The increasing impacts of cardiometabolic risks and cardiometabolic disease, including obesity, hypertension, type 2 diabetes, dyslipidemia, atherosclerosis, chronic kidney disease, have led to significant therapeutic innovations that have undoubtedly helped improve cardiometabolic health in the last decade. Conventional approaches to care, such as landmark clinical trials, updated clinical practice guidelines, and population-level efforts in screening and diagnosing cardiometabolic disease have helped to improve outcomes. However, a significant proportion of the population is still at a high-risk for developing cardiometabolic disease or for exacerbated effects from existing cardiometabolic conditions.
Since patients may respond differently to therapy, many conventional approaches are unable to answer these differences at the individual level, and several approaches to help bridge this gap and individualize therapy are emerging. One of such emerging cutting-edge approaches with significant advances in the last decade is healthcare technology. Inclusion of technology has brought a remarkable revolution in healthcare, for instance, health and fitness apps promote the idea of patient self-management and bring innovation in individualized health care by converging with genomics, genetics and systems biology. As the evidence-base for technology in healthcare, and specifically in cardiometabolic health, continues to increase, its utility is increasingly recognized by experts and incorporated as part of clinical practice guidelines. In this context, we had an opportunity to talk with Patrick Wayte, Senior Vice President of the American Heart Association’s Center for Health Technology & Innovation, about the role of technology in health care.
Today an individual can self-monitor their health by using smartphone-enabled fitness apps, as well as wearable scanners to monitor their weight, sleep, blood glucose levels, electrocardiographic activity, blood pressure, body temperature, heart rate, and more. Latest statistics indicate that there are more than 97,000 health and fitness apps available in the marketplace in 2019. The cardiometabolic health space is increasingly being influenced by this tech-realm, and according to Mr. Wayte “one of the extraordinary opportunities with technology is the combination of high fidelity and high volume data coming through the body sensing devices tied to ultimately nudging systems analytics and AI systems that allow the individual to make much better decisions about their health”. “If this approach is further linked with pharmacotherapy, genetic sequencing, and what physicians know about treating disease, we have a great opportunity to have a deep understanding of the individual patient, how they process medication, perhaps even what are the precursors to disease, allowing for rapid interpretation of increasingly sophisticated amounts of data”, he mentioned.
The use of technology is very powerful and confers numerous advantages to both the patients as well as providers, including massive amounts of data, which can also bring additional challenges. Hence, it becomes very pertinent to know the answers of many important questions, including how to streamline and filter through this information and leverage it for the benefit of patients. Mr. Wayte told us that the American Heart Association has been working very diligently to answer these questions. “We are always talking with healthcare providers on how to best use the data, and it is a very difficult endeavor. The Association recently worked alongside the American Medical Association (AMA), Health Information Management Systems Society (HIMSS), and the DHX group to lauch Xcertia, a non-profit dedicated to promoting best practices in the development and use of healthcare mobile applications. Another step on which the American Heart Association is actively working with different stakeholders to create a sort of “healthcare outcomes clearinghouse,” something that works throughout the body of evidence and consolidates the outcomes data with technology which will help to filter and standardize the data beneficial for patient care.
The next very logical question is whether caretakers, as well as caregivers, are ready for this big, dynamic change that technology is bringing to healthcare. The answer can be effortlessly reflected from the current statistics, approximately 52% of smartphone users collect health-associated data, and around 93% of doctors indicated that mobile apps can enhance patient health care quality. “The healthcare community is already experiencing this, because patients are bringing in data. On the other hand, patients and consumers are very ready for it. But there is definitely a gap in terms of determining what information is relevant for patient care and for making clinical decisions, and the traditional healthcare systems’ ability to make sense of it right now” – Mr. Wayte mentioned.
We now have several evidence-based technology approaches in cardiometabolic health, but if patients are not adequately using them, it can undermine their clinical value, similar to the impact that medication non-adherence has on overall outcomes. As such, the importance of patient engagement and education cannot be overstated. Mr. Wayte mentioned that the American Heart Association is working to aid patients as well as clinicians to eradicate the barriers for an easier adoption of technology. “We are trying to bring together clinical algorithms, health content, care plans, and digital solutions, including remote patient monitoring with the intent of trying to get alignment with evidence-based care. We believe that this would be beneficial to both clinician and patient engagement with technology, in terms of sticking with the regimens, believability and credibility” – he mentioned.
Not only this, technology has the potential to bridge the socioeconomic patient care gap by optimizing and improving healthcare in rural areas. However, there are significant challenges with the affordability of technology, particularly in rural areas, due to the slow absorption of technology reimbursement in the healthcare payer systems among others. “One of initiatives that we are developing to address this aspect, is to create a health equity plan for technology that aims to improve access to various healthcare thechnologies across socioeconomic status to give everyone the same opportunity to improve health and prevent deadly diseases” – said Mr. Wayte. “Lastly, we are also pioneering an effort that will encourage our own clinical professional members to volunteer their time through telehealth systems for consults to federally-qualified health centers and community clininics, which will reach rural and medically underserved communities” – Mr. Wayte mentioned.
Healthcare technology is emerging as a major player to bridge real clinical gaps and improve patient care. As we continue to evaluate its role in the prevention, diagnosis, and treatment of cardiometabolic disease, it is important to educate clinicians about best practices and current evidence base. CMHC, in collaboration with MedTech Impact, organized the Cardiometabolic Technology Summit: Digital Advancements and Practical Solutions, which took place during the 14th Annual CMHC meeting in Chicago, IL and further explored these issues and much more. During the summit, Mr. Wayte overviewed some of these efforts in his presentation titled “New Generation Engagement: The New Frontier.