From stethoscope to smartphone: How Vitome is redefining heart screening

Based at the University of Hong Kong (HKU), Professor Joshua Ho, Associate Professor in the School of Biomedical Sciences and Lead Scientist at the Laboratory of Data Discovery for Health, is redefining cardiac screening with a device familiar to most of us—the smartphone.

When placed on the patient’s chest, the phone—using Vitome’s Vitogram solution—transforms into a sophisticated screening tool, capturing heart sounds through its microphone and alerting patients to potential heart complications. In an interview with HealthTechAsia, the CEO of Vitome shared the journey from research in Australia to developing AI-powered heart sound analysis in Hong Kong, bridging the gap between early detection and accessible healthcare.

Professor Ho’s interest in detecting cardiovascular issues was sparked by years of working at the Victor Chang Cardiac Research Institute in Sydney, where he had the opportunity to study a wide range of cardiovascular conditions. “It was there that I realised just how significant cardiovascular disease is as a leading cause of death—often overlooked. While cancer receives much attention, far more people die from heart conditions, and early warning signs are frequently missed,” he explained.

One condition he worked with in Australia was congenital heart disease in children—structural or physiological heart abnormalities that disrupt normal blood flow. 

“These disruptions often create abnormal heart sounds, known as heart murmurs. Detecting murmurs is a key task for paediatricians using a stethoscope, but it requires trained expertise. I realised that if we could capture these sounds digitally and analyse them with AI, we could potentially detect heart problems earlier and more broadly.”

Upon returning to Hong Kong, he received funding in 2020 through the InnoHK programme, supporting the development of research into commercially viable products and services, particularly in biotechnology and medical devices. Prof. Ho and his team at the University of Hong Kong began developing algorithms to analyse heart sounds, initially using specialised microphones.

The team pivoted to a device capable of capturing heart sounds remotely following the unexpected arrival of COVID-19. With telemedicine becoming essential, doctors were unable to perform physical examinations, including listening to the heart with a stethoscope.

“We realised that the microphones in modern smartphones are sophisticated enough to capture high-quality heart sounds,’ Prof. Ho said. “This opened up the possibility of using phones to collect and analyse heart sounds, enabling us to detect murmurs and estimate heart rate without specialised equipment.”

Facing challenges such as real-time recognition, noise filtering, and accurate classification using AI, Prof. Ho and his team founded the startup Vitome, which provides a platform for smartphone-based heart sound analysis, with the aim of integrating it into public and private medical systems or existing mobile apps for patient use: Vitogram. 

Vitogram is primarily designed for screening, aimed at large populations—including individuals who may be unaware of any existing heart conditions—and is suitable for a wide range of age groups.

“If the system detects a potential indication, the goal is not to cause panic but to encourage further medical assessment,” Prof. Ho said. “When doctors evaluate conditions like valve disease or other structural heart problems, they always take a holistic approach. Listening to the heart sound is only one part of the assessment—they also ask questions to check for additional symptoms and perform integrative analyses.

Typically, if there is a possible issue, the next step would be a cardiac ultrasound, or echocardiography, which allows doctors to visualise the heart and assess the opening and closing of the valves. This provides a much more definitive diagnosis.

Prof. Ho emphasised that Vitogram is designed to complement, not replace, healthcare professionals. “Where possible, any concerning findings are referred back to doctors for follow-up, ensuring that human expertise remains central to the process.”

Screening for heart conditions

Vitogram can detect three key types of conditions through heart sound analysis: heart rate abnormalities, structural defects such as valve disease or congenital issues, and arrhythmias like atrial fibrillation.

“Most devices already measure heart rate,” Prof. Ho noted. “What surprised us was how accurate a smartphone can be. In a recent study, we compared heart rate measurements from a smartwatch and a smartphone while participants were running. Our heart sound measurements were extremely precise—sometimes even slightly more reliable than the watch. Watches can be affected by sweat or movement, whereas the pounding heart sound is louder and clearer under exertion.”

Second, Vitogram detects heart murmurs, which may indicate structural defects. “In children, they are often used to detect congenital heart disease—a structural abnormality present from birth. In adults, especially the elderly, murmurs often point to valve disease. Humans have four heart valves, and any of them can be affected by conditions that impair proper opening or closing. Valve disease can be subtle at first and may go unnoticed until it becomes severe, which is why early detection is so important.”

Third, the technology monitors arrhythmias—abnormal or irregular heart rhythms. ”One condition we are currently studying clinically is atrial fibrillation, one of the more common arrhythmias. If left unmanaged, atrial fibrillation can significantly increase the risk of stroke, making early detection critical.”

While Vitogram is designed with physicians in mind, Vitome is currently exploring a patient-focused solution and is seeking funding to support a large-scale trial, ensuring reliable use at home and accurate interpretation of the data. “Once proven effective, our solution could scale rapidly. It relies on devices people already have—their smartphones—so anyone could use it at home, anytime, anywhere,” Prof. Ho said.

The large-scale study accounts for the types of phones people use, ensuring real-world applicability. “Our goal is to scale up and prioritise usability. The system is designed to be model-agnostic, though newer smartphones are recommended for safety and consistency.”

Diversifying across medical specialties and regional markets

While smartphone technology continues to evolve, Prof. Ho and his team remain unfazed. “Even with new generations or entirely new forms of technology, there will still be a variety of sensors. Our expertise in our research laboratory lies in making the most of these diverse data sources,” he said, noting sensors such as movement detectors and cameras.

“What we focus on is integrating this data to transform general sensors into meaningful health data tools. This is truly the core expertise of our company. I believe that no matter how devices evolve—perhaps in two years the phone will take an entirely different form, or become wearable—it won’t matter. There will still be sensors, and our strength lies in making the most of the data they provide.”

The team is also collaborating closely with clinicians across medical specialties. “Lung assessment is a natural extension, since the stethoscope is used for both heart and lungs. Lung sounds help distinguish conditions such as upper respiratory infections, pneumonia, or airway issues like asthma or bronchitis.”

With smartphones now ubiquitous, the team is looking beyond Hong Kong. “Cardiovascular disease is a worldwide problem. This approach is highly scalable, and we definitely want to expand its use,” Prof. Ho said.

The most common application his team has heard from doctors is disease screening, particularly in regions where access to diagnostic tools like ultrasound is limited. “Ultrasound is currently the gold standard for detecting valve disease, but it’s not always available. In contrast, smartphones are widely accessible and often already in people’s hands, making this approach much more practical and convenient.”

From a strategic perspective, his company is initially focusing on the Asia-Pacific region—primarily Hong Kong, China, and Southeast Asia—where proximity facilitates collaboration and studies.

“My vision is to establish a strong presence in the region,” he said with a smile. “There is tremendous demand for innovative medical devices. Uptake has been very encouraging, and we are meeting many eager users.  Our focus is to grow the technology and expand into new applications, developing a range of phone-based and phone-assisted devices that capture human health data in digital formats.”