It’s well known that heart failure is a sweeping national problem — the condition affects more than 6 million Americans and costs the country more than $30 billion per year.
Geisinger, like many other health systems, is embracing technology to better manage this complex condition. On Wednesday, the Pennsylvania-based health system announced it was launching a pilot program in partnership with virtual heart failure monitoring startup Bodyport.
The health system already has case managers who monitor high-risk heart failure patients who have been discharged from the hospital, and it also uses data analytics to predict which patients are at highest risk of an adverse event or readmission. But now Geisinger wants to try and incorporate a wearable into this program.
In the case of this partnership, the device is more of a “standable” than a wearable, pointed out Dr. Vishal Mehra, a cardiologist at Geisinger, in an interview. The health system is using Bodyport’s cardiac scale — which is a scale that uses sensors to measure a person’s metrics of heart function and body fluid status after they stand on it for about 20 seconds.
There are plenty of wearable heart monitors on the market, such as those made by Fitbit, Philips and Omron, but Bodyport’s device also pays special attention to buildup of fluid in the body. Fluid buildup is often an indicator of worsening heart failure, so Geisinger is hoping Bodyport’s wearable can do a good job of identifying patients in whom this is occuring, Mehra declared.
There are also implantable devices that can measure pulmonary artery pressure, which increases fluid buildup in the body. Some of these include Abbott’s CardioMEMS and Endotronix’s Cordella system. By testing Bodyport’s product, Geisinger is exploring a less invasive and cheaper alternative for detecting worsening heart failure, explained Sarah Smith, the company’s founder and chief product officer.
Geisinger is preparing to enroll about 200 patients with heart failure in this 12-month pilot program. Some of these patients will come from the group of at-home heart failure patients who have already been assigned a case manager and some will be referred after being discharged from the hospital, Dr. Mehra said.
Once a patient is enrolled in the program, Bodyport will ship a scale to their home address.
“It’s a really simple experience for the patient to start using the device. It’s just powered off of four AA batteries, and it’s cellular connected so there’s no need for the patient to have a smartphone or home WiFi. It will immediately start working and so as soon as the patient takes it out of the box and steps on the scale,” Smith noted.
After a patient takes their first measurement, that information gets uploaded to Bodyport’s data platform. This information can also be integrated into a provider’s EHR, but Geisinger is waiting until after the pilot to explore that option because EHR integration is usually a pretty big undertaking, Mehra said.
Geisinger case managers can log onto Bodyport’s data platform at any time to access patients’ data — these heart metrics and fluid accumulation data help them triage patients and intervene to potentially avoid readmission. Bodyport’s platform also sends an alert whenever a patient’s fluid accumulation reaches a high level that is indicative of worsening heart failure.
The overarching goal of this pilot is to see if Bodyport’s device and platform can improve case managers’ efficiency when monitoring heart failure patients, Dr. Mehra declared. If the device proves successful, Geisinger will also see improved patient outcomes and lower costs, he added.
“Heart failure is a complex phenotype. Patients are quite diverse in the way they present and the management that’s needed. But the one thing that sort of ties it all together is the ability to predict an impending worsening. If you can figure out a methodology that allows the treating team to find out that the patient is not doing too well, even before they actually start to feel poorly, then that gives the treating team much more time to help them avoid a downward spiral towards an admission or an ED visit,” Dr. Mehra explained.
Geisinger will closely track readmissions and emergency department visits among the study participants and compare that data to its heart failure patients who didn’t have access to Bodyport’s scale. The health system will also collect qualitative data from its clinicians and case managers to understand whether Bodyport’s technology increased efficiency and eased burnout during their workdays, Dr. Mehra said.