By Dr. Ian Meredith, global chief medical officer, Boston Scientific
October 12, 2021
In the next two decades, the global population over age 65 is expected to increase exponentially. With this aging population, we will see a rise in the development of chronic conditions like cardiovascular diseases and diabetes. People with these chronic “non-communicable” conditions often live with a poorer quality of life, and the vast majority will develop more than one such illness over time.
Adding to this challenge, the World Health Organization estimates there is a 36-year gap in life expectancy based on the economic and social context in which someone is born. Even for residents in the same city in the United States—among the richest nations in the world—health inequities can be startling. In Chicago, for example, The Economist reports a 30-year gap in life expectancy for residents living in neighborhoods along the same subway line. For many people, race and socioeconomic status effectively negate the benefits of living in a country with a strong health care infrastructure.
Digital health solutions that connect patients more quickly to the care they need, and can in turn help them manage their health on a day-to day-basis, have tremendous promise to help ameliorate the strain of these challenges and democratize access to care. Every year at Boston Scientific, we host the Connected Patient Challenge, a competition for entrepreneurs that will help get us closer to a reality where digital health connects all patients more easily to the care they need.
This year, participants developed ideas for digital solutions that can close the health care disparities gap, including technologies that improve patient-doctor communication, help patients more easily monitor their conditions at home, and enhance shared decision-making between provider and patient. Five finalists pitched their ideas during a virtual event on August 12, and Kalia Health was selected as this year’s first-place winner.
Kalia Health is developing a home-based early detection test for preeclampsia, a complication that can develop in the last 20 weeks of pregnancy. Preeclampsia is often straightforward to manage when diagnosed early, but not all expecting mothers have access to routine prenatal check-ups. As the winner of the Connected Patient Challenge, Kalia Health will receive $15,000 of in-kind support from Boston Scientific and Google Cloud Credits.
General Prognostics was selected as the second-place winner for their product idea, CardioID, a bloodless blood test for heart failure management in a patient’s home. Co-founders Javier Echenique and Sidhant Jena presented for the team, which will receive $10,000 of in-kind support from Boston Scientific and Google Cloud credits.
Product ideas like this show us that it is an exciting time with limitless potential to tap into the power of digital health to improve health care for all. Specifically, advancements in digital health can help us overcome three critical obstacles that prevent minorities and marginalized groups from getting the care they need. The first, lack of information—whether about new procedures and treatments or the potential side effects of a medication—limits peoples’ ability to advocate for themselves. Another obstacle is adherence—or sticking with treatment plans. Despite their doctors’ recommendations, many people fail to follow instructions for post-visit care, whether due to lack of understanding or other obstacles to fully complying with recommendations. Instead, they may abandon their treatment plans, which compromises their ability to get and stay well. Still, the biggest challenge for some patients, particularly those in rural or underserved communities, is that they simply cannot make it to the doctor’s office or hospital. The drive is too long; no public transportation is available, or they just can’t take the necessary time off from work to get there.
To illustrate these obstacles in context, let’s look at Alecia, a hypothetical 65-year-old Medicaid patient who has been diagnosed with peripheral artery disease (PAD). Alecia can’t afford to travel to the vascular clinic that specializes in her condition, so instead, she is seen over 15 times in one year through a combination of planned visits to her primary care physician’s office and unplanned visits to the emergency room. After all of these visits, her care team has only fragmented information to make decisions about her care. To make matters worse, Alecia feels frustrated by the time she’s spent in the hospital and she continues to suffer from leg pain—a common symptom of patients with PAD. She does not have a well-defined treatment plan to follow.
But Alecia’s situation is much improved when digital health becomes part of her care. After a training session with a member of her doctor’s staff and a smartphone, she accesses an app with info about PAD treatment plans. The app reminds her to exercise daily and eat a low sodium diet. She logs her daily pulse, blood pressure and symptoms into the app and shares this info with her doctor and her care team who now have a 24/7 snapshot of her health status. With easy access to her own health data, Alecia feels more empowered, and her care team knows when to reach out and check in. She has a personalized plan that allows her to manage her condition. She talks with her doctor over the phone when issues arise, discussions that help her avoid trips to the emergency room. After several months, Alecia’s leg pain improves and she can resume her daily walks around the neighborhood.
Alecia may be a hypothetical patient, but her story illustrates how, once empowered, people who face significant barriers can realize more equitable health care.
Looking beyond the hypothetical, digital health solutions are already advancing care. For example, when Giannetto De Rossi, a 78-year-old artist, was rushed to the emergency room with an acute episode of heart failure, his physician implanted him with a diagnostic device that has since issued three alerts. Each time one sounds, his care team intervenes telling him what to do based on the data provided by his device – the HeartLogicTM Heart Failure (HF) Diagnostic. Because his doctors can immediately relay advice to prevent the incident from worsening, Giannetto has not only avoided long and costly hospital stays, he has also been able to carry on with an active life.
Technology or therapy is only as meaningful as the people it can reach. It’s the responsibility of all stakeholders to ensure that innovative medical technologies reach those who need them the most. Fully realizing the potential of digital health to democratize and improve care will require collaboration at multiple levels – with input from patients, care providers, innovators and investors. Together we can create an innovation ecosystem that solves the challenges of health care in the 21st century.
To learn more about the Connected Patient Challenge and 2021 winners, visit the challenge website.