Schneider Children’s Hospital

Schneider Children’s Hospital


Telemedicine: A remote physical examination using a novel device is as safe and effective as a conventional examination.


Sharabi A and Waisman Y.

The department of Emergency Medicine. Schneider Children’s Medical Center of Israel, Petach Tikvah, and the Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.


TytoCare is a novel device designed for conducting a remote physical examination of ears, throat, heart and lungs and wirelessly transmitting the results for a clinician’s review from a distance. The aim of our study was to evaluate the safety and efficiency of the Tyto device.


The study was a prospective study of children aged of 2-18 years presenting to an emergency department (ED) of a tertiary facility. Participants were examined by a physician using the Tyto device and following this exam were evaluated by an ED senior physician using conventional physical examination tools. The Tyto assisted (TA) examination data of right ear, left ear, heart, right lung, left lung and the throat was then remotely evaluated by an independent senior physician. The TA and the conventional examinations were compared and analyzed using the Chi-square and Kappa tests for agreement. The quality of the data retrieved, user experience and safety were evaluated using a 5 point scale.


Of 138 children studied, 59% were boys. The average age was 8.1 ± 5 years. The agreement (kappa) for right ear, left ear, heart, right lung, left lung and throat examinations resulted in 0.467, 0.781, 1, 0.905, 1, 0.796, respectively, where 1 is perfect agreement, >.75 is excellent agreement, .40 to .75 is average to good agreement, <.4 is weak agreement, 0 is agreement by chance and <0 is no chance agreement. Non- agreement examinations also included cases where a diagnosis could not be made due to clinical conditions, such as cerumen in ears. The average quality score was 3.93, 4, 4.94, 4.35, 4.31, 4.9

respectively and average user experience score was 4.64, 4.76, 4.95, 3.92, 4.1, 4.76, respectively. No adverse events were recorded during the course of the study.


The remote physical examination findings of organs studied using the Tyto device were as safe and effective as the conventional physical examination. In addition, the quality of the readings and user experience received positive ratings from physicians. TytoCare shows promise as a tool to assist in the accurate diagnosis of patients as part of a telehealth visit.

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