AliveCor's Revolutionary Approach to Heart Monitoring

What if you could gain unparalleled insights into heart health from the comfort of your home? Join us as we uncover the incredible journey of Dr. Ben Green, from house-calling family physician to a pivotal figure at AliveCor, a trailblazer in cardiac technology. Discover how AliveCor is on a mission to revolutionize cardiac care with accessible and advanced EKG devices, boasting over 3.5 million users globally. Dr. Green walks us through the evolution of AliveCor's groundbreaking devices, including the first personal EKG launched in 2012 and their progression to six-lead and twelve-lead devices, all designed to empower clinicians to make precise decisions remotely.

We venture into the future of remote patient monitoring, examining how technology is reshaping healthcare delivery. Explore the integration of wearables like Holter monitors and ECG patches that provide critical data without overwhelming clinicians, and learn about AliveCor's strategic partnership with GE Muse to streamline healthcare workflows. We also dive into the challenges and promising shifts in reimbursement for remote monitoring, shedding light on how these changes might drive higher adoption. Additionally, we touch on the transformative potential of decentralized clinical trials, offering wider patient access and richer data collection, setting the stage for more inclusive and insightful research.

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Transcript

Speaker 1 0:03

Hi everyone. Today we explore the world of remote patient monitoring and clinical trials, uncovering some trends, challenges and groundbreaking solutions with our guests from AliveCore. Let's get started. Dr Ben Green, how are you?

Speaker 2 0:20

I'm doing great. Thanks for having me, Irma.

Speaker 1 0:22

Oh, fantastic. We're so excited to talk to you today. We'd love to start with a little bit about your background what inspired your journey into this field and what led you to your current role with AliveCorps.

Speaker 2 0:36

Sure happy to. So, first off, I'm a family physician and I finished my residency back in 2007. And and at that time I kind of knew I wanted to do something a little different outside of the office and I fortunately got into house calls and I started doing home visits. And I ended up doing home visits for about 10 years and really, you know, the home visit is the you know the full remote visit, and so I really got to see, you know, how patients and how people obviously live their lives.

Speaker 2 1:13

You know health care happens not in a doctor's office but really at home and everywhere else. So I was able to really see, like I said, a lot of amazing things and how we can bring healthcare to people. After about 10 years of house calls, I really got into telemedicine and really taking that house call and delivering that virtually using video technology like this and then devices and tools. I spent about four years at Amazon building a telehealth program their first telehealth program and then for the past three and a half years I've been here at AliveCorps, which has really taken remote cardiac services to the next level, and in my role here I lead clinical services, which means complementing our devices with clinical services and cardiac services that we can provide to patients at home or wherever they are.

Speaker 3 2:12

Wonderful and tell us more about AliveCore's mission these days. You're such a standout we see you everywhere in the health tech space, including in the off-the-shelf best buys of the world and what makes you such a standout in this world today?

Speaker 2 2:31

Sure, well, alivecore has been around for about a dozen years and I don't know that people know that, but we created the first personal EKG device back in 2012. First personal EKG device back in 2012. And since then the company has evolved tremendously. And I'll also say with respect to our mission. Heart disease remains the number one killer worldwide. The latest stat I saw is every 1.69 seconds someone worldwide dies from heart disease and at AliveCore, we're not okay with that. So really, our mission is to save lives and bring cardiac data, highly personalized cardiac data, to clinicians, to patients, wherever they are, whenever they need it. So really, that is our charter and that's why I'm here, why our founders started the company and why we're all here building these solutions and why we're all here building these solutions.

Speaker 1 3:26

Wow, that's quite an achievement, and you've been around for a dozen years, like you said, any standout milestones you're proud of, including from maybe early on, like?

Speaker 2 3:40

you've just mentioned all the way to the present day. Sure, yeah, so, as I mentioned, we came out with the first personal EKG device back in 2012. And since then, we've evolved our device portfolio. So in 2019, we launched a six-lead personal EKG device. So that provides six times the amount of data to doctors and to patients. We're very proud of the fact. We have over 3.5 million users of AliveCore devices and cardiac devices over the years. We're available in over 44 countries. At last count, we are doing over a million ECGs a week coming into our cloud.

Speaker 2 4:25

And, as a clinician, as a physician, also very proud and you see it here on the screen over 200, I think it's over 225 now publications of cardiac devices in the clinical literature showing that these devices are useful for patients, they're useful for providers, and and those are, those are worldwide, worldwide studies. And you know, and the last thing I'll say, you know this this was a company that originally, you know, created a device for patients, for consumers, and, and that's remains, you know, one of our largest segments of customers. And if you go on Amazon, you'll see over a hundred thousand reviews of our devices four and a half stars, uh, or higher, um, which is just a testament to the fact that you know, we can bring a medical grade device and, uh, you know, two patients, two consumers, um, and they, they, they obviously find tremendous value, um, and and tremendous value for their clinicians and we, we get that so often, so often, where the clinician is so grateful for the data now that they're able to see you know, from patients that they're treating now remotely.

Speaker 3 5:32

Yeah, very exciting and give us a peek behind the scenes in terms of what goes into the product development, particularly in the past years where you've doubled down and you know how did that impact. You know your approach to serving patients.

Speaker 2 5:44

Yeah, you know, I think you know how did that impact? You know your approach to serving patients. Yeah, you know, I think you know the. You know, back in 2012,. You know, one lead ECG did not exist. It wasn't an available solution for people at home.

Speaker 2 5:59

So, obviously, in the area of rhythm monitoring, you know, one lead ECG is quite capable of detecting a lot of abnormal rhythms and really all that abnormal rhythms, but we, as a company, we're not, we were not OK with just providing one view. So let's, let's go to six, so that six lead device, as I mentioned, came out and now doctors are able to to glean more information, they're able to make more accurate clinical decisions than just that one lead. And then, just this last year, in June in fact, we launched a 12-lead version, our first 12-lead device, and the 12-lead ECG is really equivalent to a 12-lead ECG in an office setting and these are now devices that, in the future, patients can use. These are for clinicians today, but these are now devices that that are able to capture that full picture of the heart in a way that's that's super simple, super rapid, very patient friendly, very provider friendly as well, friendly as well. So so, devices, you know the device portfolio that I just talked about is a big part of what we do, but we also provide services. So so device and data by itself is is just that.

Speaker 2 7:13

You know how do you marry that with? With clinical care, clinical services. You know, we're fortunate to have a huge cardiology community across the US and the world that are that's using this data. But for people that may not have a cardiologist they may not have a doctor that's looking at this data, we do provide that to patients. So we're able to provide board-certified cardiologists virtually to patients, whether that's an asynchronous conversation or a live conversation. We're able to deliver that to patients as well. Because, you know, my feeling is, you know, yeah, that data, like I said, on its own can sometimes cause more harm than good. So we're able to provide the clinical decision making, the guidance, to patients when they need it. Wow.

Speaker 1 8:00

Fantastic. Actually, evan and I are AliveCore users. We have one of the earlier devices and maybe don't have a physician closely monitoring them on a regular basis. You know values is right there, so let's talk more about remote patient monitoring. It's such a hot topic right now and clearly you're a pioneer in a specific space. Stepping back a bit, what trends are you seeing in digital health space in general, and how might these be influencing the work that you do at AliveCorps?

Speaker 2 8:48

Yeah, yeah, remote monitoring and remote patient monitoring it's evolving quickly. It's not new, as we all know, and, as I mentioned before, housecall hasn't been around forever. There's been data coming from homes, coming from patients, for decades. That could be a temperature, it could be a blood pressure, it could be a weight glucose more recently. But I think what we're seeing now is that, like I said, evolving very quickly. So we're now able to monitor brain activity and home EEGs, sleep activity, prenatal monitoring I was just reading about a company doing that so really bringing a lot more types of monitoring to the home, which is great.

Speaker 2 9:38

However, with that opportunity, there's a lot of responsibility now for the healthcare community to use that data to make that actionable, to not just create more noise. But yeah, we're at a point where, obviously, technology is at the place where we can do a lot of things remotely. You know, certainly in a cardiac space, where we are. You know that that has been, you know, growing tremendously in monitoring patients at home. You know whether it's with a Holter monitor, a wearable patch, also, not not new technologies, but things that are evolving very quickly where we're using additional insights, additional AI, for instance, to make sense of that data, because it's a lot of data. It's a lot of data that's getting generated and, unfortunately, a lot of that data just gets lost. But now you know we have the opportunity to be more actionable with this.

Speaker 3 10:37

Well, it's a fantastic opportunity. So so much excitement and intrigue. But you know, with getting these products to market there are some real challenges. What were some of the roadblocks and hurdles that you and the team had to overcome over the last many years to get to market?

Speaker 2 10:52

Yeah, you know, the challenge with remote monitoring in general and with ours and we still get these questions too is the data inundation concern. So, wow, this patient now has the opportunity to collect this really important and valuable information. But is it going to overwhelm me as a provider? How is my staff going to absorb all this data? So workflows are very important, fortunately for us and reimbursement is another issue and I'll get to that in a second but fortunately for us, doctors in the community have been recommending our devices to patients, despite the fact that this data inundation concern exists, and what they're seeing is not data inundation. They're seeing the right data come through when it's necessary.

Speaker 2 11:44

So in the past, when a person did not have an EKG device, for instance, but they had symptoms and they had atrial fibrillation, they might call their doctor. They might say this is what's going on. The doctor doesn't have much more information other than maybe some symptoms, and in a lot of cases, the patient would have to go to the ER or they would have to come in for an office visit. And in a lot of cases, that patient would have to go to the ER or they would have to come in for an office visit. Now, with this data, they're able to make a more appropriate decision, if you will. But what we're seeing is not that tremendous data overload, at least on the ECG side.

Speaker 2 12:18

The other thing we as a company have done which has been fantastic is we've integrated with existing systems. So we have a company have done which has been fantastic is we've integrated with existing systems. So we have a partnership with GE Healthcare and GE Muse in particular, which is a very popular and widely distributed ECG viewing software, so our data from our devices can flow directly into GE Muse, really making the workflow very familiar to doctors. It's not new workflow. They don't have to log into a different system. They can log into the system where they look at ECGs already, and now a cardiac ECG is in there. So that's very important.

Speaker 2 12:56

And then the last thing I'll say is reimbursement, which is an issue, and I think we're seeing some changes and some some evolution there. But for many years, this data and the work involved in looking at this data and being actionable on this data was really uncompensated care for the doctors and and a lot of doctors were doing it despite that, which is which is fantastic. I'm going to credit to them, but it is a lot of extra time and effort and a lot of doctors were not doing it because of the lack of reimbursement, but we're seeing some things change with respect to that. It was just announced a few weeks ago that the RPM codes are going to be. Some of the requirements are going to change in terms of the number of days of data coming through, so we'll see what that does to utilization.

Speaker 1 14:27

That's good to know that there's progress happening in that specific area as well. Now real world data and real time monitoring. We've been talking about it all this time. Now let's pivot to clinical trials. Let's pivot to clinical trials. How does this play a role in ensuring more successful outcomes and actually perhaps even changing the game and how clinical trials are able to move forward with this new technology?

Speaker 2 14:55

Yeah, yeah, yeah. It's a great question. And again, with that opportunity now we have with general remote monitoring, you world of clinical trials, decentralized clinical trials we're able to do these trials remotely or partially remotely is a game changer and it's changing a lot of things. I think COVID was an accelerant to that. You know a lot of trial and researchers had to do things remotely. Actually, my family, we were involved in a vaccine trial with my kids and that was done remotely other than getting the vaccine, but all the questions were handled via a mobile app.

Speaker 2 15:38

So now we're able to in the world of clinical trials, reach more patients, reach more patients with maybe rare diseases where in the past, if it wasn't in that region, you really had trouble finding those patients. So now we're able to expand kind of that catchment area but also democratize access to clinical trials. Again, if it was done in a certain region you had a certain level of diversity. We're able to now expand that tremendously. And then the other real fantastic thing about remote data collection is we're able to collect more data than just point-in-time data that we once did with only in-person trials. So if you were monitoring ECGs, for instance, with only in-person trials, so if you were monitoring ECGs, for instance, the only ECG that was monitored was the one where you came into that clinic and got that ECG. Now we're able to do either continuous monitoring or more frequent ECG monitoring at home, and there's a lot of clinical applications and we're very involved in many trials that are now moving, either partially or fully, to a remote setting.

Speaker 3 16:47

Wonderful. You must have just a ton of stories and anecdotes and insights into real patient stories, Any you care to call out or that come to mind. It's such an impactful solution I think.

Speaker 2 17:03

Yeah, yeah, you know, we, as I mentioned, we get so many positive reviews through either Amazon or our own review channels and just going through those, I think that the story is it really? Tell the story, if you will. There are many patients who bought our devices and they may not have had a condition Like you mentioned earlier. Just worried, well, or just wanted peace of mind, just wanted to check.

Speaker 2 17:33

And and we have patients day in and day out that they do that and they and little did they know that. They checked themselves and it was determined that they have atrial fibrillation, uh and uh, you know, condition that can lead to strokes and and and and really debilitation. So we have countless people that are sort of surprised of a new diagnosis. We have other patients, one recently who had symptoms and she had palpitation. She had unexplained symptoms for a long time and she saw her doctor, saw her cardiologist. They hooked her up to Holter machines, holter patches for years and were not able to catch the abnormality. She went and bought a cardio device and within a few months she was able to actually detect it with a cardio device because she had it, it was, it was there when the symptoms happened.

Speaker 2 18:34

Um, with cart, with cultures and other devices like that. If it's, if you don't have a symptom or you don't have a that condition while you're wearing the, the, the, the solution, you're, you're out of luck, so, um, so we have patients like that and people like that that, um, you know, they've been sort of not failed by traditional options but their condition was not diagnosed. So we get patients like that as well. So, yeah, it's very rewarding to see how we help people and save lives ultimately Wonderful.

Speaker 1 19:08

That's fantastic. So you already shared so many advancements. They already seem futuristic. But looking further into the future, where do you see additional advancements in remote patient cardiac monitoring? Where do they take us? And maybe tell us a little bit more about what excites you the most, about the potential impact on patient care, and it sounds like from a physician perspective, how it might change how the care is getting delivered in partnership with patients and the technology.

Speaker 2 19:42

Yeah, yeah, you know from from a live course perspective and what we're doing in cardiac monitoring, you know I'll say it's it's not just rhythm anymore, it's sort of the one thing I'll say you know where, whereas rhythm abnormalities and arrhythmias are a big problem in healthcare and and we have obviously a great solution that can, that can help detect rhythms, can help people with established arrhythmias monitor the condition, you know, ongoing. You know that's only one area of cardiac health. There are a lot of other more serious areas. And you know, with our 12-lead device that I mentioned earlier and I'll show it because it's such a cool device I mean, this is it and this has the ability to take a full 12-lead ECG and a device like that can now really take a picture, if you will, of the heart to look for ischemia, look for signs of heart attack, look for signs of heart failure, things that a one lead or six lead device is limited, whereas a device like this now can really help in know, in some cases move care upstream or, in other cases, help diagnose conditions that may otherwise not have been diagnosed or been diagnosed much too late. So that device, for instance, you know, think of that going into patients' homes, with, you know, with a visiting nurse, or being in an airplane or a train or a cruise ship or really anywhere where you know EKGs maybe are not prevalent today.

Speaker 2 21:18

I think the global opportunity for a device like that is tremendous, again where devices and 12-lead ECGs are not available or not readily available. So that is a huge opportunity, um, certainly for for for this device. Um, I also think moving, moving from diagnosis to um to to prediction is also really exciting area. So so, devices like these are fantastic for diagnosing a condition or or, or you know, picking up an abnormality, um, but how do we detect something that could be developing a month from now or six months from now or a year from now? And we're seeing some really amazing things happening in AI, where we're looking at ECGs over time and it's able to detect subtle changes or changes that are indicative of a future condition, and I think that is tremendously powerful. And you know a lot of it's still early, but I think, again, moving care more upstream to versus where we are today, where we can treat disease pretty well, but how do we predict disease and prevent diseases is a huge opportunity.

Speaker 1 22:32

Oh, that's so exciting. I'm personally so interested in prevention and prediction and also there's quite a disparity, I think, when it comes to women's health and cardiac health in women, just because of presentation of symptoms, is so different from men. So I'm personally just very excited about all these developments and opportunities. Evan, do you want to start your last question?

Speaker 3 22:59

This was such an amazing discussion and we're a big fan of digital health wearables In particular. We have the rings and the Apple Watches of the world. But I know when I brought your device back from Best Buy, um Irma was a little skeptical oh this, you know, another gadget. Yes, yeah, another one. But it was so fun, the whole gamification of it and in terms of sharing it with friends and family and you know, uh and it, it. It turned out to be just so interesting to use personally, and we'll be at CES in Las Vegas in January where there'll be yet another wave of, you know, wearable and digital health devices and apps. So we just can't wait to see how this progresses. Thanks so much, ben, for joining us and staring just a peek behind the curtain. It's been really, really eye-opening.

Speaker 1 23:50

My pleasure so much and thanks everyone for listening and watching and sharing and getting this information out there to people who need it, who directly benefit.

Speaker 3 24:00

So thank you all, absolutely Thanks.