Heart disease and high blood pressure are the world's leading killers and one way to combat them is to track key health indicators, such as blood pressure and heart rate. The problem is that even with the introduction of digital technology, it's often difficult for people to regularly take readings and interpret the results. One alternative to traditional sphygmometers and stethoscopes is Mocacare's Mocaheart cardiovascular health monitor, which we put through its paces.
While heart-rate apps aren't new, Mocaheart takes things a step further with a pocket-friendly scanning device that combines thumb scans with algorithms to measure blood flow and velocity as a way to assess blood pressure, heart rate, and blood oxygen levels. It then converts these via a smartphone app into a simple 1 to 5 scale called the Moca Index that gives a snapshot of overall cardiovascular health. According to Mocacare, the idea is to provide non-professionals with an easy way to track and interpret health trends over time by means of an interactive system.
Set up
Out of the box, the Mocaheart unit is very simple, consisting of a sleek metal lozenge made of medical-grade stainless steel and a biocompatible plastic back that comes in a choice of colors. At under 1 oz (30 g), it's extremely portable, but also very fragile and not at all water resistant. On the front of the unit is an optical sensor with an infrared and visible light source, and an electrode plate. Between these is an on/off button. Also in the box is a very basic and very short micro USB cable for charging, and a start up guide that provides the basics for operating the device with simple explanations, which are important for the target market of older, less tech-savvy consumers.
Mocaheart is one of those devices that is extremely simple to set up in terms of hardware. It's just a matter of plugging the included USB cable into a computer or wall adapter, then waiting for the unit to charge, which takes about half an hour. In terms of mechanics, using it is also very simple. Placing one's thumbs on the optical scanner and metal electrode pick up allows the Mocaheart to measure heart rate, blood oxygen level, and blood flow in about 30 seconds.
However, the unit can't do any of this on its own. It's really a data collection device for the downloadable Mocaheart app, which controls the scanning process, runs the algorithms, and provides the readouts.
Trying it out
Setting up Mocaheart proved more difficult than expected, needing several tries involving usernames, email addresses, and passwords to set up an account. Part of the reason may be that the Android version is still a work in progress and while we were evaluating it, the app had a major update, which improved functionality.
Once installed and configured, the app connects to the unit via Bluetooth. This is automatic when the unit is turned on, but we found that it has to be within 3 ft (1 m) of the phone or the connection doesn't take.
Taking a reading is designed to be easy, but it does take a bit of practice. To operate, the user opens the Mocaheart app, switches to the "Measure" mode, then turns on the unit. The app confirms the connection and an animation demonstrates how to hold the unit and what a good signal should look like. The user then places one thumb on the optical sensor and the other on the electrode. The app counts down, then starts the reading. During the reading, a graph line shows the readout of the heartbeat taken from the artery in the thumb. The app recognizes when it has a poor reading and either prompts the user or automatically repeats the scan.
Once the reading is taken, the algorithms evaluate the data and convert it into the Moca Index number. This is displayed along with the heart rate, blood oxygen level, a time stamp, and local weather conditions. Based on studies conducted at MIT and Stanford University, the Moca Index uses blood velocity as a measure of blood pressure and combines this with the resting heart rate and blood oxygen level to produce a health assessment rated on a scale of 1 to 5. In this, 2 is normal, 1 is deficient, 3 and 4 are unsatisfactory, and 5 indicates a possible medical problem.
According to Mocacare, the Index reading is only half of what the app does. It also displays history and trend views of readings and Index numbers and automatically records factors, such as weather and location. These are shown in visual graphs of daily, weekly, monthly, or annual trends, so users can track their progress and make a note of changes in their health status. In addition, the readings can be shared through the app with friends, family, and healthcare providers, and annotations can be attached to particular readings to record factors such as diet, illness, and physical activity. In addition, the app can send reminders to help keep users on their tracking program.
Calibration
One thing we found to be very important about Mocaheart is that it needs to be calibrated in order to provide reliable readings. In the app's user profile page, users can enter details about their sex, age, weight, height, smoking habits, alcohol use, and any outstanding medical conditions, but the most important is blood pressure.
We found that blood pressure was the key part of the calibration process. Every six months, the user needs to enter a blood pressure reading taken within five minutes. This calibration is essential because without it the Moca Index is unreliable. When we tried to use the Mocaheart without calibration, it provided a reassuring readout of 2, which is the most healthy. Calibrated against a sphygmometer, this shifted to 5, which is probably more accurate for a middle-aged man with high blood pressure who's been neglecting his medicine.
In use, Mocaheart started out as disappointingly unreliable with connections between unit and phone failing with monotonous regularity. However, this was corrected when the app updated itself and the connection became reliable so long as the unit was kept close to the phone. Placing the fingers correctly with the proper pressure took some practice, but this wasn't a major problem. However, we did find that though the battery lasts up to five days on a single charge, it needs to be kept topped up for the unit to operate properly.
Perhaps the biggest drawback for Mocaheart is the Moca Index. True, it does greatly simplify interpreting health data and is probably very easy to understand by the layman, but the Index isn't very granular and, unlike blood pressure readings, it's very hard to have any sense of what is actually happening over time. In a sense it's like a traffic light system without much leeway between "okay" and "uh oh."
Mocacare emphasizes that Mocaheart isn't a substitute for proper medical testing. It isn't intended as a diagnostic tool and won't be marketed as such until it receives FDA clearance to allow the readings for clinical use.
Mocaheart is available for US$149.99 from Mocacare.