Telemedicine and proactive health screenings can give us better health outcomes and save enormous amounts of money, translating into extraordinary returns for investors buying into this vision.
Many people take an exclusively reactive approach to medicine, never seeking healthcare until they experience symptoms that are not getting better. This is far from the ideal way to keep your body in the best condition, nor is it the least expensive way to handle your health.
Consider that we use proactive care with our automobiles, but many of us don’t do the same for own bodies. As a car owner, you have a stake in maintaining the condition and reliability of your vehicle. You probably wouldn’t ignore any warning lights or service requests, just continuing to drive it, until one day it breaks down. Today, many cars send data to the dealer via a telematics system; if something is amiss, you may get a text from your dealer asking you to bring the car in. It’s telemedicine for your car.
We are more proactive about our car maintenance than our health, which makes no sense considering that your body must, by definition, last your entire life. The consequences of ignoring your health can be dire.
Proactive screenings are on the rise for cancers of several prominent types, but adoption and frequency of screening are important and often not adhered to by patients who may put screenings off because they are unpleasant. Colonoscopies, mammograms, cardiac stress tests and others are no-one’s idea of a good time.
It's an odd hangover from history, that Health Insurers and Health Systems exist to help maintain your health, yet many of the doctors and hospitals providing services may do better financially if you get very sick. A review of the funding for diagnostics research, versus drug and therapeutic funding, would show the industry’s reactive focus on treating symptoms and saving people who are already sick.
Ignoring proactive screening technology is not aligned with optimum health of the served population. Today, because of lack of access to good inexpensive healthcare, underserved segments of the population have much worse health outcomes and will benefit disproportionately from growth in low-cost convenient screening. Providing convenient and low-cost proactive screening will dramatically improve outcomes for all groups and will more than pay for itself in money saved, as well as reducing the load on emergency departments being used for primary care by the underinsured or uninsured.
Chronic diseases and disorders may persist for years or decades, reducing quality of life and costing the health system a great deal of money. The set of chronic diseases is diverse, and the effectivity of proactive healthcare varies with different disease types. Using diabetes, cancer, and heart disease as examples can illustrate this point:
Type one (Insulin dependent) diabetes is unavoidable today, with limited or no opportunity for proactive efforts pre-diagnosis. This is set to change at some point in the next few years, but for now, longevity in good health is achievable for diabetics, by improving blood sugar regulation through monitoring combined with telemedicine reporting. Using the best technology ASAP after diagnosis could be considered proactive, regarding extending quality of life into a diabetic’s later years, and all diabetics should be taking advantage of it. Managing diabetes without technology is certainly possible, but this is harder on the body since the blood sugar swings will be more extreme. High blood sugar is destructive to the microvasculature of the retina, among other considerations. This diabetic retinopathy is the leading cause of blindness in the west today. High blood sugar also damages the kidneys and the lower extremities.
Many cancers have outcomes which are almost fully dependent on early detection, which involves screening procedures on a regular basis. Breast cancer, colon cancer, and prostate cancer screenings are good examples of proactive healthcare saving lives. Unfortunately, some less common cancers that we do not currently screen for, such as pancreatic cancer, are asymptomatic until the disease has progressed so far that a cure is less likely. Extending the benefit and reach of proactivity will be enabled by a policy of investment in screening diagnostics. A relatively small amount of investment would no doubt pay dividends by reducing the burden of suffering as well as the cost of cancer to the health systems. This should be the focus of aggressive pursuit.
Regular cardiac screening plus diet modification, medication and exercise can help patients substantially delay or prevent the onset of heart disease and heart failure. Unfortunately, partly because of the public’s reactive healthcare mindset, the incidence of heart failure is rising at 9% a year, fueled by the increasing number of heart attack survivors and uncorrected bad exercise and eating choices. Ideally there should be a convenient means of proactive cardiac condition evaluation as we age into our 40s, 50s and beyond.
Convenient check-ups and proactive maintenance of health can save health providers and patients massive amounts of money. New screening tool development can be prioritized by ranking the most life-enhancing as well as the most cost-reducing technologies. Noninvasive and at-home screenings, without the need for medical personnel, should be the goal whenever possible. Your healthcare provider could provide convenient screenings in the following ways:
Key points for investing; The proposed screening technology should be assessed against the following:
Dragorosso is focusing first on cardiopulmonary screening, which has several markets, the largest of which is to serve Heart Failure outpatients. Every year, a sizeable number of the 6.2 million US HF outpatients go into Acute Decompensated Heart Failure (ADHF) requiring urgent admission to hospital to correct fluid retention and stabilize their condition, costing US healthcare over $40 billion annually. To reduce the number of these admissions, regular monitoring of an HF outpatient’s key hemodynamic and cardiopulmonary parameters can provide sufficient advance warning of ADHF to avert hospitalization in half the cases.
The health-tech giant Abbott has embarked on a CHF monitoring effort centered around an implantable sensor which measures the pulmonary artery (PA) pressure waveform. Changes in pulmonary artery pressure give five days warning ahead of impending decompensation. Regrettably, installing the Abbott monitor involves an expensive and invasive procedure, since the sensor must be passed by catheter through the right side of the heart to get to the installation site in the Pulmonary Artery, where it is held in place with spring arms. Associated costs and risks have meant that the device is mostly approved only for class III & class IV (i.e., severe heart failure) patients.
We will provide a range of heart failure telemedicine solutions at a cost far lower than the Abbott device, able to gather the required set of metrics non-invasively. Our goal is that our equipment can be used by any patient in any condition. In many cases the subjects will be able to conduct these one-minute automated tests themselves at home without the need for medical supervision. The results will be transmitted to our monitoring system which will use Machine Learning software to provide actionable information to the healthcare provider as necessary. We estimate the cost to develop the device and bring it to market to be less than $20 million. That’s 0.05% of the $40B potentially avoidable costs currently being paid out every year. To reinforce the point: the cost to bring this diagnostic to bear against the most expensive problem in US medicine is a two-thousandth of the annual cost of the problem.
Comparing the lifetime cost of daily monitoring of a heart failure outpatient against the Abbott device, we forecast our solution being one fifth of the cost, and we will continue to improve affordability as the solution is deployed at scale. Our long-term vision is that every heart failure outpatient will have a dedicated monitoring system in their home, supplied at no cost by their healthcare provider.
Great medical benefits will accrue from improving proactive healthcare through improved diagnostic technology. This trend can save enormous amounts of costs to health systems and insurers and go a long way toward leveling the healthcare playing field by providing inexpensive and accurate at-home screening to anyone.
Healthy people think of the heart as a reliable pump that can have disastrous failures if we don’t manage our health. Good enough to last a lifetime, but easily damaged by bad choices with behavior, diet, and drugs. Using technology, we will improve our medical approach to cardiac care, improving lives, reducing costs, and avoiding bad outcomes.