The new normal, Health News, ET HealthWorld


Connected cardiac care : The new normalAshvanni Srivastava, COO, iMedrix Inc elucidates about the remote patient monitoring and mobile form factor powered by sophisticated algorithms that are disrupting the cardiac care, particularly by enabling anywhere anytime connects for the patients, with a real-time cardiac risk assessment, and quick access to expert medical advice.

What are the changes, big trends, or disruptions emerging in remote monitoring devices in the cardiovascular care space?

Cardiovascular diseases (CVDs) have overtaken cancer as the leading cause of death in India. The prevalence of CVDs and cardiovascular risk factors is increasing day by day. Early detection and management of CVD, particularly for high-risk individuals, monitoring and treatment with real-time response to acute situations is the biggest disruption happening. Cardiac care is moving out of hospitals, into homes and offices; and outreach areas to cater to the underserved.

In emerging markets or countries like India, the primary driver for remote monitoring in the CVD space is accessibility and real-time access to expert advice. The burden of CVD is particularly high in Asia (or among Asians). Studies have shown that heart failure condition at average sets in earlier among Asians than among western phenotypes. Amongst the non-communicable diseases (NCDs), cardiovascular disease is the leading cause of mortality accounting for nearly 17.9 million deaths worldwide and 2.58M deaths in India, annually (WHO Report on NCD Country profiles, 2018). Multiple reports and data confirm that almost 29-30% of the affected population is asymptomatic, attributing to late detection of the condition, and the high mortality rate.

Furthermore, COVID-19 has transformed and accelerated the pace of digital health adoption. Our belief is further endorsed as we witness consolidation across the globe – from Hillrom acquisition of Seattle’s Bardy Diagnostics ($367M), Philips’s acquisition of BioTelemetry to transform the delivery of healthcare, and Bostin Scientific acquisition of Preventice – Remote Patient Monitoring (RPM) is the new normal.

How Remote Patient Monitoring cardiac devices are changing the practice of cardiology? Do you think this momentum is accelerated due to pandemic, if so how it is going to change the cardiology treatment?

Even before the pandemic, access to medical-grade tools and expert advice for cardiac care has been the biggest challenge faced by at-risk patients especially when faced with life and death acute situations, considering these interventions were available only at a major clinical facility.

RPM solutions are disrupting the healthcare ecosystem by enabling anywhere anytime connects for the patients, with a real-time cardiac risk assessment, and quick access to expert medical advice. Further, with sophisticated AI algorithms cardio conversations have become data – insights conversations enabling quick decisions and timely clinical intervention. The markets are witnessing a fundamental shift of outpatient cardiac care; screening, early detection, diagnostics, decisions and services now available outside the traditional four-wall structures.

The pandemic has certainly enhanced the adoption of digital tools and next-gen technology by doctors and hospitals. This allows the health ecosystem to augment capacity, by increasing access, offer timely treatment, and manage compliance translating to improved outcomes and positively impacting life expectancy. Having experienced seamless clinical services from the comfort of one’s home, RPM solutions, especially for cardiac care are in the direct line of sight for the hospitals, public health agencies, and the consumer.

Can you tell us about the cardiac ailments which can be aided by your diagnostic solutions, about the device accuracy in each ailment, cost-effectiveness of the product and benefits across the industry for patients and providers?

KardioScreen is US FDA cleared, accessible, affordable and accurate. It can diagnose any cardiac condition, which is possible with a traditional ECG machine, with the same accuracy with just a click of a button. It can be connected via mobile. Our ability to deliver clinical-grade EKGs in real-time, in harsh operating conditions without skilled operators is a significant edge over others. More importantly, our cost per ECG is typically 10-20x lower, thus making quality-affordable cardiac care available to a much larger population, especially the underserved, like never before.

With one of the largest and most diverse out of hospital EKG databases in the world, we are transforming cardiac healthcare with Artificial intelligence (AI), Cloud Technology, and Machine learning (ML) for a under 5-minute risk assessment, real-time diagnosis by the doctor, and accurate clinical decisions. With a reach across 15 countries, we will be able to generate more knowledge about the human body in the next 5 years. The device has been adopted for critical care of AIIMS Delhi.

What differentiators do you offer in respect to other products in the segment? How is it going to help cardio care particularly bridging the gap in healthcare in terms of doctor and patient ratio, healthcare infrastructure?

We help by treating the right patients and treating the patients’ right. Also, identify asymptomatic patients and manage population health. KardioScreen (iMedrix) is further democratizing heart health by putting a medical-grade, high-impact, life-saving device with a mobile form factor, powered by sophisticated algorithms that assist early detection and risk interpretation for the patient, assisted by a remote or on-premise doctor. The device literally “fits in the palm of your hand”.

Currently, we are the leading six and 12 lead medical-grade, mobile ECG that is US FDA cleared. This is a big differentiator, especially with regards to quality, efficacy, and safety, the prime need in healthcare. KardioScreen has a robust AI engine that is currently in process for US FDA approval. The AI engine generates clinical intelligence both for the individual and at the cohort level; thus doctors can confirm the diagnosis within minutes and diagnose deep underlying conditions. In addition, cohort-level data alerts them to patients who need immediate attention, preventive care, medication, advanced diagnostics, etc. This assists the doctor manage the overall health of a cohort while getting deep insight into any individual.

The industry partners in MedTech, pharma, insurance and government/public health organizations, and private hospitals across India, SE Asia, Middle-East, Africa, and the US are leveraging KardioScreen for real-time AI risk assessment and data analytics that is the foundation for digital transformation and patient engagement. We collaborate with the Ministry of Health and public health agencies across India, Saudi Arabia, Philippines, Malaysia, Cambodia, Nigeria, etc., and leading hospitals and digital health companies in multiple ways including COVID isolation and post-COVID surveillance.

How will the cardiac diagnostic solution help in extending real-time risk assessment and telecardiology to hospitals and public health agencies? How this is going to help to transform and scale cardiac care access, across geographies.

Our purpose is to establish analytics leadership in cardiac care. Being fully mobile, the solution allows you to collect an ECG even for asymptomatic patients. This brings a huge advantage in early detection and hence early on risk assessment and management. Hospitals can focus their efforts on those deemed to be moderate and high risk while extending medication advice and wellness benefits to low-risk patients. Similarly, public health agencies can get a real-time on-ground view on disease prevalence, understand trends and re-calibrate care programs.

A case in point; we found that in multiple S.Asian/SE Asian and ME patients, undetected type II diabetes was quite prevalent. This was a result of ECG analysis by our AI algorithms. Thus, we can apply AI insights to not only heart disease but also key co-morbidities. In addition, we can point out variances between geographic or other demographic profiles.

Our innovative business model enables products and solutions to reach global populations. Our solution provides, digital and optimized tele-cardiology workflow, data triaging leading to higher accuracy using AI/ML algorithms, auto interpretation / AI classification – emergency, high, medium and low risk, real-time alerts – SMS, Email and Cloud notifications and real-time physician connect and collaboration

How important is the users’ experience in the eHealth platform? Where does KardioScreen fit in?

The user experience is paramount to the success of any digital health platform. Most platforms focus on what they want to say and the service they provide while focusing on speed, flow, and function. But critical is to focus on the insights each stakeholder wishes for, and access conveniently. KardioScreen is instinctive, smart and addresses the needs of patients, providers, payers, pharma, and public health (5P’s of healthcare).

The key beneficiary, the patients, love that the care is provisioned for them, at home. Providers appreciate that they can diagnose and advise remotely, especially under the current pandemic. Payers value that member disclosures are accurate and compliance to a preventive program can be monitored and enhanced.

The device saves lives through instant, affordable access, anywhere, anytime with its medical-grade real-time cloud-connected solution. Additionally, it enables demographic insights, therapeutic insights, HF, and data modeling to estimate the risk and longitudinal and cohort level analytics at the click of a button.

Your diagnostic solution produces clinical-grade ECG traces and claims to be one of the largest and most diverse out of hospital EKG databases in the world. Can you brief us about the cybersecurity measures you put in place and how the technologies ensure secure patient data?

Technology is at the core of what we do as we work across geographies. Aspects like data privacy and compliance are more hygiene factors rather than “good to do” practices. KardioScreen has passed through the US FDA’s rigorous risk assessment matrix, a third-party penetration test in the US, and is hosted at HIPPA compliant infrastructure. We have taken a significant number of proprietary security measures that make us the choice of industry majors worldwide. Additionally, we work with our clients in multiple ways based on their requirements as well as prevailing policies of the hospital or even the country, with a prudent view of client requirements, while ensuring absolute data integrity and privacy.

What are the key factors that will boost the market growth of smart wearable devices and mobile technology in India, particularly in the Home healthcare space?

The medical-grade multi-parameter wearable is only a matter of time. The price will be the USP and we need to hit the hardware cost under a 100-dollar mark, which is within striking distance. In addition, just like the smartphone era, services akin to Uber, Ola, Swiggy, etc. need to come into the medical side in full force – both for wellness and illness. This is bound to propel the technology innovation ahead. In any case, Moore’s law has intersected medical, this inevitably becomes reality soon.

Having said that, trust is at the core of everything combined with convenience, ease, and comfort for driving consumer adoption. While value for consumers is paramount, innovative policies will be an imperative that, along with improved access, will substantially reduce the burden on the beneficiary.

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