The Japanese company Telemedica developed the Kikuzo training auscultation speaker that can be used to listen to real heart sounds, murmurs and/or lung sounds with your own stethoscope anywhere, anytime. The device was particularly useful when the Covid-19 pandemic forced students to train and take exams from home. In 2022, Telemedica has come back with additional new content to keep upgrading its innovative training system. We spoke with Kikuzo CEO, Kiyoshi Fujiki.
MedicalExpo e-magazine: Can you tell us about the Kikuzo speaker?
Kiyoshi Fujiki: The speaker is very simple to use. You only need to connect it to a PC, tablet or smartphone with a stereo cable then access the Kikuzo website or application online.
You can then place your own stethoscope directly on the round silicon diaphragm of the speaker and start listening to real heart sounds and murmurs that are stored on the website/application.
In the website’s library section, all types of heart and lung sounds are stored and available for listening along with explanations about the area of the body. Kikuzo plays only the same band as the biological frequency so it doesn’t include the electrical sounds that come through the speaker and the electrical device that is plugged into it. The speaker can also play low-frequency sounds important for heart auscultation.
With our system, you can also feel the thrill like on a patient with aortic stenosis or mitral regurgitation, for example.
What are the main innovative aspects of this speaker?
“One of the best advantages of this speaker is that it is very light and portable. So you can carry it and bring it anywhere, which is particularly beneficial for training. If you connect two Kikuzos, you have both the auscultation and pulse palpation functions at the same time.
In Japan, traditional training is carried out using mannequins in university training facilities. However, mannequins weigh between tens and hundreds of kilograms and are often sold for several thousand to several tens of thousands of dollars. Anytime there is a practical exam, each medical school needs several sets of mannequins. Therefore, it is often difficult for universities to prepare mannequins for the exams.
The Kikuzo speaker has improved on all of these problems. It weighs only 0.4 kg and costs $500 for 2 units. This is why it has spread so widely in Japan since its creation in 2017 and especially since the Covid-19 pandemic.
The speaker works with a software called iPax (for Inspection, Palpation, Auscultation, Examination). Its price ranges from $500 to $2,500 per year.
Hearing the sounds using your stethoscope on the Kikuzo speaker is no different from hearing the sounds of humans. Kikuzo offers all the different types of sounds and also a very good quality of sound since it only plays the biological sounds and not the electrical ones coming from the devices.
The auscultation sounds of Kikuzo are highly evaluated by cardiologists in Japan, the United States, Taiwan and many other countries. What is common to all these countries is that the more expert a cardiologist is, the higher they rate the speaker.”
The device still doesn’t have the shape of a human body. Could this aspect pose a problem for training?
In the beginning, the fact that the Kikuzo device doesn’t have the shape of a human body was cast as a negative aspect by medical training facilities. But this aspect has dramatically changed with the Covid-19 pandemic. The fact that Kikuzo is very light and compact and can be brought anywhere, anytime became a huge advantage since students couldn’t go to the university training facilities anymore.
Physical training sessions with mannequin simulators couldn’t be used online so the Kikuzo device was an ideal solution for bringing online training home. Other competitors did not choose to manufacture products like Kikuzo. We quickly had many demands for our device so that’s why we were able to spread all over Japan in a very short period of time.
The speaker works with the iPax, a new learning system for auscultation training to use with the Kikuzo speaker. Can you tell us more about it?
Yes, students connect the Kikuzo speaker to their PC or smartphone. They go to the website and they see the image of a human torso. They can move the chest piece icon on different parts of the torso and listen, with the Kikuzo speaker and their stethoscope, to the real sounds associated with the area or with some pathologies affecting this particular area. For example, aortic stenosis or mitral regurgitation.
It helps learn both auscultation sounds and areas. There are other features such as turning on the lung sounds. Additionally, by using two Kikuzo speakers at the same time, students can listen to the sounds and feel the pulse palpation like on a real patient.
When you listen to the heart sounds on Kikuzo, you always feel the pulse palpation at the same time. It is a great innovation to make this aspect available online. This pulse palpation function is also applied to blood pressure measurement and palpation methods. This content is also posted on the site.
The Kikuzo app also offers a series of quizzes for medical students and colleges. Students can compare normal and abnormal sounds, such as the lung sounds of patients suffering from lung cancer and the lung sounds of healthy patients.
Recently, Kikuzo also recorded the lung sounds of actual Covid-19 patients and stored them on their website.
What is the new content that you recently add to the speaker?
First of all, our auscultation training system which was patented in Japan in April 2018 received US approval in August 2021. The patent covers both the Kikuzo speaker and the iPax system. We are also currently applying for a patent in the EU.
Recently, we added many case studies, neonatal auscultation content and spectrum analysis videos to our system. You can see in the pictures that the blood pressure is measured in two ways, auscultation and palpation. Teachers evaluate that having two students perform the measurement in the two different ways will stimulate practical training and increase the educational effect.
Are you working on possible developments for the Kikuzo device?
The Kikuzo speaker is currently only for medical education, but in the future we are looking into expanding it to the telemedicine field.
Our strategy is to provide education for the telemedicine field. Kikuzo’s number one customers are universities, medical colleges and medical training facilities.
We have started extending our products to foreign countries such as the US, China, Korea and Taiwan. We are receiving more inquiries from European companies, as well as many countries in North America, South America and Southeast Asia.
(Photo credit: Telemedica)