One million Americans aged 55 and older will be diagnosed with heart failure in 2024. For 80% of these people, diagnosis will come only after an emergency room visit and a cumbersome process that can last 11-15 weeks.
What’s worse: Half of these patients will not live five years past diagnosis. And the cost burden on the health system is staggering – up to $10,000 per patient for the diagnosis.
However, recent technology developments have the potential to change the future of cardiac care – bringing early detection to the home at a fraction of the cost.
For example, Peerbridge Health offers a hospital-grade device for remote detection of heart failure. A recent feasibility study showed the artificial intelligence-enabled device was able to determine whether a patient had heart failure (HFpEF or HFrEF) with 96% accuracy.
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 get the lowdown on the human and financial costs of heart failure, the challenges with the current process for diagnosing heart failure, technology breakthroughs enabling early and low-cost detection of heart failure at home, and what the shortage of hospital beds and projected shortage of cardiologists mean for remote heart failure diagnosis.
Q. What are the human and financial costs of heart failure?
A. One million Americans will be diagnosed with heart failure this year. Unfortunately, 800,000 of them will get this diagnosis only after an emergency visit to a hospital or urgent care facility. And the process for diagnosis can be months as patients wait in line for time with cardiologists and imaging. Sadly, less than half of patients diagnosed after an ER visit will survive more than five years.
People with heart failure lead diminished lives. Physical activities that most people take for granted – like climbing stairs or playing with grandchildren – are arduous. Over the course of managing heart failure, many will inevitably return to the hospital due to episodes of acute worsening (decompensation).
This hospital readmission cycle is emotionally burdensome for both patients and caregivers.
The cost of heart failure in the U.S. 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 been rising and are expected to continue rising. By 2030, the American Heart Association expects the cost of heart failure in the U.S. to exceed $70 billion per year, with the total cost of caring for heart failure patients nearing $160 billion.
Q. What are the challenges with the current process for diagnosing heart failure?
A. There are several problems with how we currently diagnose heart failure. One of the biggest challenges is that easy, low-cost and accessible methods of detection have been unavailable.
Access to heart care is a particularly serious issue for rural Americans, who may have to travel great distances to see a cardiologist. Furthermore, that specialist may not have an appointment available for three or four months. Research data shows rural Americans are 40% more likely to develop heart disease and are at a 30% higher risk of stroke than urban Americans.
I always think of my own father, who lives in a remote area at the end of a gravel road. Like many older Americans, he’s not likely to leave home to seek care unless it’s urgent – and maybe not even then. Compounding matters, more than 100 (or 4% of) rural hospitals shut their doors from 2013 through 2020.
These closures have resulted in rural Americans having to travel about 20 miles more on average than in the past for common services such as inpatient care. If we can bring lifesaving diagnostics to my dad and those like him – and do it at a fraction of the cost – the impact will be significant.
Speaking of cost, the high price tag associated with heart failure testing is also a major issue. There are several tests and imaging performed by cardiologists and other clinicians to test for heart failure, including blood tests, chest X-rays, electrocardiograms, echocardiograms and cardiac catheterizations.
The cost of testing can run from $3,000 to $10,000. While spending money on testing is preferable to the billions we spend treating heart failure after the fact, many patients may be paying more out of pocket than they can reasonably afford. It only makes sense to find less expensive ways to test for heart failure.
Q. What are some technology breakthroughs enabling 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 diagnosis and monitoring tools in their homes at a far lower cost than having tests done at a hospital or cardiologist’s office.
These hospital-grade tools combine artificial intelligence with inexpensive, wearable devices that can perform remote electrocardiograms. Unlike Holter monitors, which require patients to attach 12 leads to their torso for 24 to 48 hours, these new remote EKG devices use only three leads and can conduct a test in as little as 30 minutes.
Making remote ECG devices more patient-friendly helps make sure patients and their providers can easily monitor their hearts for early signs of heart failure. And compared to the $3,000 to $10,000 cost of testing at a medical facility, the cost of testing using a remote EKG device is about $200. That reduces the cost of testing for patients, providers and payers.
Q. What do the shortage of hospital beds and projected shortage of cardiologists mean for remote heart failure diagnosis?
A. What these shortages mean is the need for remote heart failure diagnosis has become urgent. By 2030, which is less than six years from now, there is projected to be a shortage of 120,000 cardiologists in the U.S.
Combined with the expected continued decline in the number of hospital beds and the rising cost to Medicare of heart failure among Americans 65 and older, it is imperative our healthcare system find a way to detect heart failure early and at low cost.
This creates an opportunity for remote technology solutions that can bridge the cardiology care gap to enable better patient outcomes and reduce healthcare spending across the board. The optimal technologies are patient-friendly and hospital-grade. They have to be easy for people to put on and wear for the duration of testing, and they have to deliver accurate, clinically actionable test results.
As healthcare AI and remote monitoring and test devices continue to advance, and as our population continues to age, I expect to see rapid adoption of home-based ECGs and other cardiology tests. These devices can act as an early-warning system for heart failure that could save millions of lives and lower healthcare costs.
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