By 2024, one million Americans aged 55 and older will be diagnosed with heart failure. In 80% of these people, the diagnosis will only be made after a visit to the emergency room and a cumbersome process that can take 11 to 15 weeks.
What’s worse, half of these patients will not live five years after diagnosis. And the costs to the health care system are enormous: up to $10,000 per patient for diagnosis.
However, recent technological developments have the potential to change the future of cardiac care, enabling early detection at home at a fraction of the cost.
For example, Peerbridge Health offers a hospital-grade device for remotely detecting heart failure. A recent feasibility study showed this An artificial intelligence device was able to determine with 96% accuracy whether a patient had heart failure (HFpEF or HFrEF).
Peerbridge CEO Chris Darland is passionate about expanding access to care and improving outcomes for the more than six million Americans living with heart failure.
We interviewed him to learn about the human and financial costs of heart failure, the challenges of the current process for diagnosing heart failure, technology breakthroughs that enable early and low-cost detection of heart failure at home, and what the hospital bed shortage is . and the expected shortage of cardiologists mean a diagnosis of heart failure at a distance.
Q. What are the human and financial costs of heart failure?
A. This year, one million Americans will be diagnosed with heart failure. Unfortunately, 800,000 of them only receive this diagnosis after an emergency visit to a hospital or urgent care facility. And the diagnosis process can take months as patients line up for cardiologists and imaging. Unfortunately, less than half of patients diagnosed after an emergency room visit will survive more than five years.
People with heart failure lead a reduced life. Physical activities that most people take for granted – like climbing stairs or playing with grandchildren – are tough. During the course of heart failure treatment, many will inevitably return to hospital due to episodes of acute deterioration (decompensation).
This hospital readmission cycle is emotionally taxing for both patients and caregivers.
The costs of heart failure in the US, it was estimated at $43.6 billion in 2020, according to the American Heart Association. This included the cost of healthcare services, medications to treat heart failure and related conditions, and lost productivity.
Costs have increased and are expected to continue to increase. The American Heart Association projects that by 2030, the cost of heart failure in the US will exceed $70 billion per year, with the total cost of caring for patients with heart failure approaching $160 billion.
Q. What are the challenges with the current process for diagnosing heart failure?
A. There are several problems with the way we currently diagnose heart failure. One of the biggest challenges is that easy, cheap and accessible detection methods are not available.
Access to cardiac care is an especially serious problem for rural Americans, who may have to travel long distances to see a cardiologist. Moreover, that specialist may not have an appointment for three or four months. Research facts shows that rural Americans are 40% more likely to develop heart disease and have a 30% higher risk of stroke than urban Americans.
I always think about my own father, who lives in a remote area at the end of a dirt road. Like many older Americans, he’s unlikely to leave the house to seek help unless it’s urgent — and maybe not even then. Making matters worse, more than 100 (or 4% of) hospitals nationwide closed their doors between 2013 and 2020.
These closures have resulted in rural Americans having to travel an average of about 20 miles more than in the past for general services such as inpatient care. If we can bring lifesaving diagnostics to my father and people like him – at a fraction of the cost – the impact will be significant.
Speaking of costs, the high price tag associated with heart failure testing is also a major concern. There are various tests and imaging performed by cardiologists and other physicians to test for heart failure, including blood tests, chest X-rays, electrocardiograms, echocardiograms, and cardiac catheterizations.
The cost for testing can range from $3,000 to $10,000. While spending money on testing is preferable to the billions we spend down the road on treating heart failure, many patients may pay more out of pocket than they can reasonably afford. It only makes sense to find cheaper ways to test for heart failure.
Q. What are some technological breakthroughs that enable early, low-cost detection of heart failure at home? How do they work?
A. There are emerging technologies that allow Americans to use highly accurate cardiac diagnostic and monitoring tools at home at a much lower cost than when tests are performed in a hospital or cardiologist’s office.
These hospital-grade tools combine artificial intelligence with low-cost, wearable devices that can perform electrocardiograms remotely. Unlike Holter monitors, which require patients to attach twelve leads to their torso for 24 to 48 hours, these new external ECG devices use only three leads and can perform a test in just 30 minutes.
By making external ECG devices more patient-friendly, patients and their caregivers can easily monitor their hearts for early signs of heart failure. And compared to the $3,000 to $10,000 cost of testing in a medical facility, the cost of testing using a remote ECG machine is about $200. That lowers the cost of testing for patients, healthcare providers and payers.
Q. What does the shortage of hospital beds and the expected shortage of cardiologists mean for the remote diagnosis of heart failure?
A. What these shortages mean is that the need for remote diagnosis of heart failure has become urgent. This will be the case in 2030, less than six years from now projected a shortage of 120,000 cardiologists in the US
Combined with the expected continued decline in the number of hospital beds and the rising costs to Medicare of heart failure among Americans age 65 and older, it is imperative that our health care system find a way to detect heart failure early and at a low cost.
This creates an opportunity for remote technology solutions that can bridge the gap in cardiology care to enable better patient outcomes and reduce healthcare spending across the board. The optimal technologies are patient-friendly and hospital quality. They must be easy for people to put on and wear for the duration of the tests, and they must provide accurate, clinically useful test results.
As healthcare AI and remote monitoring and testing devices continue to evolve, and as our population continues to age, I expect rapid adoption of home-based ECGs and other cardiology tests. These devices can act as an early warning system for heart failure, saving millions of lives and reducing healthcare costs.
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