Polycom provides excellent stethoscope audio when using Group Series hardware with Thinklabs One. This has been tested Group Series to Group Series, and Group Series (stethoscope connection) to Real Presence Web Suite in-browser plug-in (remote physician/listener). Contact Thinklabs to test other configurations (such as connecting the stethoscope to a PC). Follow this guide when connecting Thinklabs One to Polycom Group Series devices.
There are two options for connecting the Thinklabs One to the hardware modem:
- Use the Thinklink
- Use a 3.5mm audio splitter cable, such as this one. (recommended).
The benefit of using the splitter is that there’s no opportunity to confuse the switches on the Thinklink. (The Thinklink is a multi-purpose solution for all types of connections, but in the case of Polycom, we already know that standard cables will work, so no need for the adaptability of the Thinklink.)
Connect as follows:
- Thinklabs One to lower left jack (stethoscope icon)
- Earbuds for local listening to upper left jack (headset icon)
- Upper right Output (>) to Group Series 3.5mm Line Input jack. (Exact position will depend on whether you’re using Series 300, 500, etc.)
- SOURCE – Right-most position (there are 3 positions)
- MONITOR – Left-most position (there are 3 positions)
Using a Splitter Cable:
- Connect Thinklabs One to one female jack.
- Connect earbuds for local listening to the other female jack.
- Connect the male to the Group Series Line Input. You can use an extension cable, such as this one to extend the length of the cable to the Group Series rear panel.
Thinklabs One Settings:
Volume – Set to a medium volume (5-8). If a scratching or distorted sound is heard by the remote listener, turn down the volume on the Thinklabs One. It is probably providing a signal that's too high for the Group Series input.
Filter – This is IMPORTANT. Use the low frequency settings for heart sounds or carotid (two left-
most LEDs On), and use the middle setting for lung sounds and bowel sounds. (middle two LEDs)
Refer to the Thinklabs One instructions for settings.
Auto Shutoff Time – The Thinklabs One is shipped with a 2-minute timeout, which is fine for typical exams, but for telemedicine, it's annoyingly short. To change the auto shutoff settings, do the following:
- Turn On the Thinklabs One (click any key)
- Now firmly click the upper right key (Alt key) ONCE for EACH minute you’d like to keep the device turned on. For example, click 4 times to get a 4-minute timeout, 6 clicks to get a 6-minute timeout. Make sure to firmly click but do not hold the key down for a click.
- Once you’ve clicked the number of minutes you’d like, push and HOLD the same Alt key. Keep it pushed until the One turns off. This will take about 15 seconds. Your device is now set to the number of minutes you need.
- If you make a mistake in the above, push and hold the Volume minus key and the Alt key simultaneously to manually shut off the One. Then turn it on again and start the process again.
Make sure the Line Input audio is turned on. Make sure any other settings related to Line Input are enabled. This might be a default setting. Refer to Polycom instructions. Just try it out and check if the stethoscope is audible to the remote listener. If so, no further settings should be required.
Listening at the Remote Site
There are some critically important but simple things to consider:
- Use HEADPHONES with GOOD BASS to listen to the stethoscope via a videoconference. Heart sounds have a significant amount of bass energy and very little higher frequency content. Unless you use sealed earbuds or good headphones, you won’t hear anything. You will hear almost nothing through loudspeakers – don’t even bother trying. Note also that typical videoconference headsets made by Logitech and Plantronics are designed for voice communication and have terrible bass response. It’s not about price, it’s about
- Turn up the volume on the listening end to hear better. Turning up the volume on the stethoscope may also be necessary, but increased volume on the listening end is crucial. (If there is a way to increase the volume of the Line Input on the Group Series, we recommend trying that as well. Consult with Polycom.)
- Do not set the Thinklabs One volume so loud that distortion occurs on your remote headset. Even if your volume is turned down and the One is too loud, distortion can occur. So, there is some experimentation required.
- MAKE SURE THE PERSON HOLDING THE STETHOSCOPE IS ALSO LISTENING to the Thinklabs One. It is virtually impossible to hold a stethoscope still on a patient unless you’re listening and can hear the rubbing and motion artifact you’re causing by not holding still.
Caveats and Cautions
Feedback howling noise - Currently, the stethoscope sound will also be reproduced on the loudspeakers at the patient end. This can produce feedback noise. If this occurs, decrease the volume on the speakers in the patient room and/or decrease the stethoscope volume.
Room noise – The room mic at the patient end will also be turned on while you’re listening to the patient. You will therefore hear both stethoscope and patient room ambient noise. We are investigating the possibility to allow for separate mute controls. But if this is not possible for the moment, you should ask for silence at the patient end to hear as well as possible.
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