What does the future of remote patient monitoring look like? Abbott executive Robert Ford weighs in

What's latest, greatest and next in connected medical device innovation?

 

Becker's Hospital Review caught up with Robert Ford, executive vice president of Medical Devices at Abbott, to find out. Mr. Ford discussed ways connected or smart medical devices can improve patient care and reduce costs, the future of remote monitoring, and some of the most exciting devices he is seeing on the market.

Editor's Note: Responses have been lightly edited for length and clarity.

Question: Medical device connectivity is a hot topic these days. One area that has been getting a lot of attention is remote monitoring between patients and their healthcare providers or loved ones. From your perspective, can you tell us how patients and healthcare systems can realize the benefits of remote monitoring?  

Robert Ford: For chronic conditions like heart failure, atrial fibrillation and diabetes, the ability to monitor the patient’s condition remotely not only enhances the quality of care, it also improves clinical efficiency. And, it can substantially reduce healthcare costs.

Look at heart failure, for example: Every year in the United States, approximately one million people are hospitalized with a diagnosis of heart failure — the leading cause of hospitalizations for adults aged 65 or older. The cost of treating heart failure in the U.S. is expected to reach $70 billion by 2030, from about $30 billion today.

Much of this cost can be addressed by remote monitoring. Remote monitoring via an implanted cardiac device works when a transmitter syncs with the device collecting data about the heart's activity, such as its rate and rhythm. The transmitter then sends that information to a hospital, clinic or physician's office on a set schedule. Providers can promptly review and evaluate the data and make timely interventions and remote follow-ups, as needed. This gives people peace of mind knowing they're connected with their doctor and can go about living their lives without having to travel to the doctor's office or hospital for emergency visits. 

Clinical studies show that remote monitoring can lower healthcare costs in multiple ways. It reduces the number of in-hospital device evaluations, hospital admissions, the length of stay per cardiac hospitalization, and follow-up office visits. Clinical studies with our CardioMEMS HF System, an implanted pulmonary artery pressure monitor, showed a reduction in hospital admissions of 33 percent over an average of 18 months.

All of these advantages make remote monitoring a critical tool in health management, especially for chronic conditions that contribute greatly to high healthcare costs.

Q: What's the future of medical device connectivity and remote monitoring?

RF: The future of medical device connectivity is about empowering people of all ages to be more in control of their health — and, with that, their lives. Wireless technologies that eliminate the need for bedside transmitters are part of that future, because that's one less device that needs to be carried around or managed. With that, we'll see more mobile apps that integrate more seamlessly into people's daily routines and give them the freedom to go about living their lives with more confidence and less worry. And, most certainly, there will be more data.

But data alone is not enough. There is no shortage of ideas for connecting data with people, devices and healthcare providers. The explosion in digital health technology is making it easier than ever for data from multiple sources to be shared across connected devices, apps and cloud-based services. Given the trends we're seeing in healthcare — the growing cost pressures on hospitals, health systems and patients themselves, as well as the prevalence of chronic conditions that need to be managed 24/7 — future innovations in medical device connectivity and remote monitoring absolutely must provide real, measurable value to the patient and to the healthcare institution, it must be accessible to the masses, and it must be affordable. In the medical technology arena, we must not get caught up in the technology or the data for its own sake, but instead, we must focus on the insights that data provides and, then, how we use those insights to understand trends, predict outcomes and inform health actions. Will it help patients be more compliant with their therapy? Can we use the data along with advances in machine learning to deliver personalized precision therapies? These are some of the questions we challenge ourselves to answer, and then we build those answers into our product development process. At Abbott, we've decided to focus on diabetes and heart failure to develop the life-changing technology that will make these connections.

Q: In this era of cyberhacking and patient privacy, what advice would you give healthcare providers when it comes to talking with their patients about the safety of remote monitoring of medical devices like pacemakers and ICDs?

RF: It's important first to acknowledge all that connected devices and remote monitoring have done to advance patient care in recent years — and we're just scratching the surface of what's possible. With any connected device, however, whether medical or nonmedical, there is always going to be some level of security risk. We as a community — those of us who design and make the devices and those of us who manage them and manage the patients who use them — need to be relentlessly vigilant about including the latest security protections in our products, services and systems, and continually update them as technology evolves.

Q: What are some innovative things you've seen being done in remote patient monitoring?

RF: Abbott has developed a number of life-changing technologies in remote monitoring — innovations that provide information and insights that are meaningful and actionable and, ultimately, provide clinical benefit. One example is our Confirm Rx insertable cardiac monitor (ICM), which is the world's first ICM that incorporates Bluetooth® wireless technology, allowing patients to connect their implanted ICM to their smartphone via a mobile app. Once it's implanted — just under the skin in the chest during a quick outpatient procedure — Confirm Rx continuously monitors heart rhythms. Data collected by the device is securely transmitted to the physician via the mobile app. The app also allows patients to record symptoms from their own smartphones without the need for additional hardware such as a bedside transmitter, which simplifies the process for patients.

Our CardioMEMS™ HF System, which I mentioned earlier, is another example of an easy-to-use wireless technology for remotely monitoring the heart's performance, specifically pressure in the pulmonary artery. The device is implanted directly into the pulmonary artery through a minimally invasive procedure. It transmits information wirelessly to the physician, who can adjust the treatment plan if needed, even before patients feel symptoms and without requiring follow-up appointments or hospitalizations. The CardioMEMS HF System, when used by clinicians to manage heart failure, has been proven to significantly reduce heart failure hospital admissions.  

Another example where device connectivity and remote monitoring can have life-changing impact is in continuous glucose monitoring. Our FreeStyle Libre system uses a revolutionary sensing technology that transmits glucose information from a small patch worn on the back of the upper arm. In Europe, the FreeStyle Libre system can be used with a smartphone app that allows people with diabetes and their caregivers to access and monitor glucose readings in real time. The smartphone app is pending FDA approval in the U.S. This ability to share glucose trend data is particularly important for people who are caring for elderly loved ones or others who may not be capable of managing their own glucose levels.

We've designed the FreeStyle Libre system to fit seamlessly into a person's daily life. It's calibrated at the factory so it doesn't require routine finger sticks, which is a key reason we're seeing a much higher frequency of glucose readings and closer diabetes management — resulting in fewer incidents of hypo- and hyperglycemia. And, importantly, it's priced to be more affordable than traditional CGM systems. With FreeStyle Libre, physicians don't have to be the sole motivator in glucose management, because patients themselves feel empowered by the ease of generating their own data. These features and the benefits they provide translate into better outcomes and lower overall costs — for treating diabetes and the complications that can come from it if it's not managed well.

That's an important point, because it underscores why connectivity is a valuable part of the equation when it comes to medical device innovation. For us at Abbott, innovation that's truly "smart" is innovation that is life-changing — leading to meaningful improvements in patient care and, most importantly, better health outcomes.

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