More insidious is the mind’s tendency to jump to dangerous conclusions when mishearing a garbled recording. 15mg can become 50mg—with huge impacts to patient health as well as serious legal consequences.

3. Clarity in challenging environments. Background noises from office or medical equipment in the recording or listening environment are difficult to control, and a patient with a quiet voice or unusual accent may increase the difficulty of interpreting the audio. The MDPS™ system is proven in standardized tests to improve speech intelligibility in the presence of background noise.

4. Increased productivity. Asking patients to repeat themselves, or to repeat a procedure because the results are unclear costs time, money, and frustration that would have been avoided by using advanced audio processing on the original session or recording. An investment in true diagnostic quality audio has the potential to increase productivity and quality of care immediately.

5. Improved auscultation. The low frequency sounds of heart murmurs, pleurisy, wheezing, stridor, and digestive symptoms may be outside the range of human hearing, even in a high quality recording. The MDPS™ audio algorithm brings these key factors into the volume range easily processed by the human ear and auditory cortex.

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The sounds of sickness are like the low frequency theme from Jaws, pounding in the background and warning of the next attack. If you aren’t hearing it clearly, you may be missing crucial clues of what is happening in the depths.

It might be time for a bigger boat.

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