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Dr. David J. Laub, an American Board of Urology-certified physician, has served the Santa Barbara community through his private practice since 1992. Focusing on patient-friendly and personalized medicine, Dr. Laub stays at the forefront of adopting innovative solutions in urological care.
Traditional methods of uroflowmetry present challenges that can hinder accurate and comfortable urinary health monitoring. For many years, Dr. Laub used a traditional uroflowmetry device in his office, requiring patients to come to the clinic to urinate and measure their urine flow.
Challenges with traditional uroflowmetry can include:
In-office uroflowmetry appointments must be carefully planned. Patients must arrive at the clinic with a full bladder at a precise time, which is logistically challenging and can lead to a failure rate as high as 50%. Patients asked to come in with a full bladder may be overfilled or underfilled compared to their natural urination.
Dr. Laub says, “Patients have to time their visits perfectly, which can be stressful and awkward. The nurses must ensure the uroflow device is prepared at the right moment, or there is a risk that the appointment will need to be rescheduled.”
According to the National Library of Medicine, urology appointments have an average non-attendance rate of 9%. With traditional uroflowmetry, patients can miss or reschedule their appointments because of the difficulty in holding a full bladder. This further complicates in-office uroflowmetry and can frustrate patients and healthcare providers.
In the clinical environment, patients may be too self-conscious to urinate normally into the funnel. Urinating into a funnel in a clinical setting can be uncomfortable for patients, and can affect their ability to urinate naturally.
In addition, the International Continence Society Standards on uroflowmetry notes that bumping the funnel can create artifacts and, “Moving the urine stream back and forth across the funnel results in phasic variations around the true flow rate.” Even minor movements can skew test results.
Dr. Laub says, “The tedious in-clinic testing environment can create samples that are not representative of typical human beings.”
Traditional uroflowmetry produces a one-time measurement, rather than a more comprehensive picture of a patient's urinary health. Dr. Laub says, “Traditional uroflowmetry provides only a single snapshot of flow data, which doesn’t reflect daily variations in a patient's urination patterns. For example, men often complain of a slow flow at night. Wouldn’t it be great to measure urine flow in the middle of the night? Now we can."
With traditional uroflowmetry, calibration should be verified regularly and documented, creating an additional task for in-office clinical staff.
Emano Flow addresses the challenges seen with traditional in-clinic uroflowmetry, offering a comprehensive and convenient alternative for patients and providers. Designed for ease of use, Emano Flow is a simple mobile app that patients can use to record audio of their urinations.
Figure 1: Easy-to-Use App for Patients
Machine learning technology analyzes the urination audio recordings to determine urine flow rate and volume. Physicians access these results, including averages and frequency data, through a secure provider portal. This data provides comprehensive insights into patient urinary tract function.
Since incorporating the Emano Flow technology into his practice over a year ago, Dr. Laub has observed significant advantages over traditional in-clinic uroflowmetry. Dr. Laub says, "Patients can now record urinations in the privacy of their homes, which makes them feel more relaxed. This comfort level, and the increased number of recordings, contribute to a more representative sample of their urinary habits.”
Patients record their urinations over days or weeks, allowing for comprehensive data not formerly available to clinicians. Dr. Laub says, "We've had patients record between 60 to 150 urinations over two weeks, capturing variations in flow at different times of the day and night. This extensive data is invaluable for accurate diagnosis and treatment planning."
Emano Flow data can provide new clinical insights. Dr. Laub says, "The sheer volume of data — at least 20 times more information than what we used to collect — allows us to evaluate flow patterns over time. This is particularly helpful for assessing the effectiveness of treatments. For example, we can compare baseline urine flow with data collected after starting medication. This gives us objective information on how well treatments are working."
Figure 2: Secure Provider Portal with Patient Uroflow Data
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Emano Flow data can illuminate subtle changes or anomalies likely to be missed with traditional methods and can help show the impact of factors such as medical intervention or fluid intake. The more comprehensive data can help doctors create personalized and effective treatment plans.
Patients have responded positively to Emano Flow. Dr. Laub says, "We used to get complaints about having to wait with a full bladder at the clinic. Now patients perform the test comfortably at home. There is nearly 100% satisfaction from patients avoiding coming into the office to do the procedure."
In addition, patients can view their urination information on their mobile app, giving them valuable insights into their urinary habits. This helps them make informed adjustments to their lifestyle, such as fluid intake or diet. Dr. Laub says, “Access to their data helps patients understand their voiding habits and the impact of their behaviors and treatments.”
Figure 3: Flow Information Available to Patients on the App
Most patients can comfortably access and understand the Emano Flow mobile app. Dr. Laub says, "It's much simpler for patients to use their phones for recording urinations than the old pen-and-paper voiding diaries. The app is user-friendly, and most patients, even those in their 70s and 80s, have no trouble using it.”
Emano Flow has seen over 91% patient compliance on the mobile app across all patients of all ages.
Emano Flow optimizes operations in Dr. Laub’s office by making follow-up easier. "We review collected data with patients via phone consultations, reducing the need for in-office visits. This saves us critical and costly time and helps ensure continuous monitoring and timely interventions."
In addition, Emano Flow has positively impacted the billing of urinary health monitoring for Dr. Laub's practice. With Emano Flow, there is a greater number of successful uroflows recorded, from which Dr. Laub’s practice can bill. “This significantly enhances our reimbursement,” Dr. Laub says.
Prior to using Emano Flow, Dr. Laub’s practice would conduct roughly four in-office uroflows each week. They now exclusively use Emano Flow for uroflows, opening up additional appointment time each week for other appointments.
Emano Flow empowers patients and physicians with advanced technology, making urinary health monitoring simple, comprehensive, and accurate. By putting the power of flow recording into the hands of patients, Emano Flow delivers comprehensive clinical data to optimize patient care.
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